As people grow older the natural aging process causes the skin to wrinkle and sag. Fatty tissue tends to decrease in volume and density causing the skin to fit more loosely.
In addition, there are also changes in the bones of the face, which in combination with changes in muscular action and gravity lead to more prominent skin folds especially around the chin, jaw line and neck. Heredity, personal habits, the pull of gravity, sun exposure as well as smoking contribute to the aging of the face.
A facelift is an operation that elevates and redrapes the facial skin and muscles to eliminate laxity and sagging. In recent years there have been tremendous advancements in facelift surgery, which allow a natural improvement in the overall facial appearance.
A traditional face lift addresses the mid-face and neck. It can be performed under general anesthesia or local anesthesia with IV sedation. In all cases the incisions are placed in areas where they are well hidden. Usually the incisions are made inside the hairline at the temple, running in front of the ear or in the ear cartilage then around the ear lobe and behind the ear, ending in the hair of the scalp. The skin is elevated first, and then the deeper structures (fascia and muscle) are tightened to achieve the desired result.
We use a hair sparing technique in which we advance tissue rather than excise it in hair bearing areas. The major pull of the operation is on the deeper structures rather than skin. In some cases, excess fat is removed from the neck and jowls with micro-liposuction.
Often a face lift is performed in conjunction with other procedures such as blepharoplasty (eyelid surgery), forehead lift, chin or cheek augmentation and rhinoplasty. In patients with very fine wrinkles of the skin surface, a facelift may be of limited benefit. Other procedures such as laser resurfacing or chemical peeling address these surface deformities. We have found that the combination of a facelift with laser resurfacing enhances the benefits of both procedures and results in a greater improvement of the overall facial appearance.
A facelift can be performed at any time after signs of aging appear. There is no upper or lower age limit for the operation. When the procedure is performed at a younger age the results last longer, but when it is performed later in life the over stretched muscles with lack of tone become more difficult to repair, and the results while striking, may not be as long lasting.
Q: How Long does a face lift last?
The results of a facelift are long lasting and depend on many factors among which genetics, degree of skin elasticity and personal habits and stress play a major role.
Although the procedure does not stop the aging process, it certainly slows down the clock. One of the ways you can maintain your results is by having a secondary tuck within the first two years after the original surgery. In this procedure the original incisions around the ear are opened up and the scar tissue that had formed from the original surgery is tightened.
Since the scar tissue is stiffer than the normal subcutaneous tissue tightening it results in a more lasting effect. The secondary tuck can be performed under local anesthesia or IV sedation. The recovery from this secondary operation is prompt with many patients resuming normal activity within a couple of days. This procedure has become very popular among patients who have had a facelift.
Recovery After Facelift:
After surgery the patient wears an elastic neck strap part-time for a few weeks. We do not use heavy dressings after the surgery. We find that patients are more comfortable without them.
Using the tumescent technique of injection, there is minimal bleeding during surgery, therefore we generally do not have to use any drains. Swelling and bruising vary and resolve within a week or two. Bruising is usually limited to the neck area. Initially there may be a feeling of numbness and tension in the operated area. The numbness is mainly around the incisions and it resolves with time as the sensory nerves regenerate. The tightness is mainly in the neck region and may last for a few weeks.
Patients are usually active within a few days of surgery. Make up can be applied within a couple of days of surgery. For several weeks after surgery, patients are advised to avoid sun exposure for best results. Healing is gradual and there is a constant improvement in the first few weeks. Final results may not be apparent for several months. In most cases, a single procedure achieves the desired result while in some cases; secondary procedures might be desirable to achieve maximum benefit.
Extended Subperiosteal Coronal Lift (ESCL)
This type of facelift is effective in treatment of the mid and upper face as opposed to the traditional facelift that treats the mid and lower face. The ESCL is based on craniofacial surgical techniques developed in France by Dr. Paul Tessier.
Surgery is carried out through an incision made across the top of the head in the hair and through tiny incisions in the mouth. The soft tissue and muscle is then separated from the underling facial skeleton, cheekbones, and orbit and nasal bones. The tissues are then lifted as a complete unit effectively reversing the gravitational changes of aging. The hair is not shaved and nor hair or skin are removed. This allows a lifting of all the structures from the forehead down to the jaw line such as the brow, the corner of the eyes, the nasal tip, the corners of the mouth and the jowls. It is especially effective in enhancing the cheekbone area.
The operation is performed under general anesthesia. Operating time may vary according to the patients needs but usually last three and a half to four hours. Recovery is similar to the standard lift although the initial swelling may be more pronounced. Most patients resume relatively normal full activity within two to three weeks. Numbness of the scalp is present for a while after surgery, but the sensation returns with healing. The plane of dissection is close to the nerves that control movement of the face. Damage to these nerves may cause weakness in the muscles of the forehead, although in most cases normal function usually returns within a few months.
Overall this technique has proven to be superior to other lifting procedures providing a stronger lift and a more balanced improvement. Because the lift relies on deeper structures and not just the skin and muscles, the results are far longer lasting.
To enhance and maintain your surgical results we offer a medical line of skin care products using Glycolic Acids and Antioxidant therapy, along with progressive skin peels such as Glycolic Acid peels and Microdermabrasion.