FOURTH QUARTER 2007, VOLUME 21, NUMBER 2

Controversies in facelift surgery, your options, what’s new, and what works for you

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Controversies in facelift surgery, your options, what’s new, and what works for you

Ask the Surgeon / Health Tip / What’s New

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Are you looking for a dramatic difference in your appearance? Are you willing to have extensive surgery? Would you prefer as little downtime as possible after surgery with subtle results? Although these questions cover the extremes, you could still be talking about the same procedure– a facelift.

From its early days in the 1920s until today, the facelift has evolved to provide more natural results and to meet the changing demands of the consumer. Today, more patients are seeking minimally invasive techniques, which has inspired a variety of facelift offerings—all with the goal of personalization to meet the patients’ needs. Remember that a minimally invasive procedure may or may not correct the areas that are concerning you.

Ask yourself what improvements you would like to see. The facelift typically improves the lower two-thirds of your face. It addresses sagging skin, fat, and muscle. The angle of your neck and lower jaw can also be restored to a more youthful appearance. Your surgeon will work with you to decide which technique will bring you the optimal results you seek. The key is an individualized approach. The following options will provide you with a starting point to discuss at your consultation appointment.

Full Facelift
A full facelift, or traditional facelift, is designed to remove accumulated fat, re-support the neck muscles that have stretched, and remove excess skin—primarily in the lower two-thirds of the face. It smoothes the neck area, reduces jowls, and refines the jaw line. The facelift procedure can improve wrinkled skin; however, skin type and patient age are important factors in the result.

Incisions are made around and behind each ear. The skin is raised, excess fat and skin are removed, the underlying connective tissue is lifted and repositioned, and permanent or long lasting absorbable sutures are used to hold the soft tissue and overlying skin in its new location. The surgery is typically performed taking two to four hours depending on the extent in an outpatient facility or in a hospital setting. Patients return home the same day of surgery. Swelling diminishes after one to two weeks.

Deep plane facelift
The deep plane facelift was developed in the 1980s and is more extensive than a full facelift. The deep-plane facelift uses the deeper tissues to reposition the facial muscles and the cheek fat pad. The focus is on tightening and fixating the sagging deep soft tissue and the SMAS layer (superficial muscluloaponeurotic system). The muscles and fat pads of the cheek and midface are elevated and then secured in their new, youthful position. While the deep-plane facelift allows more facial sculpturing to correct problems in the cheek and midface region (e.g., reducing the appearance of deep creases between the nose and the mouth), the procedure is more invasive and requires a longer recovery period.

Midface lift
This lift has been used for the past decade. It is performed through tiny incisions placed inconspicuously within the hairline and on the inside of the mouth. During the procedure, the fat pads of the cheeks are repositioned up and over the cheekbones where they belong. This redraping improves the nasal furrows and restores a more youthful appearance. This option is advantageous to the patient seeking improvement in the cheek and lower eyelid area, which the traditional facelift cannot provide.

Most important: Choose the right facelift to achieve the right results. Ensure that your facial plastic surgeon is trained in multiple techniques so that you are not limited to a single operation. While younger patients may require less extensive procedures or older patients may request less downtime, recent advances in techniques and modern variations to the traditional facelift offer a wide range of procedures to fit your needs. Trust your face to a facial plastic surgeon to personalize your procedure to decrease operative time, reduce postoperative complications, and provide optimal results. Make your appointment to discuss your facelift today!