Face Lift

Many factors of a person's face determine the impression of age in that individual. Extra eyelid skin, extra neck skin and jowls are obvious signs of age, as are thin crepe paper skin, gray hair and wrinkles. There are many effective procedures to improve all of these problems and rejuvenate the face.

Extra neck tissue makes a person appear old, overweight or both. To correct this problem, one must determine if the tissue is loose skin, extra fat, sagging muscle or a combination of all of these. If the problem is simply too much fat then liposuction, done through a 1-centimeter incision, will produce a younger, thinner neck. If the problem is fat and muscle, then through a slightly larger incision under the chin, fat is removed and the muscles are tightened to improve the neckline. This is called myeloplasty. If fat, muscle and skin are involved, then the appropriate plastic surgery procedure is a neck lift, where the myeloplasty is done and the extra skin is removed in the hair behind the ears. None of the procedures leave noticeable scars, and they will all improve the neck significantly.

If the patient is bothered by a deep fold in the junction of the cheek and upper lip, then this person is a candidate for a face lift. A face-lift improves the cheek fold, improves the jowls, and also treats the neck. Every face-lift also includes a neck lift at the same time. For patients who have a deep fold in the cheek and excess jowel skin, but a good neck, then a mini facelift can be done where the neck is left alone. All these procedures are tailored to match each individual patients concerns.

Overview

Face-lifts suspend the sagging muscles to their original position to give more youthful support to the face. The skin is then tightened appropriately for the final effect. Most people feel they look 5-10 years younger on average, but some have an even more dramatic improvement.

Because the basic support of the face has been improved, the effects of a facelift last longer than the old techniques. Patients can expect results to last for 7-10 years before even considering a repeat cosmetic surgery procedure. Even if nothing else is done, the patient's face will always look better than if they had never had a facelift.

Many patients want to look younger but are afraid they will look different. With our cosmetic surgery procedure, we rejuvenate the face by resuspending the muscles back to their original position and not by removing fat; therefore, our patients never have any new looks. Patients are always concerned about the scars. The incisions are very inconspicuous in the hair above and behind the ears and in the crease in front of the ears. The scars are there, you just cannot see them.

Everyone wants to know if the cosmetic surgery hurts. Surprisingly, virtually all patients report tightness in the cheeks and neck, but no pain. We like to hear that the surgery feels tight, as that means that the procedure will last a long time.

The plastic surgery procedure is done in our facility under twilight anesthesia where the patients are totally asleep. Patients feel nothing and remember nothing, but they are breathing on their own. We feel this is a major safety advantage. Many times facelifts are combined with eye lifts or brow lifts to maximize the rejuvenation effect. Most cosmetic surgery patients go home after these procedures, but some stay overnight with a registered nurse to be more comfortable. Our written post-operative instructions tell patients to rest with their head elevated and apply ice compresses to keep swelling down. The dressing will usually come off at two days. Patients can then wash their hair and begin to move about more. There are no sutures to remove, but staples in the hair come out at 7-10 days.

Post-op/Complications

Patients may drive when they can make evasive movements without hesitation. We advise no major social or business engagements for 2-3 weeks to ensure plenty of time for healing. Many plastic surgery patients are ready sooner, but we like to be conservative on our recovery time.

Like any cosmetic surgery there can be potential complications like bleeding or infection, but these are rare. Wounds healing poorly because of bad blood supply are almost always linked to smoking. Smokers should stop smoking at least three months before plastic surgery to help reduce the chance of healing problems. Patients can experience temporary alterations in their facial expressions. This has several causes. Tissue swelling and skin tightness can alter our expressions. Bruising to the muscles and nerves can also produce the same result. These are all temporary phenomenon, but in the extreme case could be permanent if a nerve were cut rather than bruised. This would be very rare.

Everyone experiences numbness in the cheeks after surgery. This usually resolves within 1-2 months.

After facelifts where the tone of the skin has been improved, many patients then want to improve the quality of their skin. This can be done with the Obagi skin program, skin peels, IPL photorejuventation or laser resurfacing. These procedures are delayed at least 3-6 months after a facelift to ensure safety.

Procedures

A new approach using "threads" or long non-absorbing sutures to suspend the face using only local anesthesia has not produced durable results and is not now a viable alternative in our practice. Another plastic surgery technique known as Thermage uses microwaves to heat the subcutaneous tissues and theoretically cause collagen contraction and skin tightening. This has an 85% failure rate at one year. We do not recommend either of these techniques. As new plastic surgery technologies come on line, we will evaluate them for safety and efficacy. When new procedures meet our high standards and surpass the results of the current procedures, we will adopt them.

Facelifts, along with many other procedures, are a safe and predictable way to reliably rejuvenate the face. The results last for years and don't change the way you look; they just make you look younger. We know what you want.