Aging of the face occurs when the soft tissues of the cheek "fall" down to, or below, the level of the jaw. This results in jowls and deepening of the crease from the nose to the corner of the mouth. Simultaneously, the skin and muscle of the neck loosens and hangs. A facelift is designed to counteract these movements.
There are many types of facelift techniques, but I employ the most advanced, which is not only tightening the skin, but reconstructing the deeper tissue layer called the SMAS. The SMAS is the layer of tough tissue under the skin that is sagging in the cheeks, and which extends down and includes the muscle of the neck. The SMAS layer is elevated and tightened, and may also be combined with liposuction of the neck. The skin then is tightened gently over the reconstructed SMAS. This is the most natural looking facelift (avoiding that "pulled look"), and longest lasting (probably 7 to 10 years and often longer). My computer imaging is very accurate to show you what you might look like after a facelift. In addition, I will show you many actual patients who have similar problems, and then show you their results after I performed their surgery.
The scar of a well-performed facelift should be only minimally noticeable, even if the hair is worn short or back. This requires meticulous stitching (I use only dissolvable sutures under the skin, not on the surface), and weaving the scar inside the natural lines of the ear, and up into the hair. This takes more time in the operating room, but is definitely worth it. During the consultation, I will show you exactly where these scars occur, and we will look at many pictures so you can see how it fades over time.
A “rhytidectomy” is performed by making an incision that starts in the temple area. The scar then comes down and follows inside the cartilage of the ear, then around the earlobe, behind the ear, then across and down along the neck where the skin meets the hairline. The SMAS is tightened under the skin. This longer incision may be required for patients who have an unusually large amount of neck skin that needs removal.
The "short-scar rhytidectomy" or MACS lift is the newest evolution of facelift techniques designed to limit the length of the scar, to just around the ear, but not up behind the ear or down along the neck hairline. Because of our improved instruments, I can still completely reconstruct the SMAS as I do during a regular rhytidectomy, but now using a much shorter incision. This can achieve a terrific result in the selected patient. As shown in this patient, you don’t get the “pulled look”, and can actually make you look like you have lost weight by correcting the neck and chin area. This now is the most common type of lift I perform. Many people also call this a “mini-facelift”.
The "weekend-facelift" or necklift is a technique designed to tighten the neck muscles, and remove fat of the neck with liposuction, but the SMAS is not reconstructed. In selected patients, this can give an excellent effect without the longer healing time of a complete facelift. The jowls and cheeks, however, are not changed by this procedure. This technique can also refresh a previous facelift.
Because of the different types of facelifts, rhytidectomy, short-scar rhytidectomy, or necklift, you can see the value of your consultation. We will address your goals, your anatomy, and the best technique for you.
I take extra care to give you a natural-looking face, and use special techniques to minimize your scars. As is true with all plastic surgery procedures, this is more “art” and skill than many people realize, so different surgeons may get very different results. It is your job to evaluate your surgeon’s skill.
At what age should a patient have a facelift? While the tendency now is for younger men and women (in their 40's and 50's), to undergo this procedure, rather than waiting until their 60's and 70’s, a skilled plastic surgeon using these advanced techniques can obtain a more natural-looking, longer-lasting result no matter what the age. I routinely perform this surgery on patients ranging from their 40’s to their 80’s, tailoring the surgery to meet their specific goals.
Surgery: Facelift surgery requires sedative anesthesia (not general), usually administered by an anesthesiologist, takes appx. 2.5 to 3.5 hours, and you go home the same day. Drains are not necessary (and uncomfortable!). A chin strap is worn for one week, and then at night time only for the second week.
Healing time: Ice or frozen peas are used around the eyes for the first 24 hours. Clips in the hair are removed on the fifth day. Walking is started immediately, limited exercise starting at 2 weeks. You feel OK, but the bruising and swelling around the eyes and neck keep people off work or away from major social activities for 2-3 weeks. Mini-facelift patients usually have bruises located only in the neck which may last for 3-7 days.
Pain level: Surprisingly, most people experience very little pain. During your consultation, I will explain why this is true. Rank=2-3 Pain information
Risks: The scars are hidden around and behind the ears, and sometimes under the chin. The cheeks and possibly ears will be numb but this diminishes with time. The neck and face will feel tight for weeks. Low risk of bleeding or areas of the skin that don't heal properly (but this is increased in smokers). Other risks. Risk information
Costs: $9,000 to $11,000 total (depends on the type of lift and type of anesthesia). Cost information