La possibilità di migliorare l’aspetto di un viso senescente è data dall’intervento di lifting o ritidectomia.
Lo scopo principale è quello di ottenere un viso più luminoso e giovanile senza stravolgere il decorso della natura.
La tecnica prevede lo stiramento della cute ed eventualmente del piano sottostante attraverso delle incisioni nascoste nei capelli e intorno al padiglione auricolare.
Si può agire su tutta la faccia ma anche sulla regione frontale,temporale ed il collo e può essere associata una blefaroplastica o una liposcultura per migliorare il risultato.
Attualmente molto richiesti sono i mini-lifting o i lifting parziali che rappresentano un buon compromesso perché si effettuano in day-hospital, sono poco invasivi, richiedono piccole cicatrici e assicurano un recupero veloce ed un buon risultato estetico.
Gli effetti dell’invecchiamento cutaneo, della gravità, delle lunghe esposizioni al sole, nonché dello stress della vita quotidiana si riflettono sul viso. Si osservano così profonde rughe, pieghe e rilassamento dei tessuti del volto e del collo.
La procedura chirurgica che pone rimedio a questa situazione è il lifting facciale, tecnicamente conosciuto come ritidectomia.
La ritidectomia, come peraltro tutte le procedure di chirurgia estetica, non ferma però il tempo, ma sposta solo indietro le lancette dell’orologio, migliorando i segni più visibili dell’invecchiamento.
I migliori candidati all’intervento di lifting facciale sono donne o uomini che hanno chiari segni di invecchiamento, ma una elasticità cutanea buona e strutture ossee forti e ben definite. La maggior parte dei pazienti che richiedono questo intervento sono pazienti di entrambi i sessi con un’età compresa tra 40 e 60 anni. Ma il lifting del volto viene eseguito con successo anche su pazienti di 70 o 80 anni.
Rischi
Se la ritidectomia è eseguita da un chirurgo plastico esperto, le complicanze sono rare e solitamente minori. Va comunque detto che ogni individuo ha una risposta personale e difficilmente predittibile in termini di guarigione. Oltre le complicanze generiche (valide per tutti gli interventi chirurgici), va ricordata la possibilità di uno stupore del nervo facciale (solitamente temporanea) ed una guarigione più lenta e difficoltosa per i fumatori per i quali è addirittura controindicato l’intervento chirurgico.
Preparazione all’intervento
E’ buona norma, a cominciare dalla settimana precedente all’intervento, non assumere Ac. Acetilsalicico (aspirina) per evitare problemi di coagulazione. Se il/la paziente ha i capelli troppo corti, sarà preferibile che li faccia crescere per poter nascondere meglio le cicatrici durante la guarigione.
L’intervento chirurgico
La procedura chirurgica richiede alcune ore. La localizzazione e l’estensione delle incisioni varia a seconda del singolo caso clinico. Generalmente cominciano dietro la linea dei capelli all’altezza della tempia, si estendono verso il basso al davanti dell’orecchio lungo le pieghe naturali, girano intorno al lobo auricolare risalendo dietro all’orecchio sino al suo apice superiore. Se anche il collo necessita dell’intervento, una piccola incisione supplementare viene eseguita sotto al mento.
I tessuti cutaneo e sottocutaneo vengono separati dai muscoli, il grasso in eccesso viene asportato, i muscoli trazionati ed ancorati, la cute viene quindi stirata e la porzione in eccesso rimossa. Talvolta piccoli tubicini di drenaggio possono essere posizionati per un paio di giorni. Le incisioni vengono infine richiuse con suture delicate.
L’Anestesia
La maggior parte degli interventi di ritidectomia vengono effettuati in Anestesia Generale, ma possono essere condotti anche in Anestesia Locale ed eventuale sedazione secondo i desideri della paziente.
Il post-operatorio
Il dolore non è eccessivo ed è ben controllato dalla terapia farmacologica. Il fastidio invece può essere significativo ed è legato all’edema dei tessuti (molto importante nelle prime 48 ore). Il primo giorno l’edema (gonfiore) sarà di notevole entità, il secondo giorno sarà ancora più imponente, per poi andare a decrescere nel corso delle settimane seguenti. Piccole aree di iposensibilità sulla cute possono manifestarsi normalmente; tendono a risolversi nello spazio di alcune settimane spontaneamente. I bendaggi vengono rimossi in 3°-4° giornata ed i punti rimossi tra la 5° e la 14°giornata. Ecchimosi diffuse su tutto il volto in forma ed entità diversa, rappresentano la normalità e si risolvono spontaneamente.
Ripresa dell’attività
Il/la paziente viene dimesso/a generalmente dopo due giorni di ricovero. Nelle prime 2 o 3 settimane, il gonfiore, le ecchimosi, l’aspetto evidentemente un po’ distorto del viso dato dalla difficoltà dei movimenti ed il pensiero delle cicatrici, potranno portare ad un pensiero di delusione, ma dopo la terza settimana con il migliorare dell’aspetto, la situazione psicologica tenderà a ristabilizzarsi. Occorrono comunque non meno di 4 settimane per poter nascondere bene i segni dell’intervento. Per questo stesso periodo ogni attività sportiva deve essere completamente interrotta.
Il nuovo aspetto
I cambiamenti dopo un lifting facciale possono essere fantastici, soprattutto se si ha la pazienza di superare i primissimi momenti del post-operatorio.
Purtroppo le cicatrici sono abbastanza lunghe, ma tutte ben mimetizzate. Bisogna ricordare comunque che con un lifting facciale noi non fermiamo il tempo e quindi il processo di invecchiamento cutaneo, ma riportiamo solo indietro le lancette dell’orologio, ragion per cui è possibile che, dopo alcuni anni, si possa riproporre la necessità di un secondo intervento.
Il lifting facciale può cambiare l’aspetto e restituire quella self-confidence perduta, ma non necessariamente cambia il proprio look secondo i propri desideri o modifica il modo di fare delle persone che ci circondano.
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