This is the most exciting cosmetic plastic surgery operation. I call it the “Rolls Royce” of plastic surgery.
Our face is our personality and our expression. It is how we view the world and how the world sees us! Every detail on the face is significant. And all the details of the face together create a beautiful face with the facelift procedures. The facelift therefore –when properly done- is really the synthesis of many meticulous details that are accounted for and addressed with surgical precision and an artful aesthetic.
The personal aesthetic of the plastic surgeon is also critical. A properly done facelift can easily “remove” 10-15 years from the natural age of a patient. The longevity of a good facelift is also expected to be about 10-15 years.
A good facelift is a natural one. If I can walk on the street and spot those men and women who had a facelift then it is not a good job. A beautiful face is warm, expressive, soft, tight and youthful. The good facelift accomplishes that.
The facelift corrects the visible changes of aging.
What are the visible changes with age?
1) Descent of the malar fat pad or else know as descent of the cheek.
2) Nasolabial folds (smile lines)
3) Jowl formation
4) Nasojugal folds (folds and lines under the eyes)
How is it done?
The incision which I place in the hair for the most part, in the ear and partly in front of the ear exposes the midface. I lift the whole midface superior where it used to be. This direction of lift or pull is a very natural one and thus yields natural results. Proper elevation of the midface creates cheek fullness, and enhances the cheeks. Furthermore proper midface elevation removes the jowls and improves the nasojugal folds and the nasolabial folds. If the eyelid surgery is done at the same time the result is more harmonious.
What is a beautiful face?
The following make a face as beautiful as it can be.
1) A beautiful look. The “look” includes the eyebrows, eyes and all the tissues around the eyes. The combination of the endoscopic brow lift and the midface lift define the areas around the eyes and define the shape of the eyes.
2) Prominent cheeks. This is done with midface elevation and repair.
3) Cheek depression. Just below the full cheeks there has to be a slight depression or hollow of the cheek as it goes down toward the law bone.
4) Jaw lines. Very defined jaw lines without jowls is an extreme element of beauty. The midface lift accomplishes that.
5) Straight chin. With age the chin begins to descent. In some cases it is severe and we call that witch’s chin.
6) Tight Neckline. The necklift is as important as the facelift but very few surgeons take the time to address it. The problem with the neck is the muscles primarily and not the fat or the skin of the neck. The best results for the necklift are to tighten the neck muscles like a corset. This creates a great jaw line.
Timing of a facelift.
I recommend facelifts at an early age. There are many advantages to staring young. For one the skin has better elasticity and tightness so the result is superior since the skin quality is better. Furthermore by starting early you don’t allow the aging changes to worsen overtime and the changes are not so drastic.
In my younger patients who have tight skin I may perform the facelift subcutaneously and percutaneously. Therefore my patients can have a facelift without any scaring.
I tell most of my facelift patients that on average they can attend a party 2 weeks after their facelift with some make up on their face and people would not know that they had a facelift.
Facelift surgery has a painless recovery. The recovery form the facelift has to do with how fast the swelling and bruising will go away. Most of the swelling on average will go away in the first 2-3 weeks. It does take about 6 months from the time of surgery until the face becomes totally normal like it was never touched. There is off course individual variation with every patient
Facelift with stem cells
This is the very latest in facelift technology. Stem cells do not provide a facelift on their own. Stem cells have rejuvenating and repair properties that when added in combination with the facelift they may enhance and potentate the result over time.
I like to add fat mixed with stem cells at the time of the facelift in certain areas of the face to enhance the result of the facelift.
Can stem cells injected in the face delay the need for a facelift?
Since these cells have reparative capacities it is very possible. However that has not been proven yet.
Second Facelift or Secondary Facelift
Secondary facelift or second facelift simply means the second or third facelift a person gets. The original facelift operation does not last forever simply because we continue to age. Therefore people who are aggressive to take care of themselves seek a second or third facelift.
The second facelift requires most skill and art than the first one. Usually and unfortunately most plastic surgeons during the first facelift pull too much or remove too much. Therefore the second facelift is not about removing too much excess skin but about re-positiong the tissues in such a way that it looks like a younger face. In many times volume has to be restored in the second facelift operation because as we age volume is lost from the face.
When things do not go as planned with the original facelift surgery or simply more work needs to be done the revision facelift can be most effective. The timing varies depending on the patient and the problem that needs to be fixed. It is usually a good idea to wait to perform revisions about 6 months following the original operation because by then most of the swelling has gone away.
The same principles that apply to the first facelift operation apply to revision facelift as well.