The Facelift in South American Patients

Abstract

South America is a vast territory; its people were made from all parts of the world. The miscegenation made a unique population comprised of Indian, Asian, Caucasian, African, Mestizo, Mulatto, and Zambo. The South American patients tend to have a wider face with a skin-soft tissue envelope (S-STE) that is thicker, heavier, and has less elasticity than the Caucasian patient. Upper eyelids may hood easily. In the same way, malar eminences and round face look are more prominent. The chin can be a little retracted. With aging, the S-STE tends to sag more, making nasolabial folds and jowl area more prominent, and redundant neck skin will appear loose and heavy. Facelift is popular in South American patients. They have peculiar characteristics like heavy dark sebaceous skin which lead to peculiarities in face lifting. It is usually a procedure designed to rejuvenate all thirds of the face. In the forehead, skin excision in temporal incisions is usually necessary. Midface subperiosteal lift is a possibility for heavy skin patients who need great improvement in the center of the face. The neck lift is almost indispensable to the rejuvenation of the lower third. Extended superficial muscular aponeurotic system or deep plane dissection is commonly performed so the soft tissues of the midface, the jowls, and the neck can be lifted to reestablish their youthful relationship with the underlying skeleton.

Deep Neck Lifting

“…Specific populations may also require more customized techniques. 7 Given the critical role of weight gain and the knowledge that many women fluctuate in their weight, it is advisable to measure weight in all facelift patients at the intake. Submental fullness may also be hereditary.…”

Secondary Forehead Lift in Transgender Women

“…There is a variation of the sutures depending on the design: 1) the lateral canthus is elevated with one suture to the lateral orbit or elevated to the temporalis muscle; 2) the lateral brow is elevated and/or lateralized with another suture to the temporalis muscle on the forehead; 3) the central brow is elevated with another suture to the skull (Figure 7). All these points are lifted using the Casagrande needle (similar to Reverdin needle, but smaller) for passing 3-0 polydioxanone suture (PDS II, Ethicon, Inc.) 17,18 . The needle is introduced transcutaneously through the point of elevation and is driven through the incision.…”

“…All these points are lifted using the Casagrande needle (similar to Reverdin needle, but smaller) for passing 3-0 polydioxanone suture (PDS II, Ethicon, Inc.). 17,18 The needle is introduced transcutaneously through the point of elevation and is driven through the incision. Then, the polyglactin suture is passed through the needle's guide hole and is returned to the area to be repositioned.…”