Complications of facial rejuvenation surgery.

The reversing of aging through surgical methods is the current “hot topic” in maxillofacial surgery. There are numerous training programs, short-term courses and “hands-on” programs being offered in conjunction with several thematic meetings and conferences. Undoubtedly, OMF surgeons are also being taken into the field. Usage of ancillary techniques like boutillum toxins is also gaining widespread use. These technique sensitive materials and procedures are akin to the “Sword of Damocles.” A compromised, conservative approach will not fetch desired results while a radical approach may cause a mask like effect. The clue to a successful facial rejuvenation is complete planning, understanding patient expectation, and attempting successfully matching the expectation with results via the surgical skills. The most common components of facial rejuvenation are the eyelid correction, hairline correction and correct fat relocation. In the eyelid correction, the position of the incision, usage of appropriate techniques, correct application, adherence, recreation of form and function of the ocular musculature function is crucial. If any one of the component fails, the eye position, the form and function of the eye may be compromised.[12] Hence, planning needs to be multi-vectoral and a OMF surgeon needs to spend considerable time for the same. In the case of the hairline correction, estimating the final contour may be tricky. The quality of the aponeurosis plays a crucial part: this can be of course estimated on the operation table only. An insufficiently thick aponeurosis may not provide sufficient thickness for manipulation leading to tear, and thick aponeurosis may impede manipulation - causing “poor” full appearance. Hence, estimating the thickness is one of the priorities. Furthermore, the placement of the incision within the hairline also creates “flutters.” Consideration for future hair recede needs to be exercised. In addition, the finer and numerous blood vessels predisposes to the hematoma. These factors need to be computed while planning, hairline position.[13] The free fat transfer is used to bring in the youthful appearance, especially by recreating the “fullness” in places where fat has been lost or in places where “sinking” of tissue, “crowing” has occurred. Abnormally placed fat creates unusual fullness while dislocated fat graft causes poor esthetic concerns. Furthermore, loss of the fat graft on a longer run needs to be accounted. A successful fat graft can be a potent tool if performed correctly.[13]

A properly performed facial rejuvenation brings in joy and confidence to the patient while a disappointed patient will be a sure practice breaker. The OMF Surgeon must acquaint and equip themselves properly before venturing into this procedure.