Lets face it, as we age.......along with wisdom
comes wrinkles. Many of us spend the first part of our lives blissfully
unaware of what the future has in store for our faces. We then spend the
second half of our lifecycles trying to eradicate any and all signs of time.
Moving on past the injectables which have made
their mark in the cosmetic surgery world as helping us starve off "father time"
with helpings us address varying degrees of wrinkles and folds on different
areas of the face. Eventually, we come to a crossroad that we must make a
decision on whether or not we should go under the knife for a more permanent
method, such as a face lift.
A face lift is a surgical solution for restoring
your face and neck to a natural youthful looking state. The pulled
wind-tunnel look is so passť. The goal in achieving a naturally
rejuvenated result requires much more than just technique. finesse, or artistic
sense than just lifting and tightening the skin. Today's full facelift
requires repositioning both the skin and the underlying tissues for (superficial
musculoaponeurotic system or commonly referred to as the SMAS Face Lift),
than reducing, redistributing and, in some cases adding fat to some faces before
re-draping the skin and reducing any excess. Having a face lift is much
more than sculpting and contouring the face....sometimes it means adding tissue
in the correct places, not just removing the extra skin in order to make it look
SOLUTION: Brow lift,
eye lift or face lift, which address
not only skin, but also the underlying muscle to create a smooth, firm, youthful
Sun-damaged, rough and wrinkled skin
- as wrinkles and fine lines cannot be erased by a facelift alone only reducing
SOLUTION:Fat grafting or
injections. The face becomes thinner as we age - so a round face
is associated with youth. Facelifts can be delayed or refined by injecting
fat if you have no jowl or neck looseness.
A facelift begins with carefully placed incision.
In general, these are made just inside the hairline at the temple and extend
along the natural curve of the ear, back behind the ear and horizontally into
the hairline. Well placed incisions should be placed in the natural skin
creases and shadow lines, or along lines of skin texture changes. Beveling
incisions within the scalp will permit hair re-growth over any resulting scars.
In cases, where a full lift is not necessary and excess skin in the jowls
or neck is minimal, a shorter or limited incision is possible.
Incisions allow the plastic surgeon to visualize
the underlying facial structure and fat before sculpting the face by
repositioning muscles and redistributing fat. The surgeon will reshape
your face to return muscles to where they once were and return fat to where it
has diminished. Meticulous detail and vision are needed to create the
foundation for a naturally beautiful result.
Once the face has been addressed, your surgeon
will focus on the neck, if necessary. The face does not stop at the
jawbone so when the signs of aging affect the neck, it is also worked on during
the facelift. Elements of a facelift that solely involve the neck are
often called a "neck lift". Through the facelift incision and possibly
through a small incision concealed beneath the chin, vertical bands in the neck
are surgically released and the natural muscle sling beneath the chin is
recreated for a smoothing effect. Excess fat deposits are sculpted or
removed through this incision as well.
The final step of a facelift is to drape the skin
over the new foundation, carefully reduce just the right amount of excess skin
and close the incisions.
Facelift Incisions are closed with the
skin adhesives or tissue glue
Re-draping the skin requires careful balance.
Even with the best underlying technique in a facelift, reducing too much skin
will result in an unnaturally tight look.
Liposuction techniques can assist in full or
limited facelift procedures by reducing excess fat pockets beneath the chin and
in some areas of the mid-face (such as above the
nasolabial folds or in the
jowls). Some surgeons will inject fluid that include a local anesthetic
and saline or
tumescent solution to make shaping and suctioning easier. Many surgeons
feel however; for precise sculpting necessary for natural looking rejuvenation
of the face, fat should be meticulously excised rather than having aggressive
liposuction. Liposuction of the neck is only beneficial in limited
procedures if the skin does not need to be reduced or redraped.
Suctioning the face rather than redistributing
fat can be counterproductive. As we age, we lose volume in the face.
If too much is removed with suction, the face and neck may look even older and
out of balance.
The alternatives to a traditional surgical
facelift go by many different names - but the techniques fall into three basic
Incisions are for access and minimal incisions
mean minimal access are most effect for minimal changes. Although there
will be less down time with a limited incision facelift - there is also a less
dramatic result. The limited techniques might not be appropriate for every
patient, nor do they mimic the results of a full facelift.
Limited facelifts are most appropriate with
patients who are younger with good skin elasticity and little neck looseness or
those patients who have already had a facelift and require refreshing.
Having your facelift consult with a board
certified plastic surgeon will show you all of your options and possible
techniques that would be appropriate for you. Of course the desire for
minimally invasive procedures continue to grow, so newer and newer techniques
are always under development.
PROS AND CONS OF LIMITED FACELIFTS
Smaller incisions - shorter recovery time.
Limited incision facelifts, cannot result in the same degree of correction as a
A surgical telescope or endoscope can help your
surgeon reposition muscle and fat to create a more youthful-looking result.
The use of the endoscope, most commonly with a short scar technique may even
further reduce the size of the incisions by limiting them to the temple
region, inside the lower eyelid, or inside the upper lip.
However, the caution is that by using an
endoscope your surgeon cannot visualize your aging anatomy as extensively and
therefore cannot address it as a whole. Unless your conditions are truly
limtied to a localized region of the face, such as the tear trough,
nasolabial folds or marionette lines - endoscopic assistance may not be
PROS AND CONS OF ENDOSCOPIC FACELIFT
Focuses only on limited sagging muscle of the face muscle. Cannot address
excess skin. The potential for asymmetry is greater.
Surgically designed suture threads are inserted
into the skin through a hollow needle. As the needle is removed, the barbs
on the sutures grip the skin and pull it upward. Most commonly used to
raise the skin of a low brow or a sagging cheek region, this procedure neither
affects the underlying muscles or reduces excess skin. The trend is to use
the suspension lift as an interim step to a facelift, but not all patients are
PROS AND CONS OF SUSPENSION LIFT - FEATHER
Minimally invasive, small incisions, procedure
takes less than an hour.
Skin that is too loose may pucker; skin that is too tightly gathered may also
pucker. Asymmetry and other irregularities are also possible.
Sutures may not hold, and sutures that are too tight may restrict natural facial
movements and expression. Over time, sutures may become visible on the
skin's surface. In addition, infection is possible. Scar tissue can
also form around the sutures and produce visible irregularities in the skin.
Local or light sedation.
INPATIENT OR OUTPATIENT:
Outpatient - performed in a doctor's office.
You may return to work as soon as the next
day, with minimal swelling and bruising. It is important to avoid
excessive facial movement for the first two to three weeks.
Although the sutures are designed to remain
in place permanently, the correction they provide may not be long term
Some patients have seen results diminish within one to two years of treatment.
Suspension lifts do not achieve the same result as full facelifts and can impair
the outcome of a traditional facelift should you decide to have one of those in