Facelift

I get this question very frequently. There are many variations to a facelift, from the placement of incisions to how you dissect and suspend the deeper structures, to attain and maintain a long lasting youthful appearance. A mini facelift usually has shortened incisions and less dissection of the soft tissues of the face that you want to have lifted for a very long time. My general philosophy is mini facelift-mini result…unless it is a younger patient with isolated areas to treat. I would probably recommend a standard facelift, which would give you a more comprehensive, long lasting result. Many patients try to cut corners and do less, while expecting the same result, but I always say “if you don’t want to do it right the first time, you will need to set aside more time to do it right later.”

If you have good skin elasticity and in general good health, neck liposuction can be a very easy procedure to undergo with a fast recovery. If you do not need a facelift, and just liposuction, you will only have a small bandage under your chin for a week that is virtually unseen. Most patients will go back to sedentary work after 2-3 days, but there may be a minor amount of bruising in the mid to lower neck. Swelling is a minimal in almost all patients. I do not routinely have my patients wear a restrictive garment around their necks postoperatively. It usually takes three to four months to fully appreciate the results due to minor swelling.

In patients who have facial wrinkles due to soft tissue volume loss, fat auto transplantation is an alternative to traditional facelift. Fat injection is a significant part of my practice, however I mostly use it to enhance traditional facelift results. I believe that in general, less invasive methods yield less impressive results.

Every patient is different when it comes to planning rejuvenation of the neck. In general, I place a small incision beneath the chin so I can safely remove excess fat and tighten the deeper soft tissues of the midline neck for a sharper contour. For a neck lift, I place incisions in the crease behind each ear for minimal visibility. For a facelift, I place the incisions behind the ears and in front of them as well. This allows for removal of excess skin. They are concealed as best possible around the ear canal and sideburn region. I always reassure my patients that they should be able to wear their hair any style they choose once healing has occurred without the worry of scar visibility.

I almost always use general anesthesia for rhinoplasty procedures. Most facelifts are also performed under general anesthesia or IV sedation. The anesthesia I use for endoscopic brow lift is general, but I will use IV sedation for other brow lift techniques.

I perform CO2 laser resurfacing. This provides generalized tightening of the face and reduces wrinkles and acne scarring. The risks of laser resurfacing are infection of the skin, prolonged redness, lightening of the skin, and areas of increased pigmentation. Overaggressive laser treatment can lead to scarring as well. Following the specific postoperative guidelines which include topical applications, oral medications and avoiding direct sun exposure minimizes these risks.

Recent studies have shown that the thread lift does not provide appreciable long lasting results. This has led many surgeons to abandon this procedure. I personally do not perform this operation. I do however believe that CO2 laser resurfacing provides an overall tightening of the facial skin. Many former smokers who have deep wrinkles and moderate sagging of the skin benefit from full face laser resurfacing. This does, however, sometimes cause lightening of the skin, and healing time can be just as long as standard surgical facelift.