Male Rhytidoplasty: Refinements in Surgical Technique

Abstract

Aging is a natural evolution with constant modifications on the whole body with more evidences on the face since it is the external appearance to demonstrate the most well-being reactions. The physiognomic expressions make the face the most important segment to show the intimae inner.

Rhytidoplasty is more frequent in female, but more and more male patients come for facial rejuvenation due to intense activities requiring smooth facial contour. Usually the public makes a relationship between physical appearance that is related to mental and intellectual capacity. Due to the frequent demand from other persons, men care about the facial expression. Even the interior world of each one must be in harmony with the face since it is a segment of the body that expresses all good and bad reactions. Situations through which you interact with others and that allow you to show reactions and expressions, where the first impression is forever.

Besides the facial contour, other anatomical elements must be analyzed as the nose, lips, mouse, eyelids, eyebrows, and auricles since they change as time goes by.

Surgical planning is an important step preoperatively when all anatomic alterations must be identified and to show to patient in front of a mirror. Facial asymmetry is quite often not noticed by patient but should be well informed to patient and described on the surgical planning. Such analyses will provide adequate orientation during operation. It is useful to show to patient location and extension of scars after surgery. Preserve the sideburns in its natural location, as it is a fundamental reference in facial anatomy and during rhytidoplasty. It is necessary to maintain your conformation by making skin incisions in front and behind the traction and removing excess skin from the face and neck according to the desired vector.

I perform rhytidoplasty procedures at the hospital under general or local anesthesia with intravenous sedation always under care of an anesthesiologist. In both types of anesthesia, I employ local infiltration with anesthetic agent following tumescent infiltration with saline solution to facilitate tunnelization procedure which does not damage the vascular network underneath the skin. The operation is done without bleeding as well as postoperatively. Seroma formation is quite rare since most of the perforating vessels are preserved on similar way as abdominoplasty is performed (Avelar, Abdominoplasty: new concepts for a new technique (Abdominoplastia: Nuevos conceptos para una nueva técnica). In: 26th Annual International Symposium of Aesthetic Plastic Surgery, Chairman: Prof. Jose Guerrerosantos, Puerto Vallarta, Jalisco, 1999; Avelar, Rhytidoplasty with non-traumatic undermining. Panel of facial rejuvenation: ultimate achievement with additional procedures. In: 16th Congress of ISAPS, Istanbul, May 2002; Avelar, Rhytidoplasty – technical improvement by subcutaneous dissection without undermining. Face lift giants. In: 4th International Symposium on Aesthetic Plastic Surgery, Bonn, 20 Apr 2002).