Modern facelift surgery
Facelift Surgery (rhytidectomy) is a cosmetic plastic surgery that is increasingly being performed to rejuvenate the facial structures that sag with age.
If you want to see some photos of facelift surgery patients, look here:
What happens to the face as we age?
The aging process has specific effects on the skin of the face:
- The skin color changes and blemishes occur
- Skin elasticity decreases because the elastin and collagen proteins disintegrate
- Skin thins out as structures such as dermis and hair follicles undergo involution
- Fat deposits of the face move down as the ligaments and facial structures holding them up stretch and break
- Muscles loosen and stretch down with gravity
- The bone structures of the face resorb and cause regression of the maxilla and mandible
What a plastic surgeon does in a facelift
Facelift surgery is designed to address each of these different situations using different surgical techniques:
- The muscles and fat are lifted up in a rotational manner and sutured into place.
- Skin is elevated and excess removed from behind and in front of the ears.
The surgery typically takes about 3-4 hours and is often accompanied by eyelid lift (blepharoplasty) and/or forehead lift surgery.
Although multiple techniques have come and gone over the years, these basic principles have stayed the same:
- Remove skin only,
- Lift the skin and muscle/fat, or
- Lift all of the facial structures clear off the facial skeleton.
In my opinion, a skin-only facelift is a waste of time, a deep plane facelift is horrendous and a skin and muscle/fat elevation facelift is… just right.
A modern facelift
What has not stayed the same is the difference in philosophy with respect to the surgery. Twenty years ago, plastic surgeons would wait until the patient needed a full facelift and often a brow lift, too—a full overhaul. Indeed, cosmetic patients would only come in when everything had drooped!
A more modern approach is to view each cosmetic facelift patient individually and address only the areas of the face that have sagged and need to be lifted. For example, a patient may need to have their neck and jowl lifted but not their cheeks, or they may need a brow lift but not an eyelid lift (blepharoplasty).
Facelift under local anesthesia
Another modern innovation has been performing facelift surgery on cosmetic patients under local anesthesia. The patients are given a mild sedative by mouth such as Valium and some pain medication. The areas for surgery are then injected with local anesthetic to numb the skin.
The advantages of facelift with local anesthesia are:
- No general anesthesia and its side effects
- No changes in blood pressure as with general anesthesia
- Less complicated recovery
- Less “frightening” surgery
- Reduced cost
The modern facelift has developed into a safe, reliable and uniquely tailored cosmetic surgery procedure in the hands of board-certified plastic surgeons—of course! A small procedure under local anesthesia and a fortnight of healing can make a huge difference in your face.