The methods of facial rhytidectomy are generally divided into traditional classic surgery and newly developed improved methods or new technologies. The former is frontotemporal rhytidectomy, lower neck rhytidectomy and total neck rhytidectomy; The latter, such as endoscopic rhytidectomy, small incision rhytidectomy, laser rhytidectomy, collagen and expanded PTFE filling rhytidectomy, etc. Each method has its advantages and disadvantages, applicable objects (indications) and limitations. Key points of operation: make a coronal incision between ears at 7 cm behind hairline; Remove three small muscles of forehead, remove the frown muscle between eyebrows and the depressor muscle at the back of nose, and suspend the orbicularis oculi muscle at the outer corner of the eye. Finally, tighten the skin and fascia up and down, suspend, cut off part of the skin, and sew up the wound. The operation time is about 2-3 hours.

1. Frontal rhytidectomy: suitable for people with many and deep forehead wrinkles, drooping eyebrows and upper eyelids. Frontal wrinkles are called dynamic wrinkles, which are caused by the contraction of frontalis muscle (forming the line of looking up), frown muscle (vertical line between eyebrows) and depressor muscle (horizontal line of nose root) to achieve facial expression. Surgical incision is selected on hairline or in hair. Surgical separation of forehead skin and muscles, muscle resection or cutting, and then pulling the separated skin and eyebrows upward and backward respectively. After removing excess skin, carefully suture the incision. Its disadvantage is that the scalp is numb about three months after operation, and the incision may be bald.

2. Temporal rhytidectomy: Internal rhytidectomy is to eliminate or reduce crow's feet. The crow's feet is a dynamic wrinkle caused by long-term contraction of orbicularis oculi muscle, which is located outside the outer corner of the eye and radially surrounds the outer corner of the eye. Surgical incision can also be selected on hairline or in hair. After separating the skin and treating the orbicularis oculi muscle during the operation, put it back and tighten it, remove the redundant part of the skin disease, and carefully suture the incision. Its disadvantages are that crow's feet are not corrected obviously and sideburns are easy to shift.

3. 1/2 face and neck rhytidectomy: It is suitable for people with wrinkles and sagging in aging face, and can eliminate or alleviate crow's feet, wrinkles, wrinkles and sagging cheeks and neck, and deep nasolabial groove. The surgical incision is along the hidden groove behind the ear. Surgical separation of skin, such as aponeurosis, after separation, forcibly pull up the aponeurosis and fix it, and then push the skin back to fix it. The so-called "two-way compression" can achieve a good effect of "rejuvenation" after surgery. Its disadvantage is that the nasal groove and labial groove have not been properly corrected, and at one stage, the facial expression appears unnatural.

4. Endoscopic rhytidectomy: At present, it is limited to forehead rhytidectomy. During the operation, the deep surface was accurately separated through a small incision on the scalp to the endoscope, and the muscles were cut or removed with special tools under the direct vision of the endoscope. Then push the skin up and down on the scalp, tightening the excess part of the forehead, that is, being folded on it and on the pillow. The biggest advantages of endoscopic rhytidectomy are small incision, less bleeding and light injury, but with the help of endoscopic direct vision, the accuracy and precision of the operation are lost. However, the extra part can't be removed, and it is folded at the top and occipital. It is expected that it will calm down within a period of time after operation, so it will not be noticed because it is covered by hair. In addition, because the extra part can not be removed, it is not suitable for people with high foreheads (above 7 cm).

5. Small incision rhytidectomy: it is the "foreign things serve China" of endoscopic rhytidectomy technology. The advantages and disadvantages are the same as those of the above-mentioned endoscopic rhytidectomy, except that the endoscope under direct vision is not used. Only suitable for people with slight wrinkles on forehead and brow, loose skin or simply raising eyebrows.

6. Collagen or expanded polytetrafluoroethylene filling wrinkle removal: Collagen used for collagen injection filling wrinkle removal is extracted from calf skin and can be used in human body after treatment. Plastic surgery injected it into the dermis to eliminate deep wrinkles, injected it into nasolabial groove, crow's feet, vertical lines between eyebrows and so on. The method is simple to operate, and the beauty seeker has no great pain, and the wrinkles are relieved or disappeared immediately after injection. However, it is only suitable for simple and locally deep wrinkles and younger wrinkles, and cannot correct sagging and aging. In addition, collagen is absorbed, which may cause allergic reaction. Expanded polytetrafluoroethylene (PTFE), as a tissue substitute for filling and suspension, is in the ascendant, and it is superior to medical silica gel in physical and chemical properties and histocompatibility. Filling nasolabial groove, forehead wrinkles and crow's feet is one of the uses of ePTFE. The effect is good and lasting, and it is not afraid of absorption or allergic reaction.

7. Laser rhytidectomy: Its principle is to evaporate excess water in the tissue by laser irradiation, eliminate the aged stratum corneum of epidermis, repair and regenerate collagen fibers of dermis, thus making the skin balanced and delicate, restoring the elasticity of skin tissue and eliminating wrinkles. Laser wrinkle removal can treat the "dead angle" parts that other traditional surgical methods can't do, such as the tiny wrinkles around the mouth and lips, the skin of the lower eyelid, the tiny wrinkles in the frontotemporal region and so on. Its disadvantage is that some people have excellent pigmentation after operation.