Facelift Options

R. Dale Reynolds, M.D.

Is a lunchtime facelift a contradiction in terms? It really depends on what your plastic surgeon means when they say facelift. Any “facelift” should improve the jawline, tighten the neck and remove the jowls in the lower face. There also may be some improvement in the nasolabial folds and marionette lines.

A facelift shouldn’t be expected to help much with most other lines or creases in the face. A classical facelift involves removing excess skin of the face and neck to obtain a more youthful look. The most popular and effective technique involves tightening or removing some of the muscle layer (SMAS) under the skin so that the tension of the lift is not on the skin. This avoids the over-pulled, windblown look that everyone wants to avoid. In addition to an incision around the ear, an incision is often needed under the chin to tighten the muscle layer of the neck and to remove any excess fat in this area (if it cannot be removed by liposuction alone).

For these procedures local anesthesia is required. Most plastic surgeons will also give sedation or a general anesthetic. It can usually be performed as an outpatient procedure and is often combined with eyelid surgery (blepharoplasty) or a forehead lift. Pain is usually minimal but strenuous activity must be avoided for 4 weeks after surgery. Some swelling or bruising may occur, especially around the eyes.

Recently some surgeons and non-surgeons have been promoting a less invasive type of “facelift”. Non-surgeons promote this for obvious reasons. Options include fillers (fat, Radiesse, Restylane, etc) or barbed sutures. This type of lift can be done with barbed sutures that are placed under the skin under a local anesthetic with the patient awake. It doesn’t last as long, look as natural, or do as much as a true facelift.

There may a place for them in young (30’s) patients that need minimal refinement or don’t have the time required or the desire to undergo a surgical recovery. The degree of change from this type of procedure is less dramatic and only lasts several months to 2 years depending upon the procedure. While they are less invasive, they still carry risks and these should be understood. Patients have more options than ever before and must know what they want and how to obtain the best results possible by weighing the advantages and disadvantages of each procedure.

Some questions to consider asking your plastic surgeon are:

-How much longevity should I expect from this procedure?

-What are the possible complications and likelihood of each?

-How long will the procedure take?

-What should I expect during recovery?

-How common are revisions and how are they handled?

It may also help to speak with other patients who have had a similar procedure by the same plastic surgeon. Photographs may help but each patient has unique anatomy and everyone has a different potential for healing. An endorsement by happy patients after a similar procedure by the same plastic surgeon is the best screening tool. To ensure a good experience make sure you are comfortable with your surgeon, your options, and the procedure you choose together.

Please direst questions and comments to R. Dale Reynolds, MD at 915-532-6662 or at www.reynoldsplasticsurgery.com.