Some of the most common complaints of patients with the aging face that the Face Lift Surgeon hears include laxity or sagging of the skin of the cheeks, jowls, and neck. Patients tell the Face Lift Surgeon they have excess skin of the neck or that their lower face has become square. Some of the surgeon’s patients even note that they dislike their lines or folds (marionette lines) around the mouth and that their chin is loose and that these issues were not present in their youth. Other patients just feel as though they look tired or run down. On closer inspection patients note loss of definition to their jaws or cheeks. Many of these problems result from laxity of the soft tissue and loss of volume of the face. Correction of these problems may come in several ways but restoring the volume in its natural position is the goal of the Face Lift Plastic Surgeon.
One of the most common treatments for facial aging is the facelift (facialplasty). Face Lift plastic surgery, although quite an older plastic surgery procedure, has seen many changes over the years since it was first described. Essentially the face lift surgery operation seeks to lift the descended skin of the cheeks, jowls and neck and suspend it into its normal, more youthful position. Most facelift procedures also address the layers deep to the skin by elevating or suturing this soft tissue of the face to a more aesthetically pleasing position. Today’s facelift, as performed by the Face Lift Plastic Surgeon, does not seek to only “tighten” the skin although youthful skin is not loose, but to restore it to a more natural and pleasing shape.
The Facelift surgery procedure can be performed by the Board Certified Face Lift Plastic Surgeon as an out-patient procedure or with an overnight stay. The Plastic Surgeon makies inconspicuous incisions in and along the hairline, along the natural curves and creases of the ear and hid behind it. By special techniques, deformity of the hair growth is avoided and the ear shape is left unchanged and in a natural position.
Along with correction of the face, many desire to remove the sagging skin of the neck. Not only may there be an excess amount of skin but there can be laxity and weakness of the muscles of the neck, as well as, excess fat. These combine to hide the more youthful appearing jaw line and neck contours. The neck lift is frequently performed, in addition, to a facelift – by the Plastic Surgeon – and can be achieved through the same incisions or an additional small incision under the chin. The loose neck skin is released and lifted, the weak muscles can be tightened and the excess fat removed to create a defined aesthetic contour that is natural.
Because other areas of the face such as the eyes or brows may appear to be sagging a Blepharoplasty (Eyelidplasty, Eye Lift) or Brow Lift (Forehead Lift) may be combined with a facelift. These add only a small amount of time to the facelift and can enhance the overall results.
Some patients have a large amount of sun damage (actinic damage) along with the typical findings of cheek, jowl and neck deformities. This type of damage creates the fine wrinkles (rhytides) of the face, eyes and lips. Pigmentation changes such as age spots (solar lentigines), freckles and small scaly patches of red and brown (actinic keratosis , solar keratosis) are also common in patients with sun damage. Many patients who desire correction of the aging face elect to address their skin aging at the same time. Fractional laser resurfacing, chemical peels, and skin rejuvenation can be performed by the Plastic Surgeon’s team to address these issues.
Volume restoration is now considered a major component to correction of the aging face. Many of the Face Lift Plastic Surgeon’s patients seek volume correction. The Plastic Surgeon can use dermal and subcutaneous fillers either alone or at the same time as facelift surgery. There are many options for these injectables including Hyaluronic Acid preparations such as Juvederm or Restylane. Other products such as Radiesse or Sculptra have a biologic component that increases production of collagen thus adding to the volume effect of the product. Of Course Fat transfer (grafting) allows a patient to use their own tissue to increase soft tissue volume. This is becoming a very popular procedure as it is usually readily available and easily harvested. Although fat grafting has been derided in the past, new techniques in harvesting and injection have made the results more reliable and longer lasting. Recent research has also noted that fat grafts and the microscopic components that are transferred with the fat also have biologic activity that can improve collagen deposition, improve scarring, reduce wrinkles and improve vascular perfusion to the recipient sites. Dermal fillers and fat transfer can be used at the same time as facelift surgery to augment the results and you can discuss these options during your complimentary consultation with the Board Certified Facelift Surgeon.