I want/can: plastic surgery or Smas-lifting. Shock, tears and the desire to escape from the procedure

Selection of a patient by a cosmetologist

The slogan - to make the hardware SMAS lifting procedure available to everyone who wants it - is not correct, and even harmful.
First of all, these are patients aged 30 to 60 years with the first and second degrees of severity of gravitational ptosis.

We are not talking now about a mandatory condition - the absence of relative and absolute contraindications - this should be observed by default. The main indication for the ultrasonic SMAS lifting procedure is gravitational ptosis and sagging soft tissues, as well as lipolysis of local areas of the face and body.

Let’s imagine a situation where a fairly wealthy patient came to the clinic for a consultation and regularly visits a cosmetologist. She has already done everything to her face: fillers, threads, collagen stimulators, etc. Therefore, in this case it is impossible to say that we will get any clearly expressed results with this patient. There is practically no ptosis.

Thus, a cosmetologist must understand in each specific case what result he expects, as well as whether it will suit his patients.

SMAS lifting technology in detail

Hardware ultrasonic liposuction, an analogue of the operation practiced in plastic surgery, has a number of advantages. First of all, smas face and body lifting is a gentle non-surgical technique. Lifting with the Ultraformer device is carried out without anesthesia, after the procedure there is no need for rehabilitation time, there are no restrictions on skin phototype, at any time of the year.

The powerful ultrasonic effect of the device is realized through the use of 7 multifunctional attachments: 4 for exposure to the face (7 MHz - 1.5 mm, 5.5 MHz - 2.0 mm, 7 MHz - 3 mm, 4 MHz - 4.5 mm), 3 more on the body (2 MHz -6.0 mm, 2 MHz -9.0 mm, 2 MHz - 13.0 mm). The principle of operation of the cartridges is based on the influence of ultrasound with a frequency of 4 and 2MHZ. Correction of skin tissue is achieved by heating the skin, subcutaneous fat and superficial musculoaponeurotic system (SMAS) with a focused ultrasound wave. High-intensity ultrasound causes vibrations in the tissues, which leads to local spot heating in them, followed by contraction and stimulation of the synthesis of new collagen. Thanks to the clear directionality of ultrasonic vibrations, targeted energy delivery is ensured without damaging surrounding tissues. Multi-level effects guarantee three-dimensional volumetric natural lifting, noticeable immediately after the procedure and growing over 2-3 months.

The procedure algorithm looks like this:

• Photos are taken - “before” and “after” the procedure;
• the doctor identifies and marks problem areas with lines;
• Ultrasound energy contracts the connective tissue of adipose tissue, thereby creating a volume-reducing effect.

The Ultraformer's High Intensity Fusion Ultrasound (HIFU) technology provides visible results in just one session. As a rule, to solve aesthetic problems, patients need one procedure, the duration of which is 35–90 minutes.

Contraindications to the ultrasonic SMAS lifting procedure

Absolute contraindications:

• systemic connective tissue diseases;
• general infectious diseases and skin lesions in the areas of intended treatment;
• severe forms of acne, active systemic or local skin diseases in which the regeneration process is impaired;
• oncological diseases;
• endocrine diseases in the stage of decompensation;
• the presence of metal intradermal implants in the treatment area (except for dental implants);
• decreased or absent threshold of pain (thermal) sensitivity;
• pregnancy, lactation.

Relative contraindications:

• increased body temperature;
• pulmonary heart failure in the stage of decompensation;
• infectious diseases; diabetes mellitus in the stage of decompensation;
• the patient has a pacemaker (consultation with a cardiologist is required);
• neuritis in the area of ​​influence.

When is a facelift done?

With ptosis of the oval face, when there is drooping of the soft tissues, the chin angles become less pronounced, and the skin loses its tone, the choice is no longer so great. A facelift is the only way to restore contours. Thread lifting involves the introduction under the skin using a flexible cannula needle of the thinnest absorbable or non-absorbable threads, followed by tension and fixation of soft tissues. Facelift (SMAS) is a serious plastic surgery during which the surgeon works not only with the epidermis, but also with the deeper subcutaneous muscular-fibrous layer. Lifting the oval of the face is carried out by detaching and moving deeper layers, resection of excess stretched skin that forms folds, with their subsequent fixation using sutures hidden in the natural folds of the skin in the area of ​​the ears. Facelift requires preparation, the rehabilitation period takes longer, but the effect is worth it! The range of indications for facial plastic surgery is more limited than for mesothreads.

General indications for facelift with mesothreads and surgery (SMAS)

• Ptosis of the oval face and skin (“triangle of youth” is turned upside down);
• Nasolabial folds;
• Wrinkles on the forehead and around the lips,
• Expression wrinkles around the eyes;
• Age-related drooping of the corners of the lips and eyes;
• The face looks tired and permanently swollen;
• Unclear mental angles;
• Asymmetry.

To one degree or another, both methods help to cope with these shortcomings. However, if a facelift allows you to visually look younger by 10-15 years, then a less radical thread lifting can make you look 5-7 years younger. After 50 years, if there are deep wrinkles, jowls, nasolabial folds, or significant sagging of the face, the wisest decision would be to undergo a SMAS facelift. After 40 years, a facelift with mesothreads or endoscopy of individual areas is usually sufficient.

Is it painful to do the ultrasonic SMAS lifting procedure?

It is impossible to give an unambiguous answer to this question, because during the procedure, different devices use different levels of energy, different distances between points, and the sensitivity of each patient is different. Application anesthesia is useless, since the effect occurs on the deep layers of the skin.

But sometimes some cosmetologists are guided by the principle “I’ll squeeze harder so that the effect is more noticeable.” Some equipment manufacturers have begun to disable this feature at the hardware level.

Therefore, until you try to give the patient several impulses, you will not know. And the sensitivity of each area of ​​the face will be different.

Result and recovery period

Smas lifting has a short recovery period. If the skin turns red after the session, it will return to its normal color after 3 hours. Swelling is allowed, which usually lasts no longer than 2 days.

What not to do after an eyelid lift for 5 days:

• wash your face with hot water, steam your skin, warm it up in every possible way;
• visit the pool;
• do facial piercings, chemical peeling;
• sunbathe, including in a solarium;
• load yourself with physical exercise.

The advantage of smas-lifting is that the effect is visible immediately after and has a cumulative property: within 90 days the result will only improve. The doctor, based on the indications and complexity of the problem, can prescribe from 1 to 3 visits with an average frequency of once every six months.

If you need a lift, but you are afraid to go under the surgeon’s knife, come for non-surgical blepharoplasty at the Biomed clinic. We carry out this procedure on the latest generation ULTRAFORMER III device.

All doctors of our center have undergone specialized training and have confirmation in the form of certificates. We will be glad to see you at the Biomed laser therapy centers in Moscow and St. Petersburg!

Mesotherapy

Mesotherapy is an injection of a cocktail of vitamins, enzymes, plant extracts and hormones. These products improve skin tone and help get rid of excess fat. Mesotherapy is especially effective for those who are afraid of the appearance of jowls, sagging skin under the lower jaw.

Mesotherapy sessions can begin from the age of 30. Around this age, preventing the signs of aging gives the best results. At a younger age, mesotherapy is used to combat acne. The injections also get rid of the vascular network.

To get the best result, you need to undergo a course of procedures. On average, it takes 3-4 visits to a cosmetologist to get rid of skin problems. The intervals between sessions are 10-14 days.

Unfortunately, mesotherapy does not eliminate deep wrinkles, but after the injections the wrinkles will become smaller.

Contraindications:

• pregnancy and lactation;
• infections, exacerbation of chronic diseases;
• individual intolerance to drugs;
• problems with blood clotting;
• neoplasms;
• vascular and heart diseases;
• renal failure.

Sometimes side effects appear after the session - redness and bruising. Allergic reactions are rare.

Skin care recommendations:

• Avoid other cosmetic procedures.
• Do not visit the bathhouse, sauna, swimming pool, or solarium for another 2 days after the session.
• Avoid makeup for 24 hours after the procedure.

Possible complications

Modern technologies make it possible to carry out face lifting with minimal risk to health. But, nevertheless, complications are possible.

Hematoma is an accumulation of blood under the skin. This complication occurs almost exclusively in patients suffering from hypertension. Moreover, if the diagnosis is known, the treatment is correctly selected, the risk of hematoma is minimal. The problem arises when a patient undergoes a facelift who has not paid attention to periodic, perhaps rare, increases in blood pressure, and is not aware of his problem. To protect yourself from this complication, it is necessary to expand the scope of the preoperative examination.

Another complication of a facelift associated with poor preoperative preparation is necrosis (death) of the skin. This problem is the lot of smokers and patients with decompensated diabetes mellitus.

The most unpleasant complication, which, fortunately, is extremely rare, is damage to the branches of the facial nerve. Fortunately, in the vast majority of cases, facial nerve function recovers on its own within a few months.

If the operation is performed by an experienced surgeon, a full preoperative examination has been performed, and the patient fully complies with the doctor’s recommendations, then the likelihood of negative consequences will be minimal.

How to prepare for a consultation

The first step to plastic surgery for facial rejuvenation is a consultation with a plastic surgeon. We live in dynamic times and we value your time. In order for the consultation to be as effective as possible, at home, in a calm environment, decide for yourself what exactly you don’t like about your appearance. Dig through old photographs, find the ones you like, and take them with you. This way we will be able to identify those age-related changes that need correction, and quickly come to an agreement on the necessary methods. For example, looking in the mirror day after day, it is difficult to notice how the volume of tissue on the cheeks or the volume of the chin has decreased. Looking at a photo from 10-20 years ago, it’s easier to imagine what we want to get.

Write a list of questions that interest you and do not hesitate to bring it up during the consultation. Leave space between questions for notes. Over the years, we have developed an information sheet that contains answers to the most frequently asked questions about facial rejuvenation. You will receive it during your consultation so you can read it calmly at home.

If you would like to take a loved one with you to the consultation, whose opinion you trust, please do so. It is important that your companion understands that he is coming to support you and suggest some questions that you may forget to ask.

Indications:

1. Doctor's recommendations for tightening facial skin without surgery;
2. Maintaining the desired effect after plastic surgery.

Using this procedure you can achieve:

1. Facial tightening;
2. Clarity of face shapes;
3. Improved appearance;
4. Smoothing out small wrinkles and creases in the skin.

A greater percentage of the desired result can be obtained if the excess tissue on the patient’s face is small.

Age restrictions

Experts do not recommend SMAS lifting for those who are under 40 years old without special indications. At the same time, you should agree to this procedure only if other methods of tissue rejuvenation do not lead to the desired result.

Device for SMAS lifting from Ulthera System

Many years later and after clinical trials, ultrasound lifting

Ulthera has received FDA (Drug Administration) approval and has been found to be effective and safe.

Video: Impact on tissue using the Altera Systems device

Thanks to the presence of a special program that determines the thickness of the tissue layer, you can achieve a quick positive effect.

Using Deep See, a specialist can set the depth of the muscular aponeurotic layer and program the device to a given depth.

In this picture, the depth of exposure of the rays is shown in green. In other words, the cosmetologist first creates a plan for visual work, and then begins to implement it.

Cause of problems

Over time, the soft tissues of the face sag, and the muscles, stretching, lose their elasticity. As a result, “bags” appear under the eyes, the cheeks take on a “bulldog” appearance, and folds are visible near the nose.

If the lifting does not affect the SMAS layer, then it will not be possible to achieve a quick effect from this procedure.

In ancient times, due to the lack of hardware methods, the muscle layer was tightened using plastic surgery, the recovery period after which lasted for months.

Therefore, to prevent negative consequences after the surgical method, ultrasound lifting was created, which is based on a modern method of achieving elasticity and tightening of facial skin and getting rid of old connective tissue.

Features of aging facial skin

None of us can escape aging. Although this is a natural process, awareness of this fact does not make it pleasant. It seems like just recently we admired our bright blush and delicate, soft, elastic skin in front of the mirror. And now she is dull, pale and covered with wrinkles.

Girls begin to notice age-related changes from the age of 25 (if heredity is not very good, then earlier). Why is this happening?

1. Cells renew themselves more slowly, so the stratum corneum of the skin becomes thicker.
2. The collagen and elastin fibers that support the framework of our skin change. They become thin, rough, stretch, and perform their function much worse than before.
3. Gaps form in the protective hydrolipidic layer. Because of this, natural moisture in the skin is retained worse.
4. Substances (collagen, hyaluronic acid, lipids), which are extremely necessary for the skin, are produced more slowly, but are quickly consumed.
5. The protective functions of the skin become weaker. In this regard, it is more difficult for her to deal with the aggressive influence of the external environment.

Internal violations accumulate, over time they come out and become obvious. They are expressed by the following characteristics:

• dullness of the skin;
• loss of smoothness and elasticity;
• the appearance of the first wrinkles (day by day there are more of them, they become deeper);
• formation of dark circles and bags under the eyes;
• changing the oval of the face;
• the appearance of a double chin.

How to prepare for surgery

If your determination to look younger after the consultation has strengthened, decide on the date of the operation and coordinate it with the clinic by calling +7(495)2269647.

One month before surgery, you should quit smoking and stop taking hormonal contraceptives and weight loss medications. If you are constantly taking any medications, please agree on their use with us.

2 weeks before surgery you need to undergo an examination. The results of the examination must be sent to us by email. Based on the results of their assessment, we will contact you. If you have no contraindications for surgery, we continue preparations. At home, prepare sterile gauze wipes and medical alcohol (vodka or other strong alcohol is also suitable), and painkillers or powders - Nimesil, Ketanov, etc. They will be needed after surgery. There is no need to take them to the clinic.

The night before surgery, eat your normal dinner.

On the morning of the operation you should neither drink nor eat. You can only take a sip of water. Take your passport, money, and toiletries with you to the clinic. Dark glasses and a headscarf are also needed to hide from prying eyes when you go home. Think about transport. The ideal option is for someone close to you to pick you up the day after the operation. If not, you can call a taxi to the clinic. Taking public transport or driving alone is a bad idea.

Worthy alternatives to HIFU devices

As you can see, the ultrasound HIFU therapy device can improve the condition of the face and neck, but it is not omnipotent. At the same time, there are worthy alternatives to this technology in the aesthetic market in the form of radio frequency (RF) lifting and dynamic muscle activation (DMA).

Radiofrequency lifting

The principle of radio frequency (RF) lifting is the non-surgical tightening of tissue using local heating. In this case, an effect similar to an ultrasound HIFU therapy device is achieved in a slightly different way.

During the RF lifting procedure, the electromagnetic field causes the movement of charged particles in the tissues, causing their temperature to increase. The degree of heating depends on the tissue resistance to radiofrequency exposure, the power of RF energy and the duration of the session. In fact, collagen molecules “heat”, leading to partial denaturation of the protein. At the same time, collagen fibers can be shortened by up to 30%, creating instant skin tightening and a lifting effect.10

The second and in a certain sense even more important effect of RF on tissue is thermal stimulation of cellular activity. In response to sublethal heating, cells begin to actively divide, and the synthesis of collagen and other components of the extracellular matrix accelerates.

Modern radiofrequency lifting is most often performed using mono- and multipolar devices:

• Monopolar RF lifting – Thermage device.
• Multipolar RF lifting – Legend Pro+ and Divine pro devices (TriPollar RF technology).

Monopolar Thermage has a strong and pronounced effect in just one session, and the multipolar handles of the Legend Pro+ and Divine pro devices, using special TriPollar RF technology, warm up the tissues more gently and in several sessions.