A facelift, technically known as a rhytidectomy (from the Ancient Greek ῥυτίς (rhytis) 'wrinkle', and ἐκτομή (ektome) 'excision', the surgical removal of wrinkles), is a type of cosmetic surgery procedure intended to give a more youthful facial appearance.

Surgical facelifts are effectively combined with eyelid surgery (blepharoplasty) and other facial procedures and are typically performed under general anesthesia or deep twilight sleep.

The first textbook about facial cosmetic surgery (1907) was written by Charles Miller (Chicago) entitled The Correction of Featural Imperfections.

At the same time, the British plastic surgeon Harold Delfs Gillies used the Esser-graft to school all those who flocked towards him who wanted to study under him.

The first female plastic surgeon, Suzanne Noël, played a large role in its development and she wrote one of the first books about esthetic surgery named Chirurgie Esthetique, son rôle social.

[citation needed] In 1968, Tord Skoog introduced the concept of subfacial dissection, therefore providing suspension of the stronger deeper layer rather than relying on skin tension to achieve his facelift (he publishes his technique in 1974, with subfacial dissection of the platysma without detaching the skin in a posterior direction).

After Skoog died of a heart attack, the superficial muscular aponeurotic system (SMAS) concept rapidly emerged to become the standard face-lifting technique, which was the first innovative change in facelift surgery in over 50 years.

[10] In 1979, Tessier demonstrated that the subperiosteal undermining of the superior and lateral orbital rims allowed the elevation of the soft tissue and eyebrows with better results than the classic face-lifting.

[citation needed] Contraindications to facelift surgery include severe concomitant medical problems, both physical and psychological.

While not absolute contraindications, the risk of postoperative complications is increased in cigarette smokers and patients with hypertension and diabetes.

Patients are typically asked to abstain from taking aspirin or other blood thinners for at least one week prior to surgery.

A psychiatric illness leading to unreasonable expectations for the surgical outcome, such as a distorted perception of reality, can be a contraindication to surgery.

Expectations of the patient, the age, possible recovery time and areas to improve are some of the many factors taken in consideration before choosing a technique of rhytidectomy.

The SMAS (Superficial Musculo Aponeurotic System) layer consists of suspensory ligaments that encase the cheek fat, thereby causing them to remain in their normal position.

[21][22] Resuspension and securing the SMAS anatomical layer can lead to rejuvenation of the face, by counteracting aging and gravity caused laxity.

The difference between these operating techniques is the extra repositioning and fixation of the orbicularis oculi muscle in the composite facelift procedure.

In these cases a mid face-lift is sufficient to rejuvenate the face opposed to a full facelift, which is a more drastic surgery.

The ideal candidates for a mid face-lift is when a person is in his 40s, or if the cheeks appear to be sagging and the nasolabial area has laxity or skin folds.

To achieve a younger appearance the surgeon makes several small incisions along the hairline and inside the mouth, this way the fatty tissue layers can be lifted and repositioned.

This lift is a more temporary solution to the ageing of the face which also has less downtime and is done on people who have deep nasolabial folds, sagging facial structures, yet still have a firm and well-contoured neck.

[citation needed]The subperiosteal facelift technique is done by vertically lifting the soft tissues of the face, completely separating it from the underlying facial bones and elevating it to a more esthetically pleasing position, correcting deep nasolabial folds and sagging cheeks.

[citation needed] With the skin-only facelift only the skin of the face is lifted and not the underlying SMAS, muscles or other structures.

One of the fathers of plastic surgery Sir Harold Gilles described a simple ellipse of skin excision in a socialite who was pleased with her quick recovery and outcome.

A professionally trained cosmetic doctor, Vincent Wong, said that a thread lift is the most dangerous procedure an aesthetic practitioner can do.

A great many things can go wrong, more so than any injectable treatment, because threads stay in the skin and cannot be pulled out; while the results can be very good, the procedure can also cause irreversible damage.

[27] A nurse sent undercover by the BBC to take and secretly film a course teaching thread lifting was shocked at the unprofessionalism and unsafe practices she was taught.

Less common, but potentially serious, complications may include damage to the facial nerves and necrosis of the skin flaps or infection.

In men, the sideburns can be pulled backwards and upwards, resulting in an unnatural appearance if appropriate techniques are not employed to address this issue.

[2] One of the most often overlooked (or not discussed) areas of a traditional facelift procedure is the effects on the anatomical positioning and angles of the ears.