History of the Facelift: Evolution of Plastic Surgery
By Dr. William Cohen on July 30, 2018
The facelift has a much longer history than you might expect. Though commonly associated with modern movie stars, the first facelift actually dates back to the very start of the 20th century.
The team at our Orange County, CA facial plastic surgery center would like to go over the history and development of the facelift. This should give you and idea of how far the field has come in such a short amount of time.
1901: A Skin Tightening Forerunner to the Facelift
The first proto-facelift took place in Berlin in 1901. Eugen Holländer was asked by a Polish aristocrat to lift her cheeks and the corners of her mouth. To accomplish this, Holländer removed an elliptical piece of skin from around the ear area. He simply made the hole and tightened the skin, but there was no attempt to lift the structures of the mouth.
1907: The First Textbook on Facial Cosmetic Surgery
The first actual facelift would require additional know how even though people were theorizing and writing about surgical techniques for some time. This may explain the first textbook on the facelift being released before the first facelift itself was performed. The textbook was titled The Correction of Featural Imperfections, written by Charles Miller of Chicago.
1916: The First Facelift
The first actual facelift was performed in 1916, 15 years after Holländer’s early attempt. The facelift was performed by Dr. Erich Lexer, a German surgeon and former sculptor. This was a proper lift procedure, in which the skin of the face was lifted from the underlying fat, redraped, and then pulled tighter.
Lexer’s surgery was the predominant type of facelift for the next 60 years, though the results were not the same as those that would be achieved decades later. Some sources liken the outcomes of Lexer’s surgery to a “wind tunnel look,” meaning the facial skin seems particularly tight and taut.
1914-1918: The Birth of Skin Grafting
As an aside to the history of the facelift itself, the First World War brought about a number of relevant surgical innovations when treating wounded soldiers. A Dutch surgeon named Johannes Esser developed a skin grafting technique which would prove crucial in the development of reconstructive surgery.
1970-1980: The SMAS Facelift Technique
In the late 1960s, Tord Skoog developed the concept of subfacial dissection, which meant lifting a deeper layer of tissue rather than just the skin to achieve facelift results. His proposed technique would be published in 1973 or 1974. Mitz and Peyronnie would publish their own findings in 1976, describing the SMAS (superficial muscular aponeurotic system) facelift. The term SMAS was coined by French craniofacial and plastic surgeon Paul Tessier, who was familiar with Skoog’s innovative work.
The SMAS technique involved cutting deeper than just the skin and immediately underlying tissue. The SMAS would also adjust and suture much deeper tissues for better and longer-lasting results.
1981-1990: The Deep Plane Facelift
Dr. Tessier would continue his research into the facelift and its refinement, using coronal incisions to adjust the eyebrow and soft tissues, seeking better results than traditional facelift. The idea was to lift the skin over the skeletal structure for better rejuvenation results. By the 1990s, Dr. Sam Hamra developed a deep plane facelift technique, again targeting a lower layer of tissue for optimal outcomes.
1991-Today: Modern Techniques for Patient Satisfaction
Since the 1990s, the focus in modern facelift surgery is to reduce scarring, make results more effective yet simultaneously more subtle, and to reduce healing times and the severity of side effects. As surgeons continue to explore the possibilities of their craft, we’ll be sure to share them with you on this blog.
Contact Dr. William C. Cohen
For more information about facial plastic surgery and how it can help you look younger and more refreshed, contact an experienced cosmetic plastic surgeon. We will work with you to develop an effective custom treatment plan.
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