Medical Term: Rhytidectomy
Facelift surgery becomes a surgically necessary procedure in many individual as they age, if they have desires to project a youthful appearance, an inviting expression, and a well-rested, healthy and vibrant look. Non-invasive modalities such as injectable therapy, lasers and chemical peels, for example, only go so far in improving sagging tissues, facial definition, and loose and wrinkled skin. Ultimately, skin-tightening procedures are required to elevate sagging tissues, tighten muscles, and improve facial contours and skin appearance. The term “facelift” sometimes sounds unappealing, as most individuals are afraid of resulting stigmata of facial cosmetic surgery where they have seen natural features look distorted, pulled, and mask-like. The goal of facelift surgery is not to change your appearance, but to create a natural-looking youthful appearance so that you look like yourself, only years younger. Dr. Brown focuses on natural results. Unusual appearances, distortion or immobility of facial expression, visible scars, and an overdone, pulled-look is unacceptable. Maintenance of existing hairlines is also important so that patients are comfortable in short hairstyles and women feel at ease wearing their hair up or back. Dr. Brown feels that the best plastic surgery is when it looks like it hasn’t been done.
There are several different techniques used in facelift surgery. Each surgical approach is individualized per patient, taking into consideration areas of concern and personal goals. An efficient, effective, and minimally invasive procedure is desired along with longevity of results. Procedures can involve part or all of the following: full face lift, neck lift, neck liposuction, mini-facelift, soft tissue fillers to restore lost volume, and skin resurfacing to smooth wrinkles. The eyes, brows, ears, perioral areas, chin, neck, and hair may be considered during your evaluation and in determining your optimal procedure, so that the entire face looks harmonious and balanced. Certainly, patient desires and personal surgical goals become foremost in formulating a treatment plan.
Who is a Candidate?
- A person who has experienced a loss of skin elasticity and muscle tone of the face and neck from aging, gravitational and environmental factors
- Patients of any age who have lost a significant amount of weight with resulting deflation and sagging of facial and neck tissue and skin.
- Someone with facial or neck wrinkles, or jowls, prominent facial folds
- A person with a tired facial appearance
- Individuals with full necks, ill-defined jawlines due to genetics, fatty deposits, sagging neck muscles
- Younger individuals may desire intervention sooner rather than later, to maintain their youthful look and put off more aggressive procedures.
- Common age ranges for facial rejuvenative surgery in our practice are 40-70 years old. Healthy individuals in older age ranges do very well with surgery and the recovery process
- Non-smokers. Patients who smoke or have a significant smoking history may be at risk for skin healing complications
Goal of Surgery:
- To provide the patient with a more youthful, healthy appearance that is also somewhat age-appropriate
- Improve skin tone and wrinkles
- Improve neck line, profile, jowls
- Reduce neck fullness, fatty deposits, tighten muscles of neck and face
- Restore youthful facial contours and proportions
- A natural "non-operated on" result
- Restore lost volume, reposition sagging tissues
- The operation is done on an outpatient basis, usually under general anesthesia. Most patients will spend the night in an overnight nursing care facility. Mini-facelift patients may be able to return home right after surgery
- Incisions are hidden in and around the hairline and around natural ear contours, with a post-tragal incision desired. This means that the scar courses inside the ear along its middle third so that a vertical scar is not visualized in front of the ear.
- The skin is then separated from the fat, supportive structures, and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The underlying muscles are then tightened, the skin is redraped in a vector opposite gravity, and the excess is removed. Stitches secure the layers of tissue and close the incisions
- Lost volume is restored to the face in areas that are deficient, typically the cheeks, temples, lower lid hollows, jawline and perioral areas. Fat or other soft tissue fillers can be used depending on patient preference and the area being augmented. Avoidance of over-correction and naturalness is key. In the case of fat, liposuction is performed using a donor site such as the abdomen or thighs and then transferred to the perioral areas, cheeks, lips, temples, and smile lines. Patients opting for fat transfer to the face need to understand the unpredictability of fat "take", the risks of reabsorption, and the need to have a very stable weight to avoid appearance changes afterwards. Recovery can be longer in these cases because of increased bruising and swelling. In certain patients and in delicate areas such as the eyelids, hyaluronic fillers such as Restylane or Belotero may be preferred because of the predictability and reversibility.
- Brow lift
- Eyelid surgery
- Laser resurfacing, chemical peel, or dermabrasion
- Injectables, fillers
- Chin implant
- Hair transplant
Adjunctive facial surgical procedures done at the same time as your facelift should be considered, as the recovery process remains essentially the same as a facelift alone. Recovery is 1-2 weeks. Anticipate tightness, bruising and swelling with 2 weeks of social inactivity. Expect some relaxation after surgery with more natural contours apparent by 6-8 weeks.
How long do results last? Because patients continue to age, experience gravitational effects, and have weight fluctuations, there is no such thing as permanent results. Many factors affect the longevity of the result. These include patient lifestyle, overall health, skin care regimen, philosophy of sun-exposure, inherent skin tone and elasticity, environment, diet, exercise, and maintenance regimen. Injectables such as Botox, and soft tissue fillers done a few times per year may enhance and maintain your results. Results can last 10 years or more, with individual variability depending on the influence of the factors mentioned.
At this point in time, there is no device or technique that safely and reliably tightens facial tissue more effectively than surgery. Patients should be wary of mass marketing and fancy advertisements, which sound too good to be true. Dr. Brown keeps informed and up-to-date on emerging technologies and techniques and incorporates new techniques only when they are proven safe and effective and FDA approved. Many topics advertised and seen in the media, as well as new procedures and techniques are regularly addressed and discussed in a truthful and non-biased manner on our Facebook site.
Patients should not take any chances when it comes to their faces. Dr. Brown is a board certified plastic surgeon with the proper training and skills required to deliver a safe and predictable result.