The face lift surgery can be designed to correct problems in the neck, under the jaw and/or chin and in the cheeks.  Though singular in name, “facelift” actually referrs to a set of surgeries to rejuvenate the face by lifting tissues into a more youthful contour, and removing excess skin to give a more vibrant look. A common area of concern are the jowls, which are well addressed with a mini facelift.  This is a smaller variant of the face lift, with a shorter surgery and recovery time.  Aimed at tightening the jawline, the mini facelift is a sought after procedure for men and women as early as their 40s.  Less surgery usually translates to a faster recovery, with most patients looking non-surgical to the outside world in 2 weeks or so. Patients with more advanced facial aging requiring more extensive work to address the descent of the cheeks, jawline, and neckline can be candidates for a deep plane facelift, which is uses a multi-layered technique to reposition the deep tissues of the face and neck. The mid-facelift, which addresses sagging in the cheek or middle third of the face, tends to be more common with younger patients, while patients with more facial aging often require a full facelift to address aging in the lower two-thirds of the face. Facelifts are always tailored to individual patients’ anatomy and areas of concern, and can be combined with other facial rejuvenation procedures such as the eyelid lift (blepharoplasty), chin implants to further contour the jawline, fat transfer to restore facial volume, and laser resurfacing to improve skin quality and tone.

Patient picture after facelift at Nuance Facial PlasticsPatient picture after facelift at Nuance Facial Plastics

Today more women and men are considering a facelift or mini facelift to help restore their face to a more youthful appearance. No longer do you have to worry about a facelift giving you a “plastic” or pulled look. Dr. Kundaria’s facelift patients tell us that their family and friends say that they look just like themselves, just more youthful, refreshed, and vibrant. Facelift surgery restores a more pleasing contour to your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping. At your consultation visit, Dr. Kundaria will discuss these procedure options.

Types of Facelifts

A facelift is not one surgery, but rather a type of surgery.  This is because all of us have different facial anatomy and goals.  The surgeries range from the Mini Facelift through the Full Face Neck Lift.  The patient’s anatomy and expectations determine the extent of surgery.  The extent of surgery determines the amount of time it takes to perform the surgery as well as the recovery time, as a bigger surgery has a longer recovery.

Mini Facelift

The Mini Facelift is primarily addressed at tightening the jawline.  It is called a “mini” because the incision, and resulting scar, is shorter.  Also, the amount of skin that has to be undermined, or lifted off of the muscle layer, is smaller.  These factors make the Mini a great surgery for patients looking for a faster recovery and quicker return to their daily activities and work.

Who is a Good Candidate for a Mini Facelift?

The Mini Facelift is a great surgery for younger aged patients, typically in their 40s or 50s, who want improvement in their jowls.  It addresses the earliest signs of aging because it does not tighten the deep tissues as much.  This is a great procedure for patients that are looking for an in office surgery that can treat and prevent facial aging with both great effect, and less down time than a full facelift.  Typical downtime after a Mini Facelift is approximately 2 weeks.  After the two week mark, patients may have minor bruising and swelling, though it can be covered by makeup, and the incisions can usually be covered by hair or makeup.

Full Facelift

The Full Facelift is a more extensive procedure than the Mini Facelift, as there is more skin that needs to be undermined, or lifted, off of the muscle.  This enables a more dramatic level of lifting, and is typically for patients that in their 50s and older.  It better addresses the midface and the cheek as you get closer to the corner of the mouth.  There is more removal of skin, so the incision is correspondingly longer.  Though recovery is similar to the Mini Facelift in terms of the 2 week period, there is more swelling and possibly more bruising because of the more extensive surgery.

Full Face/Neck Lift

The Full Face/Neck Lift is a better way to address both the aging face as well as the aging neck.  It differs from the Full Facelift because the incision is longer, continuing further down the hairline.  This enables a more extensive lifting of the skin and muscle of the neck, with a great improvement in the neck line to match the new, tighter jawline.  The improvement from the Full Face/Neck Lift is usually for patients with more advanced facial aging, and more laxity, or looseness, of the skin.  

Are You a Facelift Candidate?

Facelifts have been successfully performed on patients as young as 40 years old and as old as 80. The primary goals of a facelift are tightening of the jawline and addressing the jowls.  If your face and neck have started to sag, you may be a good candidate. After the jawline, the rest of the face is assessed, and the amount of “lift”, or surgery done on the mid face through the neck is determined.  Dr. Kundaria can assess your skin’s elasticity and help you determine the appropriate procedure for you.

Where is a Facelift Done?

At Nuance Facial Plastics, we do most facelifts under local anesthesia in the office.  Avoiding the long recovery times from general anesthesia is the primary goal of this, as much of the recovery after a facelift is actually the recovery that your body has to do from having general anesthesia.  It can take several days to fully metabolize the medications you get from anesthesia, prolonging the recovery and making our patients feel more like patients.  Minimizing anesthesia speeds up recovery, and actually decreases bleeding (during the procedure) and bruising (after the procedure) as well.  

For patients that prefer to have more sedation or are having multiple procedures done, we also do surgery at outpatient surgery centers, which are a better option for some patients.

How is a Facelift Performed?

A facelift is done to tighten the deep tissues of the face, which alters the contour of the jawline, neck line, and face.  It also is done to remove excess skin, which improves wrinkles and sagging, redundant skin.  After the extent of the procedure is determined, the skin is incised, or cut, and lifted off of the deeper tissues, which include the muscular layer.  The muscular layer is tightened or lifted, followed by a removal of excess skin and closure.  

How is Recovery After a Facelift?

Patients fo home after their facelift, as it is an outpatient surgical procedure, with a face wrap dressing to hold the skin against the deeper tissues and to control swelling.  This is removed one day after surgery, as your first follow-up appointment is the day after surgery.  Once the wrap is removed and the incisions are cleaned, there is a soft jaw band that is worn for the first two weeks applied.  This is removed for bathing and incision care, but is work to hold the tissues “up” and prevent the skin from sagging while it heals.  

The incisions are cleaned with warm water and dressed with Aquaphor ointment two to three times daily for the first week.  There is no heavy lifting for the first two weeks, and intermittent icing and constant elevation can minimize any bruising and swelling that may occur.  Your next post-surgical visit is usually 4 days after surgery, and a few of the stitches are removed, or loosened, during this visit.  The remaining stitches are usually removed between 7-9 days after surgery, depending on specifics of your surgery.

During the healing time, we treat bruises with Intense Pulsed Light, which can help speed up the resolution of bruising.

The area of skin that had to be lifted off of the deeper tissues is usually numb after surgery, and can take several months to recover.  The more extensive the facelift, the longer it typically takes to regain sensation.  Of the recovery limitations, this is usually not one that bother patients much, as they are usually enjoying the results enough to forget about the numbness.

A Facelift is One Part of Facial Rejuvenation

A facelift has no substitute.  There is no other procedure that can independently tighten the muscular layer of the face and remove redundant skin.  Despite this, it is not an all inclusive procedure, as facial aging usually has several components.  One is loss of collagen in the skin, another is a loss of facial volume, and another is redundant skin and fat of the eyelids.  Therefore, a facelift is an integral part of facial rejuvenation, but it is often combined with laser resurfacing or chemical peels, facial fat grafting or fillers, and eyelid and brow lift surgeries to address the aging eyes.  This “combined” approach is the best use down time, as you do not need to budget two weeks for every surgery separately.  Also, costs can be minimized by fewer trips to the operating room.  

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