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.
Surgical
Procedure:
Traditional
facelift addresses the midface 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 times
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 facelift 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 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.
Contact Southern
California Cosmetic Surgeon Dr. Haiavy today.
