A facelift is the most comprehensive approach to treating facial wrinkles and sagging caused by aging. The surgery varies in range from minimally invasive ‘lunchtime lifts’ to more extensive, sophisticated surgery. A facelift removes excess skin, tightens underlying tissues and muscle and redrapes skin on the face and neck. It can correct midface sagging, marionette lines, jowls and a double chin, maintaining its reputation as the ‘gold standard’ for facial rejuvenation. Every year, thousands of people undergo successful facelift surgery and are pleased with the results.
When to Consider a Facelift
If you feel that your face does not reflect your youthful spirit and energy level.
Are you a good candidate for a facelift?
If you determine that your facial sagging and excess skin is a social or career obstacle.
If you show signs of facial aging but still have some skin elasticity.
One day you look in the mirror and realize that time, gravity, sun exposure and heredity have taken a toll and you simply do not look like yourself any more.
The following are some common facial characteristics that make you an appropriate candidate for a facelift:
Sagging skin in your midface and/or jawline.
Deep creases extending from your nose to the corners of your mouth (nasolabial folds).
Lines extending from each corner of your mouth down your chin (marionette lines).
Facial fat (volume) that has fallen or is displaced.
Sagging and loss of muscle tone in the lower face, resulting in jowls.
A double chin, resulting from loose skin and excess fatty deposits under the chin and jaw.
Creased and sagging skin in your neck.
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If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.
How is a facelift procedure performed?
What are my options?
Most facelift techniques focus on the lower facial areas, such as the jawline, jowls and cheeks. A facelift can also focus on the midface or the forehead. In some techniques, deeper facial tissues may be repositioned or tightened to restore a more youthful contour. In other techniques, removal or addition of fat or other soft-tissue fillers may be necessary to achieve the best results. Today, many different techniques exist with outcomes that can be consistently reliable, safe, and durable. Your incisions will depend on the area of the face that is targeted and the amount of change you want.
Once the incisions are made, various degrees of ‘undermining’ of your skin is performed, and the deeper layers of your face are lifted. Undermining separates the overlying skin of the face and neck from the muscles and tissues deep to the skin. This frees or loosens facial and neck skin so it can be redraped at the end of the procedure, making sure skin is smooth.
Then, your surgeon will raise the skin from the temples, cheeks, and neck, and lift and reposition the underlying connective tissue, removing excess fat and skin. If this procedure is performed in conjunction with a neck lift, the surgeon will draw the neck muscles together, stitching them together at the midline to form a strong sling of muscles that supports the entire neck and jaw. Your surgeon may also include liposuction of the neck and jowls. Facial implants may be added to increase cheek or chin volume.
Finally, your surgeon redrapes the skin over the new underlying structure and closes the incisions with stitches and/or small metal clips. Where needed, drainage tubes may be inserted. A padded, supportive dressing is usually applied.
The goal of your aesthetic plastic surgeon and the entire staff is to help you achieve the most beautiful and natural-looking results, and to make your surgical experience as easy and comfortable as possible.
There are several approaches to facelift surgery (see How is a facelift performed?). Your plastic surgeon will recommend an approach based on your goals and facial characteristics, including the shape of your face. The placement and length of incisions vary, depending on the facelift technique that best suits you. Your surgeon might find you appropriate for a ‘short scar’ facelift procedure in which a short incision is usually limited to the area around the ear. Brand name procedures for facelift such as the ‘LifeStyle Lift’ or ‘Quick Lift’ are still a form of facelift. One method is not superior over another and the best treatment for you will be determined during your consultation with a board-certified plastic surgeon.
What will my facelift incisions and scars be like?
Regardless of the type of facelift you undergo, you will have incisions that involve the skin around your ear.
1. The incision line usually runs along hairline and within the natural contours in front and behind the ears.
2. Skin is then pulled back and the incision is closed.
Traditional facelift: Your surgeon will make incisions in your hairline at the temples, continuing down and around the front of your ears and hidden in the natural creases behind your ears in your lower hair-bearing scalp.
Limited-incision facelift: Your surgeon will make short incisions in your hairline, starting at your temples and continuing down and around the front of your ears, hidden in the natural creases. There may also be incisions in the lower eyelids, temporal area, or under the upper lip.
Neck lift: Your surgeon will make incisions starting in front of your earlobes and continuing around behind your ears in your lower scalp. There will also be a small incision underneath your chin.