DR. MATTIA COLLI SURGEON
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BACKBRAID LIFT WITH UNLIMITED ARTIFICIAL LIGAMENT

Neck Artificial Ligament (NAL)

There is no better surgical technique to achieve an unlimited result in the harmonic traction of the neck and face. BackBraid Lift with artificial ligament is the patented surgical method published in the international literature to guarantee a result without limits of duration over time: the ligament specially created for the clinical case, is inseparable, and fixed in the correct points allowing you to pull, lift and support the neck and the part of the lower face as it was in youth. There are different surgical methods in face lifts, which certainly allow you to unglue the tissues and reposition them with different suture choices; however, all these tractions, even if carried out in a workmanlike manner, have obvious limits of result over time, precisely because the repositioned tissues are sutured to additional soft tissues, which unfortunately lose tone and support over time and change of metabolism, especially in sudden weight loss; there are surgical techniques of duplication and plication of the platysma, other methods that involve the use of traction wires, others that program the reconstruction of the anchor points of the platysma. No surgical method is comparable in result, extent of traction and durability to the BackBraid Lift with NAL: neck artificial ligament; all respecting the aesthetic canons of the look and giving a freshness to the face and neck sought for some time.

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Face lifts require more and more rapid healing, with maximum aesthetic results and easy recovery to social and work life. Different aesthetic elements define the age of a face, such as skin folds, tissue flaccidity, soft and loose neck, platysmal bands and tissue collection at the jowl area level, etc. Patients, increasingly young and attentive to small details, today wish to preserve, maintain and obtain the clean, fresh and tense face they had in previous years, especially after sudden slimming diets or workouts aimed at slimming with high-protein nutrition. To obtain concrete and lasting results, surgical techniques that involve Z-incision or sub chin level are strongly discouraged, as the plastisma is sutured at the mid-line, certainly obtaining an improvement in the neck, but never restoring the tissues upwards, where they were originally: very limited results in the post-operative time with fairly early recurrence of the fall of the neck,  especially, on the side profiles.

Non-surgical treatments, such as traction wires, can lead to some instantaneous improvement but of limited time and seem the ideal choice for those who want to improve immediately without a post-operative course.

BACKBRAID LIFT WITH UNLIMITED ARTIFICIAL LIGAMENT – WHO IS IT RECOMMENDED FOR?

The face and neck lift surgery with artificial ligament is recommended to all patients who have a fall of the soft tissues of the face and that accumulate at the level of the lower third of the face, which bother both for the feeling of flaccidity and for the tissue encumbrance of curl that determine, unfortunately configuring a tired and aged appearance. Very often even young faces appear weighed down and tired and the main causes can be both the genetics of the dermis and elastin and for sudden and rapid weight loss. It is particularly indicated in women and men who present:

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  • sharp and evident relaxation of the face and neck (especially when you bend your head forward and you notice and perceive curling or falling cheek. Most often some patients notice a marked improvement in a sitting or lying position with the face facing back, where gravity “pulls back” the tissues).
  • roughness and ripple of the skin of the face and neck.
  • they want a fresh, sensual look, to be admired as a whole, which eliminates the feeling of a tired face and the neck that does not reflect the age of the registry. All this can be achieved with small scars 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.
  • self-realization and increased self-esteem.

THE TECHNOLOGY OF THE ARTIFICIAL LIGAMENT (NAL – Neck Artificial Ligament)

The enormous advantage in the correct positioning of the NAL compared to the traction lifting is for a “timeless” traction: in fact, the implant provides a ligament that allows you to fix the whole neck and the lower part of the face to the most rigid structures between our tissues, unlike all the other lifting methods that involve the sutures of soft tissues above other soft tissues:  who curls, who duplicates, who bends, who gets traction flaps, etc. All techniques published in the Medical field, but with real results that unfortunately do not allow obtaining a decisive traction for a long time, in fact the soft tissues, which from the first offer a slight support, with the passage of time, relax and the result is not guaranteed.

The NAL, which is wrapped in a network of fibroblasts in your healing path, is a safe and inextricable implant but at the same time very soft and imperceptible; once fixed to the bone wall it allows traction guaranteed over time and without comparison. It is very important to be able to adapt the orientation of the NAL according to the clinical case and the individual patient.

The NAL allows to have a solid base of traction of the entire floor of the neck and the lower third of the face; further traditional sutures of soft tissues in the middle or upper third of the face may also be more durable over time just there is a concrete and valid support in the lower part, the one most prone to recurrence and fall.

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BACKBRAID LIFT WITH UNLIMITED ARTIFICIAL LIGAMENT – WHAT TO KNOW BEFORE SURGERY

PREPARATION FOR BACKBRAID LIFT WITH UNLIMITED ARTIFICIAL LIGAMENT

Before the BackBraid lift with unlimited artificial ligament 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.

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TECNICA CHIRURGICA

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 surgery.

This goal is achieved with a high level of surgery: the artificial ligament technology allows on the one hand a timeless traction, but on the other hand requires a correct positioning of the implant and therefore a very high level of surgery.

We give great importance to the millimeter placement of scars; they are hidden behind the ear at the level of the scalp; great importance and maximum attention is provided for the scar inside the ear in order to preserve the angle of the tragus, the only recognizable point in the case of traditional facelift: in fact, if the scar is carried out in the upper part of the tragus, the patient will lose the shadow and the natural angle of the latter, giving that suspicious appearance of “ear attached to the face”.

In the surgical protocol of BackBraid lift with unlimited artificial ligament, the angle of the tragus must be respected and maintained so that there is no sign of recognition in that area.

Another great advantage of the artificial ligament is that it offers an inextensible solid floor, which therefore does not tend to recur or fall downward; this fundamental element allows to avoid any possible widening or diastasis classic of the so fast and promoted mini-lifts or soft-lifts or weekend facelifts: eliminating and tractioning only the skin in the anterior region near the ear is the safest method to obtain a visible, wide, irregular scar that will always descend further downward: there is no traction, minimal or maximal, that the skin can support on its own. If you want to avoid securing a visible scar, scheduling a facelift cannot involve surgical times under 60 minutes.

In the BackBraid lift with unlimited artificial ligament surgery, the classic technique of incision in front of the scalp was abandoned because it was recognizable when the patient performed a hairstyle with a back braid: the scar will be very thin, imperceptible and will not be visible in a standard healing.

Incisions and scars

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 LIFT WITH UNLIMITED ARTIFICIAL LIGAMENT

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 and aesthetic result in order to explain in a completely transparent way to the patient what level can be obtained: despite the artificial ligament lifting it is suitable in most patients, the length and height of such a ligament must be designed “to measure” for each face of each patient.

The patient is listened to in detail in order to develop 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 surgery, the hair is not cut at all: the patient is required to shorten the hair at the level of the hairline behind the ear for about 3mm. The fundamental concept of the BackBraid lift is to act on the deep structures of the tissues of the face and is not based on the tension of the skin; however, the skin that remains in excess is eliminated adequately allowing the flaps to match perfectly.

ANAESTHESIA

Dr. Mattia Colli has decided to abandon general anesthesia  with the relative 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 Lift with Unlimited Artificial Ligament surgery 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 24 hours until their release the next day. The next change of dressings will be planned by the Surgeon and his team. No drains are applied, but if the patient should have limited bleeding it is preferable to apply a small soft silicone drainage, which will certainly be removed the next day.  Both the technique performed and the anesthesia is scheduled during the preliminary visit with the surgeon especially based on blood tests.

 

BACKBRAID LIFT WITH UNLIMITED ARTIFICIAL POST-OPERATIVE LIGAMENT

After removal of dressings it is normal to see a slight swelling of the treated area or neighboring 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 24 hours later exclusively by the Surgeon or his team. After this period of time, the patient will no longer wear bandages but will simply disinfect the surgical wounds thoroughly. After the following days the Surgeon will evaluate the healing of the tissue and will indicate which creams and ointments to apply for the following days.

 

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In the BackBraid lift with unlimited artificial ligament there is no pain in the post-operative period, however the patient perceives a decisive and inextricable traction the first days, so it is strongly recommended to turn the whole torso with the face and shoulders: this suggestion, valid only for the first days in the post-operative period, is essential not to put tension on the sutures and traction points of the ligament.

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 without overly hot water); all small precautions to achieve a result of the highest level.

Already in the hours following the operation, 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. It is essential to use an additional and high pillow, similar to those for rest during air travel, which do not allow extensions or push-ups of the neck, especially laterally.

OF THE FACE

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.

THE ARTENATIVES TO BACKBRAID LIFT WITH UNLIMITED ARTIFICIAL LIGAMENT AND COMPLEMENTARY METHODS

A complete facial rejuvenation plan includes, in addition to the BackBraid lift with unlimited artificial ligament of the face, 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.

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It is very often recommended, under the skin, a graft of stem cells from adipose tissue hADSCs and intranatant tissue from adipose tissue for a concrete regenerative stimulation of the skin.

The use of traction threads can also be of great help in repurposing the positioning of the malar bag, also known as under eye bags, without having to exaggeratedly volumizing it to achieve the rejuvenating effect. However, a thorough anatomical knowledge of the traction vectors of the face is very important: in the treatment with resorbable suspension threads lift (attach new link), it is essential to know the ideal potion of the traction thread: e.g., a horizontal traction, thus toward the direction of the ear provides a very artificial and very visible effect, in which the patient takes on the appearance of an unnatural traction. The vertical vector, on the other hand, allows the fabrics to be restored to the correct natural position, offering a fresh and enviable result.

I strongly advise patients to avoid multiple volumetric-based filler injections by stalling or finding an alternative solution in this very delicate area of the face and neck. To use volumetric treatments is to go for augmentation of the jawline and neck contour and certainly not to hydrate or reposition the tissues.

FACE LIFT WITH ARTIFICIAL LIGAMENT – RESULTS

The artificial ligament well anchored to the edge of the neck platysma and mastoid bone is covered and encompassed by fibroblasts that isolate and further strengthen it; the NAL is a permanent implant that cannot be stretched, soft, and cannot be felt either visually or by touch. Its property allows for a true ligament that supports the neck anchored to something rigid in a vertical direction vector, and thus follows the edge of the jaw and respects the natural canons of traction (different from horizontal traction that always manifests a dubious and suspicious surgical result). Because it is a definitive implant, it offers maximum traction even over the years, avoiding the notorious recurrences that occur with plication or incision techniques and then soft sutures of platysma in the international literature.

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