Face-Lift
About the Face Lift Procedure
Face lift, also known as a rhytidectomy, is a type of cosmetic surgery proposed to give a more youthful appearance of the face. It usually involves the removal of excess facial skin, with or without the tightening of underlying tissues. According to the most recent 2018 statistics from the American Society for Aesthetic Plastic Surgery, over 121,00 face lifts were performed in the United States by board certified plastic surgeons.
Face lifts are helpful for eliminating loose skin folds in the neck and laxity of tissues, as well as loss of volume or facial descent. Although face lift requires skin incisions, which results in permanent scars, those scars in front of and behind the ears, if done correctly, usually become inconspicuous over time. Some areas not well corrected by a face lift including the nasolabial folds, perioral fine lines, or marionette lines.
When the surgeon tells the patient, they are going to do a face lift, the patient may understand that this is a standard procedure like taking out a gallbladder. That is however not true. There are so many different types of surgeries that are called face lifts.
The typical full face lift includes elevation of the skin from both sides with scars in front and behind the ears but the patients may have no idea what is done beyond that and that can make a significant difference. Minilift, Skin lift, SMAS lift, SMAS Plication, Deep SMAS are all different types of face lifts with different results. As a patient, you should know what type of facial rejuvenation is being proposed and what are the surgeon’s typical results. This includes the exact placement of scars, the typical facial change in shape, and the long-term results.
Before
After
Types of Face Lifts
Commercial lifts or Branded lifts have become a popular attempt to lessen recovery and have the same results as traditional lifts. They are usually advertised through infomercials. Unfortunately, these lifts do not have a scientific basis behind them. There have been very few unbiased reviews written about their results and their long-term effectiveness. It is very important that patients investigate and evaluate any proposed procedure for its scientific basis and its potential to correct the issues they are seeking to improve.
Minimal Recovery Face lift, Mini Face lift
The term “mini-lift” refers to a variety of lifts that simply mean less than a full-face lift. The exact procedure done will differ depending on each surgeon’s ideas, training, and experience. Some mini-lifts mean limited scars while others mean limited elevation of the skin. Some may or may not involve manipulation of the underlying soft tissue in some way or another. For a patient to be satisfied with a mini-lift it is important that the patient personally understand what the surgeon is suggesting and whether or not that is adequate to remedy the individual issues that the patient wants to correct. A mini-lift is appropriate for early facial aging with limited cheek descent and limited excess in the neck. Recently, the addition of fat injected into various facial areas has added to the potential for improved facial rejuvenation. Fat can be injected into the cheek areas or the temporal hollows. Injections of fat can help define the jawline and give the patient that youthful appearance.
The Mid-Face Lift
The mid-face, also known as the cheek pad, is a combination of fat and fibrous tissue beneath the skin. It is not well supported and as those already weak support structures weaken further with time the constant effects of gravity cause a vertical descent of the mid-face. This creates a loss of volume in the cheek and a visual lengthening of the lower eyelids.
In Dr. Yousif’s opinion, mid-face descent along with the aging of the neck may be the most important parts of facial aging. The descent of the mid-face creates many of the most significant visible effects of aging, including deepening of nasolabial folds, jowls, marionette lines, visual lengthening of the lower eyelids, a sub-malar depression, and widening of the lower part of the face. Many different types of procedures have been proposed for mid-face restoration. Some techniques involve some type of elevation of the descended mid-face upward and outward. Unfortunately, that does not correct most of the problems of mid-face aging. The lower eyelids, the malar depression, and the nasolabial folds are all not improved. Beyond that, the face takes on an unnatural look because the fat layer has been placed in a place it was never intended to be. Some surgeons are injecting fat into the cheek area to make up for the lack of replacement of the mid-face. This just gives the face an unnatural round look. Fat injections into the midface can, at times, help to improve the youthful fullness of the cheeks but may not help the lower lid lengthening.
Deciding which technique is best for you is something that needs to be evaluated and discussed prior to surgery.
Facial Structuring with Fat Injection
Recently the addition of fat to contour the face and restore the youthful appearance has made significant improvement facial rejuvenation. Fat is usually harvested from the tummy, separated into its component parts, and then injected in different areas to restore the youthful fullness of the face. In most studies, 40% of the fat injected can last forever.
What to Expect
Key Considerations
Remember that face lifts are complicated procedures and the surgeon may choose to do the simplest one which may or may not be what you need. The surgeon should have had a lot of experience in all types of facial rejuvenation so they can offer you the right one for your situation rather than applying the same procedure for everyone.
So, ask questions, tell your surgeon your exact concerns and areas that are most important for them to address. The surgeon should be frank about expected results. If they are not or if they tell you every one of their results is perfect then they are not being honest or they have not done very many face lifts. Your first consultation is a chance for you to evaluate your potential for an overall good result, the reasonable outcomes for your areas of concern, and maybe most of all, the surgeon. Are they listening to your issues, are they providing an objective discussion about the issues and giving you alternatives that might help? Or does it feel like they are simply trying to get you to have surgery? Remember, besides choosing the right surgery you are also choosing the right surgeon. It should feel that they are your physician, offering the best options, not a salesman ready to cure everything with one magic pill. Remember, there is no short cut to good surgery. There is no secret procedure that only one surgeon knows about. And put your goals into the proposed procedures. If your most important goal is a short recovery time then that is fine as long as you know that the results may not last as long. If you want dramatic longer-lasting changes, then a 1.5-hour procedure may not be for you.
Recovery
The post-operative recovery after facial rejuvenation depends greatly on what was done. Bruising is variable but most is resolved by 2-3 weeks, if not earlier. Almost all is gone by 4 weeks. It is important to understand that the body heals by placing scar tissue to seal areas. So scars are present not only at the incision sites but also internally as well. Scar tissue can be felt as firm areas or swelling underneath the skin. The body can take 4-6 months to soften those areas.
Results
Although the results, of most facial rejuvenation, look good within the first few weeks the final result is usually seen at 4-6 months and should last for years to come. The skin in some areas may feel numb but that almost always resolves in a few months.