A Facelift also called Rhytidectomy, Facialplasty or Meloplasty can give some of the most impressive results of any surgery. This surgery has been around since the 1920’s or perhaps earlier. Earlier types of facelifts were much more simple and produced less impressive results. Modern facelift surgery uses more advanced techniques and gives better more impressive and longer lasting results.
Over the years facelift surgery has grown in popularity. This is partly due to the fact that men and women are living longer, healthier and more vigorous lives. Patients often correctly state that they look older then they feel, both physically and mentally. With the advances in medical science, more and more patients want to look as good as they feel. Fortunately a well-performed facelift can often make a patient look eight to fifteen years younger. This is especially true if other procedures are performed such as a chemical or laser peel, blepharoplasty (eyelid lift, eyelid enhancement surgery) or forehead lift (brow lift surgery). Many patients feel a great boost in self-esteem after having facelift surgery.
The answer to this question varies greatly depending on a patients goals, skin, and current appearance. Facelift surgery is performed for two main reasons: to prevent aging for instance in a young individual (someone 40ish) or to correct an aged appearance (i.e. someone 60ish). A Mini-facelift may be appropriate for someone in their early forties if they desire maintenance rather then a corrective procedure. In such a patient the goal may be to keep a young appearance rather then wait until they look “old”. This is most often the approach of movie stars and other “showbiz” personalities. More commonly patients prefer to wait until they are more aged and use a facelift as a restorative rather than preventive procedure. For these patients they wish to look much younger and have waited longer to have the facelift surgery.
The face can be divided into three parts. The forehead, the cheek area and the neck area. The standard facelift corrects the cheek area, jowls and neck area. This means a facelift includes a necklift. It does not correct the forehead area. For this area a forehead lift (brow lift) is needed. Also a facelift does not correct aging eyelids, for this problem a blepharoplasty (eyelift, eyelid enhancement surgery) is needed. A patient who only wants their neck folds corrected can have just a necklift (see the necklift section in this website).
The degree of improvement for facelift surgery depends partly on how aged the person looks and on the quality of his or her skin. If a patient has very loose, thin, sagging skin the results can be dramatic. If a patient is younger and having a facelift mainly for prevention, the results may be more subtle but still important. Facelift surgery generally corrects the deep wrinkles such as the jowls, the deep neck wrinkles or “turkey Gobbler” deformity, and the “marionette lines” which form at the corners of the mouth. It also softens the deep cheek creases (nasolabial folds). Facelift surgery is not used to improve skin texture problems such as age spots or fine wrinkles or smile lines. For this problem we need skin resurfacing techniques such as Dermabrasion, Chemical Peels or Laser Peels (see the chapter on Skin Resurfacing).
It is important not to look “operated on” or pulled or stretched after facelift surgery. It is much better to leave a few wrinkles, than to pull the face so tight that it looks stretched or fake after surgery. Dr. Lane Smith is very good at giving the patient a natural result.
A frequent question is how long does the surgery last? Many people have the mistaken idea that a facelift lasts only for a certain period of time and when that time is up, the face suddenly sags and the patient returns to his or her normal aged appearance.
The facelift works by turning the clock back. It does not stop aging, but after the facelift, a patient’s face will begin aging at a normal rate from that “new younger point”. The facelift does not have a finite duration. That is to say it does not suddenly stop working. The patient will always appear younger than if he or she had never had a facelift. However, it is important to know that the actual texture of the skin is not altered by the facelift. For that a resurfacing procedure is needed.
There are several options for the younger patient, in their 30’s and 40’s, who want facial rejuvenation. One option is the mini-facelift or mid-facelift. Another, sometimes better, option; is simply fat transfer to the cheeks and face. Fat transfer is a fairly simple procedure that lifts and fills the face restoring the youthful, full cheek volume that gets lost as we age. Fillers may also be useful (see the section in this website on Fillers and Botox).
As the face ages the subcutaneous layer of fat atrophies (becomes thinner). Also, the bony structure of the face atrophies (becomes thinner and less prominent). This leads to a general decrease in facial volume. When a facelift is performed we attempt to lift up the tissues that are sagging and move fat from the sagging, bulging areas to hollow areas or areas that should be more full such as the cheeks. For example, the jowls that are sagging contain fat that can be repositioned to a higher area and help restore youthful fullness to the face. Another very helpful adjunct to facelift surgery is fat transfer to the face. This helps restore the youthful volume to the cheeks and assists in lifting the face.
Unless a patient has a very fat face, fat transfer is always recommended for facial rejuvenation. It adds volume to the face that was present in youth and is lost with age. Fat helps lift the face, and prevents a stretched or fake look after a facelift. In addition to this there are stem cells in the fat and these can help rejuvenate the skin by possibly increasing the collagen and elastin content of the skin.
A necklift is part of the full or standard facelift. There is no extra charge for this. In other words, when you get a full facelift, the neck is also lifted. The forehead is not part of a full facelift.
While there is currently a great hype regarding the “lunch- time” facelift, “mini-facelift,” there is really nothing new or amazing about these lifts. These are mostly used as marketing tools. The earliest facelifts done in the 1920’s were mini-facelifts and many of the current techniques for “mini-facelifts” are copies of those early facelifts. At that time, surgeons did not understand the anatomy of the face and were afraid to do any extensive undermining and lifting. Hence the early facelifts involved simply cutting out a small amount of skin in front of the ear and pulling the skin back. What they discovered then, and what still holds true today, is that these “mini-lifts” produced “mini” results. If a patient truly wants a mini-facelift we are happy to perform one. The advantage of these lifts is a smaller scar and little or no bruising. A disadvantage is frequently the neck is not adequately addressed with a mini-facelift. The results are clearly not as long lasting or as impressive as our standard facelift. A good use of the mini-facelift is in the younger patient in their mid 30’s to early 40’s, especially combined with a fat transfer. In these patients a mini-facelift may be beneficial until a full facelift is needed.
There is currently a great deal of advertising regarding the Lifestyle or Quicklift. In Dr. Smith’s opinion these types of lifts are overrated and the hype is mainly a marketing ploy. Also, the claims of immediate recovery are greatly exaggerated. These lifts require as much recovery as more complete facelifts. While the names can be trademarked, there are no patents on actual surgical procedures. Hence any surgeon can perform them. Dr. Smith can perform any type of facelift and if the patient wants one of these types of facelifts he is happy to perform them. However, he usually does not recommend them because they rely heavily on sutures to pull the tissue up and less on actual tissue repositioning and skin excision. Hence, these types of lifts do not provide long lasting results in the majority of patients. Lifestyle lift was recently fined $300,000 for placing false reviews online.
A facelift can be performed under general anesthesia or under local anesthesia with sedation.
The facelift operation consists of removing the excess skin and repositioning and supporting the skin and underlying structures of the face and neck area. The hair does not have to be shaved or cut for the surgery. There are many variations to the surgery and Dr. Smith will adjust the surgery as needed to fit the needs of the patient. This discussion is a simplified and general description of the surgery. Also the standard facelift is often combined with fat transfer and other procedures such as a forehead lift or blepharoplasty. If a patient wants total facial rejuvenation and the very best results, some sort of facial resurfacing procedure is usually needed at a later date, as well as a good skin care regimen.
The incisions are made to be well hidden and not visible after surgery. Depending on each individual patient there may be slight variations in the design of the incisions. The incision begins in the hair above the ear and runs downward just in front of the ear and is hidden in the natural creases located there. It continues down around the earlobe behind the ear and then back into the hairline behind the ear. We usually begin by doing some liposuction in the neck area. Liposuction is not done on patients who have very thin necks, but most people as they age tend to deposit excess fat in the neck area. The deep creases seen in the neck are created because the platysma muscles of the neck attach abnormally to the undersurface of the neck skin. After neck liposuction these are then released from the skin and the muscles tightened and lifted. This corrects most of the aging neck appearance. Next we go to the areas around the ear. The skin is then lifted up almost all the way to the corner of the mouth on both sides. The entire neck skin is also lifted up from one side to the other. Underneath the skin there is a structure in the face called the SMAS. This structure is a remnant of the Platysma muscle in the neck. It can be grasped and pulled upward. This lifts the deeper structures of the face and makes for a better and longer lasting facelift. After the SMAS is elevated and secured with sutures, the skin is then laid back down and the excess is trimmed off. Then the incisions are very carefully closed. The incisions are closed in several layers, beginning deep under the skin and then along the skin. The sutures are all dissolvable sutures and will not need to be removed. The head will be carefully wrapped in a turban-type dressing. This dressing will be removed after one or two days and replaced with spandex type ‘face bra”. We ask patients to wear this supportive band as much as possible for the first 4 or 5 days. After that they should wear it at night and after work for at least another 2 to 3 weeks. The sutures are dissolvable and do not need to be removed.
The recovery after a facelift is not particularly painful. This is because there is some numbness produced by the incisions. This numbness is most pronounced around the ears and typically will go away after a few weeks but may persist for longer, sometimes even months. The swelling and bruising may take as long a 6 or 7 weeks to go completely away, but typically it will be unnoticeable to most observers by about 10 to 14 days. You should be able to be up and around the evening of your surgery. Patients may return to work as early as 5 or 6 days as long as they don’t mind going to work bruised. If you want to go out in public without any bruising at all you will probably need 10 to 14 days. With regard to exercise you may begin light exercise at 3 weeks and heavier exercise at 4 weeks after surgery. The incisions can easily be hidden by the hair especially in women. In men there is a small incision just in front of the ear that is usually not visible, but it may be slightly visible until the redness fades. Remember that the scars continue to improve for over a year after surgery.
Facelift surgery can dramatically refresh your appearance and take years off your face. Dr. Smith’s reputation, experience, board-certifications, and excellent results speak for themselves. The results of any type of plastic surgical procedure depend a lot on the surgeon. It is nice to know that Las Vegas has one of the best plastic surgeons in the entire country. People come from all over Las Vegas, Henderson, Nevada, Utah, California and the world to have Dr. Lane Smith perform surgery on them. If you are wondering if you are a candidate for facelift surgery it is best to make an appointment with Dr. Smith. Appointments can be made by calling the Smith Plastic Surgery Institute at 702-838-2455 or by contacting us on the web at firstname.lastname@example.org. For patients that live a long distance from the Las Vegas and Henderson area, phone consultations or email consultations are available.
A mini facelift is designed to improve advanced facial aging in the mid-face, cheek, and lower eyelid. This procedure will help to re-establish facial balance, giving an overall lift to the neck and lower third of the face. Traditional facelift surgery treats all sections of the face.
Depending on your individual concerns, there are a different types of neck lift procedures to choose from that can help improve the appearance of your neck:
It is common to combine a neck lift procedure with other cosmetic surgery such as a facelift, chin lift or any procedure that improves the jawline, jowls and cheek area, which might involve liposuction. During a neck lift, one-inch incisions are strategically placed under the chin and/or behind the ears to tighten up neck muscles that have become loose over the years. Patients with greater laxity may require a longer incision behind the ears.
The procedure, usually performed under local anesthesia with IV sedation, first releases the muscle from the skin before the neck muscles are pulled tight. After the skin is tightened, excess skin is eliminated through additional incisions around the ear.
A cheek lift and neck lift—in which lax muscles are tightened and elevated to a more youthful position—combined with liposuction along the jawline can permanently restore definition to the lower face.
Excess neck skin removal (called cervicoplasty) is performed by making an incision under your chin and behind the ears. The surgeon will then cut back and lift the skin, which will be secured with permanent sutures or a special type of permanent adhesive glue.
Another neck lift procedure, platysmaplasty, is performed to reduce the banded appearance of the neck. During the procedure, incisions will be made under the chin or behind the ears, or both. The surgeon will then insert a tiny instrument to either remove a portion of specific neck muscles or realign them, which will tighten the middle area of the neck. As with a cervicoplasty, your doctor will suture areas of the muscles in order to clasp them in the best position.