Lower face and neck facelift
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Lower face and neck facelift

Endoscopic lower face and neck facelift surgery

Use SMAS facelift and Endotine-Ribbon to completely solve the problem with lower face




At present, the most effective way to improve the cheeks and neck bands issues is the Superficial Musculo-Aponeurotic System (SMAS) facelift. The ablation depth of SMAS facelift is beneath the fascia, and Superficial Musculo-Aponeurotic System refers to a layer of muscle and fascia tissue on the cheeks. It is generally considered to be an extension of the neck's superficial muscles. During the facelift operation, this piece of tissue which mainly covers the cheeks is turned pulled up and tightened. This is also the current mainstream of facial rejuvenation surgeries

The fat fascia layer of the face can be roughly divided into three areas – the eyelid area, the cheek area and the nasolabial fold area. When the skin is aging, in addition to getting looser, the fat fascia will be sagging. Therefore, the mid or lower facelifts not only need to remove the excess skins, but also need to lift the sagging fat fascia layer. Otherwise, the surgery will be far less effective.

The endoscopic lower facelift and mid facelift are often performed together or separately, depending on the condition of the patient. The surgeon needs to judge which method to use based on his/her experiences. The surgical method adopts SMAS facelift and Endotine-Ribbon. By cutting a small incision of 3-5cm at the medial side behind the earlobes of both ears through endoscope, the surgeon needs to avoid the blood vessels and nerves, and then lift the whole tissue upward and backward in a 3D way before fixing it. This will not only result in smaller incision and less bleeding, but also hide the scars behind the earlobe so the wounds are not visible. Furthermore, this method is the most effective and last the longest.

Generally, the main causes of neck lines are:

  1. Aging skins
  2. Poor sleeping position for a long period of time, overly-high pillow, always sleep on the same side
  3. Work factors such as using computer for extensive period of time and so on
  4. Neck skin is born to be looser



If the skin is severely loose, the skin wrinkles are both concave and deep, the cheek muscles are loose, or the skin is thin and inelastic, the surgeon must perform the endoscopic lower facelift to fix the tissues with the Endotine-Ribbon, adjust and fix it on the intended lifted area, and remove the excess skins. By doing this, the sagging cheek and chin tissues as well as the loosen neck skin can be lifted and become firm. The Endotine-Ribbon facelift can simultaneously lift the loose lower jaw and neck muscles to improve the round face issue, thereby reproducing the V-shape small face. The rejuvenation facelift will also help the face to become smaller.

Endoscopic facelift [applicable scope of surgery]

Marionette lines, wrinkles around the lips, loose cheeks, loose chin and neck, etc.

Endoscopic facelift [Advantages]

Endoscopic lower facelift

  1. Lift the deep sagging lower face upward so the face will become 3-dimensional and plump.
  2. Improve the annoying nasolabial folds and show the natural and young chubby cheeks.
  3. Perform V-shape facelift to improve aging and sagging cheeks.
  4. The incisions are hidden underneath the hairs (small incision and less bleeding), and the scars were not visible.
  5. Long-lasting and excellent effect.

Endoscopic neck facelift

  1. Improve the loose neck skin to restore the firm and beautiful skin lines
  2. Small incisions, less bleeding, and highly safe.
  3. The scars are hidden behind the ears, so they are not visible from outside.
  4. Long-lasting and excellent effect.

Precautions for one week prior to the surgery

  1. No smoking prior to the surgery because smoking causes vascular contraction and reduce blood supply to the skin and thereby affecting the healing of the incisions.
  2. Eat more fruits and vegetables to absorb cellulose and vitamin C, which can increase the ability of wound healing.
  3. Stop taking Aspirin and painkillers which contain Ibuprofen to avoid the postoperative bleeding issues.
  4. Limit the intake of vitamin E to under 200 mg per day to reduce postoperative bleeding issues.
  5. Control blood pressure and blood sugar: The operation must be performed under the condition of good and stable blood pressure and blood sugar.

The day before the surgery

  1. The nurse of our clinic will call you to re-confirm the operation time.
  2. Start fasting (including water) 6-8 hours before the surgery.
  3. Wash your hair the night before. Do not apply any hair spray or hair care products.

On the day of surgery

  1. You may bring your own hat or scarf.
  2. Do not carry valuable items such as rings or necklaces.
  3. Please arrive at our clinic at least half an hour before the scheduled time of surgery.

Postoperative instructions

  1. The patient needs to be accompanied by someone within 8 hours after the surgery and note any changes of consciousness.
  2. Drainage tubes will be used after the surgery to accelerate the deswelling. Therefore, the patient needs to return to our clinic the next day to change wound dressing and remove the drainage tube.
  3. 請勿自行脫下彈性繃帶,若有不適,或是傷口敷料滲出血水,請與本診所聯繫。
  4. Apply ice pack within 48 hours after the surgery. Beware of frostbite. Apply it for 20 minutes each hour and rest for 40 minutes. Do not over-do it. Apply hot packing after 48 hours. Beware of the temperature of hot packing (test the temperature first with the back of your hands) to avoid burns. Apply hot packing four times a day for 40 minutes each time.
  5. Always take medication on time. Take medication four times a day – after each meal and before going to bed. (If it hurts badly, take painkillers every two hours at most.)
  6. Wound care: Clean the wounds every day and night with a cotton swab moistened with saline and then apply ointment.
  7. Avoid irritating foods such as cigarettes, tea, coffee or chili peppers within a week. Also avoid seafood as much as possible to prevent allergies caused by stale seafood.
  8. When lying down, try to keep the head higher than the heart after the surgery to avoid bleeding and swelling caused by movement such as bending and bowing. Please also pad the pillow high.
  9. Make return visit to our clinic one week after the surgery to remove stitches and check on the wounds and recovery.
  10. Make a return visit to the clinic one month after the surgery for postoperative follow-up.


Dr. Yi-Sheng Kao Director | Plastic Surgery Aesthetic Clinic

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