Personalized Facelift: Does Skin Composition Influence Outcome?

Determining if intrinsic differences in skin collagen and elastin influence aesthetic outcomes and tissue relaxation post facelift (rhytidectomy). This is relevant since facelift surgery has reliable and predictable long-term clinical and patient-reported outcomes. However, a proportion of patients exhibit early post-operative recurrence of facial rhytids, despite undergoing a technically comparable procedure to those with successful long-term outcomes. We hypothesize an 'early recurrence' cohort of patients exist who are predisposed to a sub-optimal surgical outcome due to inherent structural differences in the collagen and elastin of the facial skin. These patients are intrinsically predisposed to a poor aesthetic outcome, possibly due to the undiagnosed presence of a lower-spectrum ("microform") of cutis laxa. This study aims to quantify collagen and elastin structure at a histological, immunological and cellular level in skin excised during facelift. Patients will be prospectively followed-up, with post-operative aesthetic outcome compared with pre-operative collagen/elastin data.