Face Lift

The two most common signs of facial aging noted by patients are tired looking eyes and a sagging neck. Wrinkles, sagging skin, jowl and neck laxity are more and more the reason many are opting for a face lift. This operation has become very commonly performed, and is no longer reserved for celebrities. Results could last 5-10 years depending on skin, environmental exposure and genetics.

Surgical Options:

An incision is made immediately in front of the ear extending behind the ear by the earlobe. The skin, fat, and muscle are separated, lifted and then re-draped to a more youthful-appearing position. Usually the skin lifted as a separate entity upward, but the real work is in the SMAS or deeper muscular layer beneath the skin this is lifted as a separate layer from the skin lifting it upper andoutwrad thus achieving two separate vectores of pull. The excess SMAS is removed and the dissected flap of SMAS is anchored to th estable SMAS to prevent premature descent. Types of lifts include: deep plane face lift, SMASectomy (superficial musculoaponeurotic system) underneath the skin but above muscles, glands, nerves and vasculature of the face lift, and other advanced face lift techniques. Suturing is done in a way that minimizes scarring, rendering it virtually invisible after the initial healing period.

Recovery:

Face Lift surgery is performed on an outpatient basis under local and/or MAC with oral or IV sedation and usually takes 3 to 4 hours. Stitches are removed in 7 to 10 days. Most patients return to work after 2 weeks. For patients interested in traveling to New York City, face lift surgery necessitates usually a minimum one week stay.

Doctor’s Ideology:

There are many ways to perform a face lift, thus no cookie cutter solution to a particular face. Age is not the determinant for when a face lift should be done or what type of face lift but rather a patient’s bony anatomy, skin elasticity and soft tissue volume. There are many short cut face lifts and thread lifts that pass sutures without incision in an attempt to lift tissues, often these work in the short term. I do not believe this is a great solution to address the aging face, but rather falls under the category of maintenance therapy which should be repeated often. I rarely recommend the abridged face lift. There is much apprehension towards the face lift look. I have lectured and published significantly on the importance of meticulous closure around the ears to avoid the telltale signs of a facelift, as well as pulling the skin too much to avoid the “windswept” and “joker” look. To date there is nothing that addresses a sagging neck or jowls as significantly as a facelift.

Actual 6 month post operative facelift patient, not imperceptible scar with very natural looking ear after surgery.

Avoiding the Tell Tale Signs of Facelift Surgery:

The signs of the overdone or poorly executed facelift are frequently seen around us. I am very meticulous about the way I close my facelifts in that I employ various techniques to avoid that operated look. It is important to maintain the natural face. Closure around the entry point of the facelift is around the ears. One should not see scars or pulling of the ears. One complication is a pixie ear in which the lobule of the ear looks as though it is connected to the jawline, this should be avoided. Please see below an actual post operative facelift patients ear one year after surgery. Note the complete lack of an operated appearance. The ear looks natural.