If your facial aging has progressed to the point where your appearance doesn’t reflect your youthful mind and energy, there are options to repair the damage. The most comprehensive method is called a facelift. Contrary to popular opinion, facelifts can leave very natural results that correct midface sagging, tightens jowls and double chins, and eases deep creases throughout the face. All in all, a well-performed facelift can leave you looking just like yourself, simply years younger.
I was fortunate to have trained with the most established facelift surgeon in Los Angeles and this provided me with a solid foundation to build upon. In 1994 when I began my Fellowship with Dr. Frank Kamer, he had just completed developing his Deep Plane Facelift technique. This novel approach to facelifting offered many advantages over prior methods and, although I have modified things a bit, it has since remained the mainstay of my facelift procedures in Beverly Hills.
For many people, deterioration of the facial skin is not only the first but also the most distressing sign of aging. Natural aging processes such as loss of skin elasticity and facial volume lead to problems like sagging, drooping, deep lines, and jowls. The end result is that the face in the mirror just doesn’t look like you anymore.
In order to be sure that the surgery will meet your specific needs, it’s important to start with a thorough meeting to discuss your options. During this consultation, you’ll meet with Dr. Frankel in his clinic for a complete examination and discussion of your medical history, concerns about your face, and goals for the procedure.
During the meeting, Dr. Frankel will go over the different options available to you. He specializes in deep plane techniques, which offer dramatic, long-lasting results, but also offers less invasive techniques for patients who require simple skin lifts or tucks to ease their facial aging. After examining you, he’ll be able to tell you which treatments are appropriate for your needs. Once you’ve decided, you’ll also go over details like scheduling, aftercare, and payment.
My typical procedure for facelift in Beverly Hills involves dissecting underneath the deeper tissues without first separating the skin. This allows for the deeper tissues to be freed and elevated and the mass of the face can be repositioned naturally rather than being pulled and distorted by simply tightening the skin and relying on it alone to hold those tissues up. Because the heavier tissues are independently supported, the results from a Deep Plane lift last longer than traditional SMAS or skin type facelifts as I reported on with a research paper in 1998. I tend to lift in a more vertical than horizontal direction and I do not use drains.
I use many variations on this theme by dissecting more or less when indicated and sometimes extending the deep dissection underneath the muscles of the neck without any skin dissection. This latter modification renders a clean, beautiful jawline without the lumps and bumps that occasionally accompany a platysmaplasty (another way of handling the neck muscles). Of course there are times when a simple skin lift or tuck is preferred such as when some fat beneath the skin has fallen and needs to be isolated or for a revision lift.
Because I was trained using the advanced technique I find it quite simple to perform skin or SMAS type lifts when the need arises. I do not believe the reciprocal is true however. Surgeons that typically perform the more superficial lifts are generally not comfortable or as competent doing the deeper lift and thus they do not get the optimal benefits out of that surgery. Those recognized benefits are better healing of the incisional scars, longer lasting results, more natural looking (less pulled) appearance, improved circulation to the entire face, fewer post operative lumps and bumps and less bruising.
The morning of your surgery, you’ll go through one last bedside consultation to confirm the plans for your procedure before Dr. Frankel makes the necessary markings on your face with a surgical marker. You’ll then be anesthetized with a sedative and local anesthetic or with a general anesthetic depending on your preference. Once the anesthesia has taken effect, the surgery can begin.
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Facelifts are normally an outpatient procedure, so after a brief time in the recovery room, you’ll be able to leave with a caretaker to recover in an aftercare facility, hotel, or your own home. You’ll have several follow-up visits at the office to remove dressings and monitor your recovery. You’ll need to take it easy for at least a week after surgery with no driving and no bending or lifting, but you should try to walk around some and to keep your head elevated in order to minimize swelling and potential clotting.
For the next month or so, vigorous exercise will be off-limits, since it can increase bleeding and swelling, but you’ll be able to gradually increase the amount of mild activity that you do. Continue to sleep with your head elevated as much as possible. Makeup should be avoided until you’re cleared for it at a follow-up visit, and unprotected sun exposure should be minimized in order to aid scar healing.
FAQ’s about Facelift
Most patients find that their bruising is reduced enough that they can run errands with just a pair of sunglasses within a week. For closer encounters like dinner parties or getting coffee with an old friend, most patients prefer to wait 2-3 weeks to be sure the signs of surgery are almost entirely gone. By that point, most patients have no more than a small bruise remaining, and that can be easily covered with makeup.
Unlike fillers, which normally disappear within a year, a facelift completely recontours the tissues in the face and removes excess skin to eliminate sagging. These changes are permanent, so your facelift will give you lifelong results. It’s important to remember, however, that you will continue to age normally after your facelift, so for the longest-lasting rejuvenation, it’s important to maintain normal preventative measures like proper skincare, sun protection, and nutrition.
Dr. Frankel is careful to conceal scars in the hairline and in the natural creases near the ears in order to minimize visible scarring. To further decrease the visibility of scars, avoid unprotected sun exposure, which can darken scar tissue, and consider using techniques such as scar massage and topical creams like corticosteroids to further reduce scar formation.
Your face may look and feel slightly tight and tingly for several days after the surgery, but that’s a result of the swelling. A permanent tight look is a hallmark of a poorly performed facelift. Dr. Frankel is careful not to stretch the skin too much or overly adjust the natural contours of your face, so your results should look quite natural.
Skin treatments like laser treatments and peels can improve skin texture, and injectable treatments like fillers and neurotoxins can reduce fine lines and wrinkling, but these are all temporary, and none can provide results as dramatic as a facelift. If you’re looking for significant, permanent results, there is no true alternative to a surgical facelift.
A rhytidectomy, better known as a facelift, is a procedure performed by a plastic surgeon. It’s designed to tighten loose skin on the face. Your doctor also tightens muscles and tissue and removes excess fat during the facelift. This helps restore a more youthful look and eliminates the appearance of creases and wrinkles.
While a facelift cannot stop the natural process of aging, it does make you look younger. Most people who undergo facelift surgery find their confidence increases following the surgery.
The best candidates for a facelift are men and women who have prominent facial bones and supple, elastic skin. You need to have realistic ideas of what a facelift will and will not do for you. Smokers take longer to heal, so if you smoke you need to be prepared to quit.
There are different techniques used during a facelift. With all of them, the plastic surgeon makes an incision and then separates the skin from the fat and muscle. Once this is done, extra fat is removed and muscle and tissue are tightened. The skin is then pulled taut over the underlying muscle, bone, and tissue. Excess skin is trimmed away and sutures close the incision.
Some doctors use anesthesia, while others use a mix of sedation and local anesthesia. Talk to your doctor about his or her preferred method.
Because a facelift is a surgical procedure, there are risks. These are not common, but they include a reaction to the anesthesia, damage to the nerves, bleeding, and infection. Smoking before or after a facelift reduces blood flow, so healing takes longer.
The results vary from patient to patient. On average, a facelift lasts for five to ten years.
Every patient is different. Some return to work within two weeks, but others need more time. It’s essential to avoid strenuous activities for at least 14 days. You also need to stay out of the sun. Bruising and swelling are normal following a facelift. Expect the swelling and bruising to last for up to three weeks.