DR. MATTIA COLLI SURGEON
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4K ENDOSCOPIC LIFTING OF THE EYES, FOREHEAD AND TEMPLE

BACKBRAID ENDOSCOPIC LIFT WITH 4K DEFINITION

ENDOSCOPIC LIFTING

The appearance of the eyes is the first fundamental importance of facial appearance in both women and men. Genetics almost always, unfortunately, does not provide the area of the eyebrow, canthus, and the entire lateral region of the eye that is well-pulled upward, stable over time, and that allows for a fresh, sensual, and pleasing long-lasting look. The action of the passage of time, the reduced capacity of elastin, stress, and rapid weight loss diets very often result in the descent of this essential anatomical area: in fact, the first visual impact in a person is precisely that of the mid-face; that is, the eye and eyebrow area; this tendency to fall determines a tired and dull appearance in the gaze.

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The endoscopic facelift with 4k definition allows to intervene obtaining a clear and real aesthetic result that goes beyond the simple improvement of the look that is usually obtained with some botulinum fillers for the elimination of wrinkles. In the aesthetics of the gaze the tail of the eyebrow, the eyelids (especially the lower one and its entire lateral region) are of extreme importance; that’s why to obtain a fresh, alive, light, captivating, sensual face it is necessary to achieve the repositioning of these tissues upward by determining a certain stable traction over time.

All this can be achieved with small scars of about 2-3cm hidden inside the scalp, therefore totally invisible and unrecognizable.

Why stable over time?
Because you will read, inform yourself, document that there are various methods including traction wires, botox injections, hyaluronic acid injections, temporal lifting, etc. All these methods are correct from the point of view of the immediate result, albeit with extreme limits in traction, but their guarantee over time is unfortunately well limited, just think that the only temporal facelift does not exceed 4 – 6 months from the result. The reason? Simply programming was made for a traction line of some tissues, not of the look of the face in its entirety.

Other surgical methods involving extensive skin resections also have qualitatively in the long run unstable but above all unnatural results, as they use horizontal, easily recognizable traction vectors (“the patient looks as if he or she has gone through a wind tunnel”) and do not provide for the restoration of lost or desired volumes upward.

ENDOSCOPIC LIFTING IN 4K OF THE EYES, FOREHEAD AND TEMPLE: WHO IS IT RECOMMENDED?

The face lift surgery is recommended for all patients who have tired eyes and face, genetically weighed down from a young age or created by the aged and stressors as a whole. It is particularly indicated in women and men who have:

  • sharp and noticeable sagging of the lateral eyelid and canthus of the eye (especially when there is a drooping tendency of the lateral portion of the lower eyelid and canthus creating a kind of “ball eye,” that is, excessive vision of the white sclera of the eye. To better understand, it is indicated in those patients who wish to obtain a ‘more taut eye toward the lateral portion and thus more “almond-shaped”.
  • they want greater traction of the temporal area and lateral eyebrow.
  • Wrinkling and drooping of the central eyebrow toward the median canthus of the eye.
  • they want a fresh, sensual look, to be admired as a whole of respect for the natural result without visible signs or scars. All this can be achieved with small scars of about 2-3cm hidden inside the scalp, therefore totally invisible and unrecognizable.
  • sagging of the whole gaze, especially in the post-pregnancy in which the estrogen receptors of elastin change their conformation and become less sensitive.
  • great discomfort in being aged and difficulty in liking oneself.
  • increased self-esteem.

TECHNOLOGY IN 4K (DEFINITION IN ULTRAHD)

The advantages of endoscopic surgery over the traditional facelift consist mainly in the decidedly more natural results and the avoidance of some unpleasant phenomena that can occur with traditional facelifts, such as a pulled appearance due to excessive skin traction, visible scars, and hollow faces without volume. Modern technology has made it possible to develop probes with cameras with 4 times higher definition than the latest classical endoscopies; modern optics allow visualization of the surgical pathways under the skin in a very high definition of detail in 4k; images are sent directly to suitable monitors in 4k; and the whole procedure is performed with great mastery of the method by looking at the monitor and at the operating field at the same time.

Through this modern method it is possible to work on anatomical structures preserving vessels, nerves and noble tissues. The tissues are then repositioned leaving the natural characteristics of the face unchanged.

WHAT IS ENDOSCOPIC FACELIFT WITH 4K DEFINITION FOR?

It fights the force of gravity accompanied by the loss of adipose tissue.

The method originates from modern analysis of facial changes, thanks to which it has been emphasized that there are areas of fixity, corresponding to ligaments or adhesions of the subcutis, where no descent takes place, and other areas in which the subcutaneous tissue having fewer links to the deep layers, tends to slide following the force of gravity. This descent caused by the force of gravity is mainly brought about by the depletion of subcutaneous fatty tissue, that is, the loss of fat and consequently of volume and bone resorption.

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FACE LIFT – WHAT TO KNOW BEFORE SURGERY

PREPARATION FOR BACKBRAID ENDOSCOPIC LIFT WITH 4K DEFINITION

Before the endoscopic lifting surgery, all the blood and ECG tests listed and proposed during the first medical-surgical examination must be carried out. Numerous pre-operative images will be made for the planning of an increasingly personalized therapeutic path.

 

SURGICAL TECHNIQUE

The clinical case is analyzed both in a static and dynamic position, the natural expression of the gaze is preserved but at the same time, at full healing from the surgical act you can certainly enjoy the admiration of others, without realizing there has been a surgical intervention.

This goal is achieved with a high level of surgery: the 4k technology is essential for the optimization of the success of the procedure as it allows the Surgeon to be able to view in detail 4 times compared to the classic HD. Through incisions in the middle of the hair of about 2 cm thin probes are introduced and endoscopically the surgeon performs the procedure with the help of a 4k monitor.

We give great importance to the millimeter positioning of the scars, so much so that it was decided to abandon the classic technique of incision in front of the scalp because it was recognizable when the patient made a hairstyle with a back braid. The incisions and scars inside the hair allow you to camouflage the small scars to the maximum.

At this point the surgeon separates the tissues and repositions them in the correct location according to different tractions established during the outpatient visit; the high level of natural results is due to the different surgical traction lines.

 

MEDICAL SURGICAL EXAMINATION – BACKBRAID ENDOSCOPIC LIFT WITH 4K DEFINITION

The surgeon visits the patient explaining and showing the areas of sagging of the face to be repositioned according to different lines of traction and that give a harmonious result. Subsequently, it verifies the degree of elasticity of the skin: based on the preference of the required clinical results, the surgeon evaluates the degree of skin retraction in order to explain in a completely transparent way to the patient what result can be obtained.

The patient is listened to in detail in order to draw up a program: in this phase the surgeon in addition to expressing in detail responds to all the doubts expressed by the patient and limits, where necessary, unrealistic requests from the patient.

For this endoscopic intervention you absolutely do not cut your hair. This is an intervention that acts on the deep structures and is not based on the tension of the skin, so there is no direct excision of irrelevant amounts of skin for the purpose of surgical achievement.

ANAESTHESIA

At the Colli Aesthetic Surgery Center it was decided to abandon general anesthesia with its dangers: surgical interventions are performed with the most modern anesthesiological techniques of deep sedation (local anesthesia + intravenous anesthesia), so that fear and the sensation of pain are completely canceled while the unconscious is invaded by dreams and pleasant images.

Local anesthesia occurs by introducing anesthetic into the anatomical areas to be treated in order to effectively eliminate the sensation of pain. The insertion of this solution, called tumescent, also takes place with a vasoconstrictor (adrenaline) to avoid bleeding, because it reduces the blood supply in the area to be treated allowing the operating surgeon to work at his best and in a delicate way, managing to eliminate a greater amount of fat.

Another advantage is to have an immediate return to social life without having to endure classic situations of fatigue, dizziness and exhaustion typical of the disposal of general anesthesia drugs.

The time for an accurate and well-executed BackBraid Endoscopic Lift with 4k definition is about 3h. Usually the operation ends with the closure of the surgical wounds and with a compression dressing to be kept for at least 5 days until their release. The next change of dressings will be planned by the Surgeon and his team. No drainage is applied. Both the technique performed and the anesthesia is scheduled during the preliminary visit with the surgeon.

BACKBRAID ENDOSCOPIC LIFT WITH 4K POST-OPERATIVE DEFINITION

After removal of dressings it is normal to see swelling of the eyelids and other areas of the face. After the face lifting surgery, a special compression dressing is applied with a bandage around the head to be removed about 48h later exclusively by the Surgeon or his team. After this period of time, the patient will wear the custom-made bandage, specially designed for the next 24h – 48h, after which the Surgeon evaluates the healing of the tissues and may decide to leave the patient without bandages and dressing, but with the simple cleaning and disinfection of surgical wounds.

 

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There is no pain in endoscopic facelift surgery, but the inflammatory discomfort involved is similar to a headache that lasts for about 24h. The treated areas may have bloody suffusions under the eyes, and the first few days there will be perceptible hyper traction of the eyes; not to worry because over the next few days the traction will subside until the desired complete stabilization.

The patient is prescribed and provided with all the pharmacological treatments from antibiotic to anti-edema prevention and the indications that the Surgeon provides at the time of discharge.

Sports or particularly heavy activities should be avoided during the healing period because it is essential not to sweat to allow the surgical flaps to heal and the compression dressings to stay in place. Subsequently, it is advisable not to overdo it in the traction of the hair from the hairdresser or with the brush after a traditional shower (preferably the first without boiling water); all small precautions to achieve a result of the highest level.

The most important swelling will disappear within a week and in this period it is good to leave out stresses on the areas of the face put in traction.

At this stage, however, it is possible to gradually resume work, especially if at the PC or at home; intravenous sedation in fact allows, compared to general anesthesia, an immediate return to social life with the elimination of drugs from the body a few minutes after the end of the operation. In the first days, dark glasses and scarves are recommended to hide the slight swelling.

It is advisable to sleep in a straight supine position with two or three pillows under the head; the lying position taken at night in fact redistributes body fluids by transporting them from the legs to the face (which is why many people get up in the morning with swollen eyes and enlarged bags). In the first hours of the post-operative course it is necessary to avoid further swelling of the inflammatory tissues to facilitate excellent healing of the scars and not to tension the sutures.

 
 

SMOKING AND COSMETIC SURGERY OF THE FACE

 

It is good to remember that this type of intervention is carried out on the face and aims to achieve an allurè and an objectively more beautiful and admirable look.

It is good to be informed in depth by the Surgeon of the technique used and also of his experience increased over the years, and images and surgical cases of interventions already carried out can be shown.

ARTENATIVES AT BACK BRAID ENDOSCOPIC LIFT WITH 4K DEFINITION AND COMPLEMENTARY METHODS

A complete facial rejuvenation plan includes, in addition to endoscopic face lifting, also other less invasive but complementary methods.

During the surgical examination, the surgeon evaluates the state of the tissues and their traction, making the patient understand and demonstrating the harmonious and natural result of a fresh, bright and admirable face. Often many patients require a greater rejuvenation than the one proposed to them that obliges them to carry out other complementary techniques in order to balance the whole face in a natural and harmonious way: an example is blepharoplasty (eyelid surgery).

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Pre-operative planning is a fundamental part of the patient’s decision-making process together with the Surgeon: futile interventions are never sold but always motivated by a targeted and finalized objective. The patient who wants an effective traction level of the temple can always resort to temporal facelift; unfortunately this method will not be able to guarantee the initial result over time and will not be able to guarantee a natural traction and of a certain level at the level of the lateral eye as well as it cannot pull up the eyebrow in the central and medial part. Eyebrow lifting could also be considered an alternative, but unfortunately the incision is visible and uncovered even if made just above the hair bulbs; secondly, it cannot provide for the traction of the eye laterally or that of the medial eyebrow unless a remarkably long scar is carried out.

The traction wires could ideally give the idea of traction, although when you exceed the natural tension effect they lose the natural effect immediately and you have to wait a few days for a result that is stable for a few months in the post-treatment.

Botulinum-based fillers can give a great help in maintaining the surgical result in the BackBraid endoscopic lift with 4k definition, especially if done a few days before the scheduled surgery. The filler alone without accompanying the surgical result obviously gives its excellent results in the reduction of wrinkles but in the traction upwards and towards the lateral part of the eye has limited results and to obtain them it is necessary to carry out a high-level treatment.

Il trattamento con acido ialuronico nel riempimento del sopracciglio fornisce ottimi risultati appena effettuato, ma bastano pochissime settimane o mesi per vedere che appena il materiale biodegradabile richiama acqua e perda di trazione, non solo il sopracciglio perde la trazione verso l’alto ma il peso maggiorato dell’acqua porta ad una posizione più bassa dello stesso rispetto all’inizio del trattamento.

The treatment with hyaluronic acid in the filling of the eyebrow provides excellent results just carried out, but it takes just a few weeks or months to see that as soon as the biodegradable material recalls water and loses traction, not only does the eyebrow lose traction upwards but the increased weight of the water leads to a lower position than at the beginning of the treatment.

Facelifts with coronal incision are not even taken into account as methods with high anatomical dissection and with results that are not very stable over time but above all with long and visible scars, especially if carried out on the front edge of the hairline.

If a patient wants a natural, stable and admirable effect without signs of recognition, unfortunately the BackBraid endoscopic lift with 4k offers the only possibility of success and the only guarantee for the desire for results in the patient.

The patient’s case is studied and programmed thanks to numerous HD and 3D images in order to carry out a surgical programming that guarantees harmonious and balanced results throughout the gaze. The detail of the small, but still present initial asymmetries, is exasperated in order to achieve an enviable result.

Necessary to improve and correct the quality of the skin are modern regenerative medicine techniques (PRP, monocytes, and stem cells from adipose tissue and its portion of derived intranatant), biorevitalizing treatments with hyaluronic acid fillers, botox and peeling that can be performed after complete healing from the face lift surgery.

 

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Peeling, reducing the layer of superficial dead cells (stratum corneum of the skin) leads to a smooth and even skin, attenuates small intra-epidermal scars and removes skin spots. Hyaluronic fillers compact the skin making it more toned and can fill depressed or atrophic skin areas due to aging characterizing volume and roundness.

Botulinum injections (botox) smooth out expression wrinkles destined to form due to facial mimicry.

The combination of all these complementary techniques to endoscopic face lifting configures an optimal strategy to enhance effective and admirable results.

 

REASSURANCES OF FACE LIFTING

If the patient smokes, they will need to eliminate or reduce smoking at least one week before surgery and for at least the next additional 10 days to prevent nicotine-related risks. Smoking causes a decrease in the lumen of the blood vessels through which the blood flows which leads to the oxygen and nutrient tissues by eliminating the waste products of cellular metabolism. Nicotine therefore reduces the normal blood supply to the skin of the face. Eliminating smoking allows a perfect healing; vice versa it is good to know that among chronic smokers, who do not stop in view of the intervention, necrosis (death) of the skin occurs near the incisions.
 

FACE LIFT TIPS

It is important to keep in mind that an economic quantification for this type of intervention is strongly discouraged: it is very likely that the technique used is partial and superficial and that in the following years it will be necessary to re-intervene to give a harmonious and natural balance in the desired areas of the face where it has not previously intervened in a coherent and optimal way. The sum of these small interventions is much greater than a high-quality endoscopic facelift in 4k of the gaze that lasts over the years. Surely the combination of several surgical techniques in a single surgical session guarantees a certain economy of time, given that there will be a single post-operative period of recovery.

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