Facelift

Although Botox and fillers have benefits for mild facial aging, face lift is still indicated for advanced aging of the face. A face/neck lift will improve the neck line, provide projection to the cheek area, and give a more youthful look to the face. This procedure is often complemented by upper and lower blepharoplasty (removal of excess skin and improving the puffiness around the eyes), and brow lift (to correct excessive hanging of the eyebrows).

Rhytidectomy means removal of lines. However, this is a misnomer, as face lift is not as much about removing lines as repositioning of the tissues under the skin.

A standard face lift mainly addresses the jowls (the hanging bulge on either side of the chin). However, to obtain harmony, a mid face-lift, which addresses the cheeks, is usually required. Once these issues are addressed, then the rest of the face will appear "out of synch." Typically, there will be excess eye lid skin or droopiness of the eyebrows, which may require either an upper blepharoplasty or a brow lift. There may be prominent fat deposits of the lower eyelids, which can be managed with a lower blepharoplasty. The neck typically will have loose skin and muscle under the skin (so called "turkey neck"). Therefore, for the final face lift result to look natural, all of these issues must be addressed. This is usually done in one setting. However, the surgeries can be broken down into two stages, if indicated.

The face lift incision starts in front of ear, with extension into the temple, if a brow lift is needed. The incision then goes behind the ear and ends at the junction of the hair line with the posterior neck. This extension is performed only if a neck lift is performed. There will be an incision under the chin bone as well, to tighten the loose muscles in the center of the neck (platysmaplasty).

The skin of the face is elevated, usually up to and slightly past the cheek bone area. Then, using sutures, the loose tissue under the skin is re-oriented in the desired direction. Typically aging causes the tissues of the face to go down and medially. Therefore, the usual direction of tightening is upward and laterally. Once the tissues are re-oriented and the cheek area is augmented, the excess skin is conservatively removed. It is important not to rely too much on skin tightening, as the final result will look very unnatural.

A face lift will "remodel" the foundation of the face. However, for best result, a "paint job" may be needed as well. This "paint job" will improve or eliminate the remaining lines on the face. Typically, this is accomplished by a combination of laser resurfacing, Botox and fillers.

In terms of recovery, the usual patient can go to a party, with make-up, two weeks after surgery. However, the swelling will take at least 3 months to completely resolve.

Élan Institute for Plastic Surgery
2010 East First Street, Suite 270
Santa Ana, CA 92705

Phone: 714. 834. 0101

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