Facelift

As we continue to live longer, healthier lives, more and more people are eager to "look as young as they feel." As a result, facelift surgery has become increasingly popular among women and men. The medical term for this procedure is rhytidectomy, meaning "removal of wrinkles." What facelift surgery does is remove or reposition excess sagging skin and soft tissue in the face and neck. The effect is as if you turned back the hands of a clock, often making you look as you did ten or sometimes fifteen years in the past.

The major areas addressed by the facelift operation are the eyebrows, the cheek and jowl regions, and the neck. Eyelid surgery and skin resurfacing, while sometimes done at the same time as a facelift, are separate procedures.

Surgical Philosophy

We believe strongly in achieving a natural-appearing, rejuvenated look in facelift surgery, as opposed to an excessively tightened, "windblown" appearance. The goal is to make you look as you did at a younger age, not to make you look like a different person.

The Facelift Consultation

During your consultation for facelift surgery photographs may be taken for imaging purposes as well as for photodocumentation.

After you have had an opportunity to express your concerns and areas of desired improvement, your face and neck will be carefully examined, including skin and muscle tone, bone structure, fat distribution, etc. The position of your brows and cheek pads will be assessed to determine if you are a candidate for browlift or possibly midface lift. Your surgeon may suggest additional or alternate procedures to complement your desired changes. Some common adjunctive procedures to facelift surgery are fat transfer, eyelid surgery, skin resurfacing, and lip augmentation, any of which may be performed at the same time.

During your facelift surgery consultation you should have several opportunities to ask questions, and following the consultation a patient care coordinator will generally guide you through the surgery preparation and recovery processes.

The Surgery

Facelift surgery is commonly performed on an outpatient basis at an accredited, AAAASF certified surgery facility. IV sedation or general anesthesia are common for longer procedures.

A facelift involves tightening of the neck and jowls, as well as a lifting and repositioning of the cheek and temple region. This generally includes liposuction of the neck and jowl region, as well as tightening of the platysma muscle (responsible for loose bands in the neck). Your surgeon may perform a "deep plane" facelift, meaning the deep layer of tissue beneath the skin is lifted and tightening, providing an often dramatic but very natural rejuvenation of the face. Often, a full facelift will also involve a browlift.

A "midface lift" addresses the cheek pad and nasolabial folds or smile lines. Candidates for a midface lift include patients with heaviness below the cheek prominence and above the jowls. These patients often present with dark circles or hollowness beneath the eyes, which are due to a descent of the malar fat pad. The mid face is lifted through a small incision in the hair-bearing temple or under the eye. The mid face lift can be performed in younger patients in their 30's without signs of jowling or excess neck skin, or can be combined with a standard facelift when indicated.

The direct neck lift is a popular alternative among patients with prominent neck aging or "turkey gobbler neck," who may not be concerned about the jowls or cheek regions. The excess neck skin and fat can be removed with a well hidden incision under the chin. This procedure generally requires only local anesthetic or mild sedation.

Fat grafting or fat transfer at the time of facelift surgery has become a popular choice for our patients. While a facelift will tighten skin and remove or reposition drooping tissues, many patients also have volume loss in areas such as the temples, the area below the eyes, the cheek pads, and the lips. By replacing lost fat in these regions a very youthful and natural look is achieved.

Many patients benefit from eyelid surgery or blepharoplasty which can be done at the same time as the facelift. Another common adjunct is laser resurfacing which can address the wrinkles around the lower eyes and mouth (this skin is not tightened by the facelift).

The incisions for facelift surgery are nearly all hidden behind the hairline, and those that are not are placed within natural skin folds or behind the ear. When healing is complete, these incisions are usually very difficult to see.

The deep layer or superficial musculoaponeurotic system (SMAS for short) is tightened and resuspended, restoring a refreshed, youthful appearance, without stretching the overlying skin.

Recovery

After facelift surgery patients may be required to spend the night in a recovery facility or hotel which is immediately adjacent to the office or surgery center. A qualified assistant is usually available to assist with any needs, and the doctor may personally visit his patients that evening. The following morning dressings are removed, and the patient is generally allowed to return home.

Swelling and even bruising are normal after surgery, but begin to resolve within a few days following facelift surgery. Pain is generally minimal and easily controlled. By one week, most patients feel comfortable enough to resume a majority of activities (with some restrictions).

Most patients are able to return to their usual routine within two weeks.