Lifting

The essence of a facelift is to counteract the sagging of tissues (ptosis), which results from aging processes, loss of type I and III collagen, reduced skin elasticity, and weakening of supportive structures. Depending on the method used, a facelift may work by:

• mechanically lifting and repositioning tissues,
• controlled heating of the dermis, leading to the shortening of collagen fibers,
• stimulating neocollagenesis and neoelastogenesis,
• improving microcirculation and lymphatic drainage,
• cellular biostimulation without disrupting the skin's continuity.

The lifting effect can be immediate (resulting from tissue tension) or progressive over time, as the structural remodeling of the skin occurs. Unlike volumetric procedures, a facelift does not involve increasing volume but rather improving the architecture of the tissues.

Lifting treatments can be categorized based on the degree of invasiveness and the mechanism of action.

Classification by invasiveness:

• surgical lifting,
• minimally invasive lifting,
• non-invasive lifting.

Classification by mechanism of action:

• mechanical lifting (e.g., threads, surgical techniques),
• thermal lifting (radiofrequency, ultrasound),
• biostimulatory lifting,
• vacuum-mechanical lifting.

Classification by treatment area:

• face and contour lifting,
• neck and chin lifting,
• breast lifting,
• abdominal lifting,
• thigh, arm, and buttock lifting.

Each type of lifting differs in depth of action, recovery time, and durability of effects, which is crucial when qualifying a patient.

The course of a lifting procedure depends on the chosen method, but in medical terms, it includes several common stages:

1. Qualification and tissue assessment
   • analysis of the degree of laxity,
   • assessment of skin quality,
   • identification of contraindications.
2. Main procedure
   • application of energy (thermal, mechanical, or electromagnetic),
   • controlled impact on the dermis and subcutaneous tissue,
   • stimulation of repair processes.
3. Post-procedure phase
   • activation of regenerative processes,
   • gradual collagen remodeling,
   • improvement of skin tension and structure.

Non-surgical procedures are usually short, repeatable, and do not require exclusion from daily activities, whereas surgical procedures involve a period of recovery and healing.

Proper preparation for lifting procedures increases their effectiveness and safety. It includes:

• comprehensive medical history,
• assessment of chronic diseases and medications taken,
• analysis of skin condition and degree of dehydration,
• for invasive procedures – appropriate laboratory tests.

It is also recommended to:

• avoid intensive exposure to UV radiation,
• maintain proper body hydration,
• temporarily discontinue substances that may interfere with the healing process (according to the doctor's recommendations).

In non-surgical liftings, preparation is mainly preventive and optimizes tissue response.

The effects of lifting treatments result from a combination of immediate tissue tightening and long-term skin remodeling. The most commonly observed results include:

• improvement in skin firmness and elasticity,
• lifting of sagging structures,
• sharpening of facial or body contours,
• reduction of skin laxity,
• improvement in skin quality and density,
• a more harmonious appearance of the treated area.

The duration of the effects depends on:

• the patient's age,
• the biological rate of aging,
• the initial condition of the tissues,
• the type of technology used,
• lifestyle and aftercare.

Lifting does not stop the aging process, but it can significantly slow it down.

Lifting treatments include non-surgical and minimally invasive procedures aimed at lifting tissues and improving their tension by affecting the dermis, subcutaneous tissue, and supporting structures. The lifting effect can be mechanical, thermal, or biological.

Procedures with documented lifting effects, understood as lifting tissues or improving their tension and structure, include:

• Lifting threads – mechanical lifting and repositioning of tissues with secondary stimulation of neocollagenesis,
• HIFU (high-intensity focused ultrasound) – targeted contraction of deep tissue layers leading to structural lifting,
• Microneedle radiofrequency – combination of microneedling with radio wave energy causing skin densification and improved tension,
• Monopolar and bipolar radiofrequency – thermal stimulation of the dermis and shortening of collagen fibers (e.g., Accent),
• Capacitive-resistive diathermy – deep biostimulation of tissues and improvement of their elasticity (INDIBA),
• Non-ablative and ablative fractional lasers – induction of controlled thermal damage leading to collagen remodeling and qualitative lifting effect,
• Vacuum-mechanical treatments – mobilization and densification of tissues, improving their elasticity (endermology, Icoone),
• Microwaves – effect on subcutaneous tissue with secondary firming and contour improvement (Onda).

The choice of method depends on the degree of ptosis, skin quality, and the expected range of tissue lifting. In clinical practice, the best and most stable results are achieved through combined therapies, considering both structural lifting and skin quality improvement.