Facial Rejuvenation via Facelift

Facial rejuvenation via facelift is a cosmetic surgery that tightens and lifts aging skin on the face into a better position to provide a more youthful appearance. A facelift, also known as a rhytidectomy, can address natural signs of aging including:

• Sagging skin
• Bags under the eyes
• Loose jowls
• Fullness in the neck
• Forehead wrinkles
• Fine lines

Facial rejuvenation via facelift can reduce the look of tired and aged skin and leave the patient with fresher, rejuvenated skin.

Am I a Good Candidate for Facial Rejuvenation via Facelift?

Facial rejuvenation via facelift does not really have an age limit but most candidates are in their late 30s to 60s.

A GOOD CANDIDATE includes:

• Any male or female patient experiencing visible signs of aging on the face and/or the neck
• Any patient willing to undergo surgery to correct loose or sagging facial skin, neck fullness or bands
• Those who want better definition of the chin and jawline
• A person with sagging skin who still has some skin elasticity and a well-defined bone structure to provide support
• Someone with skin that is flexible enough to conform to its new contours with a natural appearance

On the other hand, someone who is NOT A GOOD CANDIDATE includes:

• Patients who are not willing to undergo surgery
• Those who cannot afford to take time off work for adequate recovery time
• Patients without adequate bone structure may need facial implants as well as a facelift

How is Facial Rejuvenation via Facelift Performed?

There are many different types of facelift procedures, with varied techniques, and several options for anesthesia. While some procedures require general anesthesia, others can only be performed using local anesthesia with oral sedation. A procedure performed under local anesthesia may be done in an accredited medical office. A procedure performed with general anesthesia should be done in a hospital or surgical facility.

• Traditional Full Facelift – This type of facelift addresses the full face and is typically performed to recover from the more severe signs of aging or to make dramatic improvements. A full facelift can address the area below the eyes, lines around the mouth, sagging of the cheeks, excess skin and fat at the jowls and fullness under the chin. This procedure is popular among patients in their 50s and 60s. However, since a full facelift treats a large region, the incisions are required to be longer. During this facelift, the surgeon will make an incision along the temple, around the ears and down towards the neck.   
• Mid Facelift – A mid facelift is used to address the tissues below the eyes and around the cheeks. The incisions are similar to a full facelift but the surgeon dissects the tissue a little deeper, to lift the muscles, which are usually unscathed during a full facelift. Facial implants or fat grafting is often used in conjunction with this procedure to enhance or define the cheekbones. Since this facelift targets less of the face, it may be more suitable for patients in their 30s and 40s.
• Lower Facelift – This type of facelift only targets the bottom third of the face. Patients of any age who want to have the sagging in the corners of the mouth lifted, deep nasolabial folds reduced, the jowls eliminated and the jaw enhanced typically choose this option. A lower facelift finds the doctor making an incision along the patient’s ears and hairline.  
• Mini Facelift – A mini facelift is often referred to as a “weekend facelift” since it involves shorter incisions and less recovery time. Nevertheless, it can still take about a week to recover. This type of facelift improves aging on the lower cheeks, jaw and neck. The incisions are usually made along the hairline and behind the ears. The muscles will be lifted into a better position and the excess skin and/or fat is removed. A mini facelift is typically recommended for younger patients with mild to moderate signs of aging.

Multiple Techniques

While there are many facelift procedures to choose from, there are also various techniques used by the surgeon.

• Many facelifts, including the mid and lower lifts, are performed with endoscopic technology. This technique consists of using a microscopic camera, attached to a small wand, to navigate the procedure. The endoscope will be inserted through an incision while two other incisions are used to lift the muscles and remove excess tissue from under the skin layer.
• Many doctors use the more comprehensive SMAS (Superficial Muscular Aponeurotic System). The SMAS is a thin, strong layer of supporting tissue that covers and surrounds the deeper facial tissues, structures and muscles. The surgeon will lift and tighten this structure to achieve overall facial rejuvenation. The SMAS layer is folded and attached to it with permanent sutures. The skin is re-draped over the facial contours and excess skin may be removed. All incisions will be closed with sutures or skin glue.
• A deep plane facelift allows the surgeon to work below the SMAS layer. With this deeper technique, the SMAS layer and the fat pads in the cheeks will be lifted vertically as a unit. The SMAS layer is also connected to the platysma (neck muscle) so a neck lift is often done in conjunction with a facelift. This is especially true with a lower facelift since the lower portion of the face and the neck age relatively the same. This portion of the procedure may require a small incision under the chin within the natural fold.
• The thread facelift is often referred to as a “lunchtime lift” since it only takes around 1 to 2 hours and is considered a minimally invasive procedure. The doctor uses tiny stitches, just below the skin, to lift the muscles. A thread facelift can usually be completed without anesthesia and no visible scars will show. This type of procedure is only for minor improvements and is most appropriate for patients in their 30s and 40s.
• A cutaneous facelift is the oldest type of facelift and is not really performed very often because the results can leave the patient with a stretched or unnatural look. Plus, the results are not long lasting. With this procedure, the surgeon will make a long incision along the hairline and lift only the skin into a higher position. This procedure is often called a “skin only” facelift.

Alternative Treatments

Other alternatives for facial rejuvenation include dermabrasion, chemical peels and dermal fillers. Dermabrasion and chemical peels use abrasive materials to remove the top layers of skin to provide smoother skin and fewer wrinkles. However, they are not really used to treat other signs of aging such as sagging skin or excess fat. Dermal fillers add volume to areas that lack fullness and to smooth out folds or wrinkles. However, fillers are temporary and will need further injections to maintain the results.

Treatments Combined with Facelifts

Facelifts are also done in conjunction with other cosmetic procedures such as facial liposuction, facial implants, eyelid surgery or blepharoplasty to provide even more of a rejuvenated and younger appearance.

What is the Cost of Facial Rejuvenation via Facelift?

The cost of facial rejuvenation via facelift varies according to the surgeon’s skills, fees charged by the facility and the geographic location of the procedure. The type of facelift also contributes to the cost. The cost of a full facelift will be greater than a mid-facelift or a mini facelift since those procedures take less time and have smaller incisions. The average cost of a facelift is in the range of $6000-$12,000. Some facelift procedures can be performed under local anesthesia with oral sedation which is more cost-efficient than general anesthesia. Furthermore, the cost will be significantly increased if other cosmetic procedures are performed at the same time.

Recovery and Downtime

The amount of RECOVERY and DOWNTIME depends on the type of facelift procedure and how quickly the patient heals. Patients who choose the endoscopic technique usually have a faster recovery time since the incisions are much smaller. Likewise, a patient who has a mini facelift will recover much quicker than someone who had a full facelift. Furthermore, the recovery and downtime are also determined by whether or not it is simply a facelift or a combination of cosmetic procedures.

Patients can expect some swelling and discomfort but this can be managed with pain medications and cold compresses. The incisions will be covered by bandages and small drainage tubes may be placed within the incision to excrete excess fluid over the first 48 hours. These tubes will be removed in a day or two at a follow-up visit with the surgeon. Keeping the head elevated for the first two weeks, and changing the bandages as directed, can help to speed recovery. Any bruising can last for 7 to 14 days but it will resolve on its own. Numbness of the facial skin and/or neck is normal and will usually improve over a few weeks. Avoid saunas, hot tubs, swimming pools and getting the face wet until the surgeon advises otherwise.

During the first week of recovery, patients should get plenty of rest but they are encouraged to walk around to stimulate blood flow. Stitches will be removed around 5 to 7 days post-op. Makeup should not be applied until the doctor gives approval. While swelling and bruising can persist for several weeks, most patients can go back to light duty work after 1 or 2 weeks. Engaging in strenuous activities should be avoided until the doctor advises otherwise.

Results

Results from facial rejuvenation via facelift can take some time to become visible. Procedures such as the mini facelift will have less swelling which allows the results to become visible sooner. On average, the results can be seen when most of the swelling and bruising has dissipated after 1 to 3 weeks. However, swelling can persist for several months depending on the extent of the surgery.

Younger patients, and those who have less damaged skin, will see better results than someone who is much older. Although there is no age limit for a facelift, patients in their 70s will not gain the same results as someone in their 40s (even if they have the same procedure).

Since most of the incisions are hidden within the hairline, scarring usually isn’t an issue. Incisions made elsewhere, such as under the chin, usually follow the natural creases in the skin and are rarely obvious. Scars can take 6 months to a year to settle down but will fade with time.

Facial rejuvenation via facelift can provide results up to 10 years. However, the face will continue to age and gravity will continue to pull down on the skin. A daily skin care regimen and the use of sunscreen, whenever going outside, can help maintain the results. Patients often seek touch-up treatments, such as a mini facelift, to keep the skin rejuvenated.

Limitations and Risks of Facial Rejuvenation via Facelift

While facial rejuvenation via facelift can correct many signs of aging, it does have some LIMITATIONS:

• Facelifts are limited with treating conditions associated with the eyes meaning they cannot correct sagging eyelids.
• A mid facelift is limited to only addressing the central facial features and it cannot treat all signs of aging. Any patient with excessive skin, severe laxity of the neck and/or heavy nasolabial folds may be limited from a mini facelift procedure. However, they may benefit from a SMAS Facelift which can remove excess skin.
• A patient who is not willing, or able, to take ample recovery time off work may be limited from a full facelift.

Facelifts all have certain RISKS in common:

• Chills
• Rash
• Nausea
• Vomiting
• Dizziness
• Sore throat
• Breathing difficulties
• Allergic reaction
• Severe swelling and pain
• Bleeding
• Bruising around the eyes
• Numbness
• Infection
• Poor wound healing
• Scarring
• Hematoma (a collection of blood under the skin)
• Nerve damage

Choosing the Right Surgeon

The most important thing to look for when choosing a surgeon is to find one with patience, precision and integrity. The surgeon should be willing to meet with patients and spend time learning their concerns and goals. Since there are countless options available for facial rejuvenation via facelift, the surgeon should be adequately skilled in the newest techniques. The surgeon should also be honest with the patient when it comes to the results that can be achieved.

Written by Cosmetic Town Editorial Team - SP 

Based on an exclusive interview provided by Gilbert Lee, MD in San Diego, CA.