FaceLift (Rhytidectomy) by Wave Plastic Surgery & Aesthetic Laser Center

As we age, gravity affects all parts of the body including the face in men and women. The effects of gravity is seen starting in the late 30s but more apparent and prominent in the 40s, 50s, and 60s with more lines, less facial muscle tones and sagging cheeks. A good facelift reverses the signs of aging with a natural appearing look and avoids making the face appear wind blown.

Facelift procedures only deal with the lower 2/3 of the face and neck. The upper 1/3 of the face and eyelids are different regions that also need to be addressed with a facelift. Since aging affects both the skin and muscle, both need to be corrected. Just tightening the skin or suspending the skin with threads or strings is inadequate. Tightening and resuspending the under lying muscle, and removing the excess skin will achieve a natural youthful appearance. The goal of the face lift is to restore the various structures back to its normal anatomical position.

At our certified outptient surgery center, this procedure is performed either with general anesthesia or under iv sedation with local anesthesia. The incision is made starting inside the hair above the ear, and down in front of the ear, and then behind the ear tracing down to the hairline in the neck. The skin is not lifted up much, but a layer of tissue called the SMAS/platysma is elevated extensively. This is used to re-elevate the facial structures and reposition the tissues to it/s more youthful location. This ensures a natural appearance.

After the procedure, you will need to do serial follow ups to receive medications to minimize swelling. You will be given specific instructions to how and when to wash your hair. Sutures will be taken out in 5 days then in 10-12 days and you will need to wear a facial garment to help minimize swelling and help reshaping the neck line. Most of the scars are well hidden and they will fade over time. Temporary swelling and numbness of the face are expected and the patient usually can return to work in 2 weeks.

+There are numerous details & techniques in performing a meticulous Facelift to ensure beautiful results:

Incision has to be precisely perpendicular so that there is good approximation during closure to ensure a scar that will be hardly noticeable.

Near the cartilage portion of the ear, the skin has to be cut thin so that the area appears more natural.

Skin undermining should be minimal to ensure smoothness and less disruption of blood vessels so that there is faster and better healing.

The SMAS/Platysma tissue should be extensively undermined to reposition tissues.

There are tissues called retaining ligament which must be completely released to assure a tension free movement of the soft tissue. These ligaments are located along the malar bone, cheeks, and along the jaw and chin. By releasing these ligaments, we have the freedom to reposition many droopy tissue in more youthful location.

For people with wrinkles along the side of the eyes, the muscle can be transected to weaken the lines.

For people with nasojugal groove-a line beneath the malar bone and the cheeks, the malar fat pad must be separately elevated and suspended.

Patients with heavy nasolabial fold, should undergo careful micro liposuction over the malar fat pad or have fat grafting to the nasolabial fold.

Patients with heavy jowls, should also undergo careful liposuction of the overlying fat. Also, the retaining ligaments of the jawline must all be released to the chin area.

Patients with wide lower third of the face who wishes for a slimmer look can benefit from removal of the buccal fat pad.

For some areas that are depressed, SMAS can be folded upon itself to augment certain areas such as submalar region.

Corner of the mouth can be elevated to give patient a more fresher appearace.

For people with heavy fat neck, the neck must be very aggressively treated. Not only is the Platysma/skin pulled from the sides, but also from the middle. A small incision is made in the natural crease under the chin. Through this area, the fat underneath the skin is removed. Also, there is a fat layer underneath the platysma muscle called the subplatysmal fat pad which should be removed. Then the platysma can be tightened both from the middle and sides.

SMAS that is trimmed during surgery can be used to augment areas that are depressed. Some of the more common areas are submalar region, nasolabial fold, and lips.

All of the pulling tension is placed on the SMAS layers. The skin is allowed to just redrape. This ensures smoothness of the face and good scar healing.

Constant reference to the preoperative photographs to ensure accuracy and symmetry.

These are some of the examples that must be considered on all patients. This kind of approach to all facelift ensures not just better aesthetic results, but also more natural appearance of the face.

+Facelift procedure steps

Step 1 – Anesthesia

Medications are administered for your comfort during a facelift procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

A variety of other procedures can further enhance the outcome of a facelift. They include:

Facial implants

Soft tissue augmentation to recontour the facial structure

Resurfacing techniques to improve the tone and texture of facial skin

Wrinkle reduction by injection

Step 2 – The incision

Depending on the degree of change you’d like to see, your rhytidectomy surgery choices include a traditional facelift, limited incision facelift or a neck lift.

A traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp. Fat may be sculpted or redistributed from the face, jowls and neck. Underlying tissue is repositioned, commonly the deeper layers of the face and the muscles are also lifted.

Skin is redraped over the uplifted contours and excess skin is trimmed away. A second incision under the chin may be necessary to further improve an aging neck. Sutures or skin adhesives close the incisions.

Traditional Facelift

An alternative to a traditional facelift uses shorter incisions at the temples, continuing around the ear and possibly within the lower eyelids or under the upper lip.

Limited Incision

Sagging jowls, loose neck skin and fat accumulation under the chin may be corrected with a neck lift. The neck lift incision often begins in front of the ear lobe and wraps around behind the ear ending in the lower scalp.

Neck Lift

Step 3 – Closing the incisions

Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear.

Step 4 – See the results

The visible improvements of a facelift appear as swelling and bruising subside. Your final result should not only restore a more youthful and rested appearance, but also help you feel more confident about yourself.

Information & images are courtesy of ASPS®

What is FaceLift Surgery?

If you are bothered by signs of aging in your face, facelift surgery may be right for you. Technically known as rhytidectomy, a facelift is a surgical procedure to improve visible signs of aging in the face and neck, such as:

Sagging in the midface

Deep creases below the lower eyelids

Deep creases along the nose extending to the corner of the mouth

Fat that has fallen or is displaced

Loss of muscle tone in the lower face may create jowls

Loose skin and excess fatty deposits under the chin and jaw can make even a person of normal weight appear to have a double chin

Rejuvenation procedures typically performed in conjunction with a facelift are brow lift, to correct a sagging or deeply furrowed brow, and eyelid surgery to rejuvenate aging eyes.

What facelifts won’t do:

As a restorative surgery, a facelift does not change your fundamental appearance and cannot stop the aging process.

Is it right for me?

A facelift can only be performed surgically; non-surgical rejuvenation treatments cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate and complement the results of surgery. Facelift surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires to to try to fit any sort of ideal image.