Facelift #plasticsurgery

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This article is for informational purposes only.

Depending on the surgeon of choice as each technique when doing the famous traditional facelift is quite different and varies from patient to patient. I ask this question and many others on realselfdotcom where you can ask medical questions. So let’s get started on a traditional facelift.

Q. What is a traditional facelift?
A. Hi, non smiling photos of your face from the front and side would help in the evaluation.  I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  Traditional facelifts have long incisions that begin in the temporal hairline, around the entire front of the ear, inside the crease behind the ear and then continue inside the posterior hairline.  This type of facelift is very invasive with extensive tissue undermining that has a recovery time of months.  I have performed many of these facelifts however in today’s busy lifestyle, very few seem interested in this extensive recovery, bruising, swelling and downtime.  The vast majority, of my facelift patients choose the minimally, invasive SMAS type facelift as described below.

Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

If you have “jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed. My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op

I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Dr. Francis R. Palmer, III MD

Q. What is the recovery time for a traditional facelift?
A. Your instructions will vary from surgeon to surgeon, so it’s important to discuss your surgeon’s specific instructions to maximize your recovery.  I generally tell patients that they must avoid turning the head or stretching the neck for 2 weeks. When you turn, move the shoulders and head as one unit or as though you had a “stiff neck.” This is important to prevent stretching the healing incisions and causing the scars to widen, as well as to prevent putting tension on the deep sutures beneath the skin, which could cause them to pull loose.  Because of this risk, we advise patients to not drive for 2 weeks following surgery. In order to minimize swelling, you are advised to sleep with the head of your bed elevated or in a recliner for 2-4 weeks post-op.  With some make-up, your hair worn down, a neck scarf, and thick-rimmed sunglasses, you should be able to go out in public within a few days with minimal attention drawn to yourself. Most patients take 2 weeks off from work after a rhytidectomy and are able to resume their exercise regimen within 3-4 weeks.

Dr. Parker A. Velargo, MD

Q. How soon can a person return to normal activity after a traditional facelift?
A. Recovery following a facelift can vary, and the level of recommended activity will also vary with each surgeon.  Typically, it will take 1-2 weeks for the immediate bruising and swelling to resolve although subtle changes will continue for several weeks to months.  I advise my patient that they should be able to drive within 1-2 weeks and can return to a sedentary job by 10-14 days.  However, it will be at least 3 weeks before one can resume strenuous activity like working out or heavy lifting.  I would suggest that you speak with your surgeon regarding his or her recommendations for your recovery because it may be slightly different based on your individual needs.

Dr. Anureet K. Bajaj, MD

Q. What are the pros and cons of a liquid facelift?
A. The face ages in three ways: Sags and bags, Lines and Hollows, Tone and Texture. When we are young our face is like an inverted triangle, with the fullest part being from the forehead to the bottom of the nose. As we age, the triangle flips upside down with our upper face being the most narrow. A “liquid facelift” is achieved with injectables like Voluma, Radiesse, and Juvederm plus Botox for smoothing lines in the forehead, around the eyes, lip and chin areas.  The first step to determine if a liquid facelift is right for you is evaluating your face to determine where your facial aging in occurring. Often times patient complain of nasal labia folds (the lines that form from the nose to the mouth area), fallen or sunken cheeks, hollowed under eyes and temples, thin lips and weakened jawlines. The key to a liquid facelift is keeping it natural looking and not getting overfilled, therefore technique and the skills of the injector make a significant difference. We use mostly micro-cannulas for our injections, which minimize bruising and allow for smooth contouring of the face. There is an Abraham Maslow saying, “If all you have is a hammer, then everything looks like a nail.” In this case it applies to choosing a plastic surgeon to access your facial aging process and determine a course of action. Often times, a patient is not a good candidate for a liquid facelift and needs to consider an alternative procedure such as a non-incisional Radio Frequency facelift or a traditional facelift. While fillers can be a fantastic solution for staving off the aging process, eventually, you will want to know your options for continuing to look natural as well as youthful. 

Dr. Mark Anton, MD FACS

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Andrea Price

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