A facelift encompasses a wide range of different procedures that can be performed to improve the lower two-thirds of the face and the neck. The type of facelift that is performed depends upon the assessment of the individual patient and the aspects of the aging face that are important to them.
To maximize rejuvenation results, patients often choose to have a facelift procedure in conjunction with both surgical and non-surgical procedures which may include a necklift, eyelid surgery (blepharoplasty), an endoscopic browlift, nasal surgery, and laser or skin resurfacing, which reduces fine wrinkles and improves the skin’s tone and texture. During your consultation with Dr. Rosenblum, he will comprehensively evaluate the degree of laxity of each area of your face in order to recommend the procedure or combination of procedures that will help you to achieve the most youthful and natural appearance.
The most important part of the consultation with an aging face patient is to listen to their concerns. Too many bad results or unsatisfied patients come from other doctors who don’t take the time to listen to their patients. Plastic surgery is not about “doing to the patient” but about “doing for the patient”. Plastic surgery is unique as a medical specialty as patients come to us and ask for certain results to be achieved and it is our duty as surgeons to educate and ensure that these goals can be met safely and naturally. This is why our initial consults are length and informative and are often followed with a second consult that requires our patients to bring photos of themselves so that Dr. Rosenblum can assess the aging process and realistically communicate and demonstrate with his patients what the likely results may be.
The first and most important aspect of evaluating a patient for a facelift procedure is to evaluate their underlying bone structure. Before we consider repositioning excess skin and sagging muscle, we evaluate whether or not the underlying bone structure will give the patient a natural, balanced result. We often need to strengthen the chin with chin augmentation (implant), or correct natural depressions on either side of chin (pre-jowl area) which is similar to the chin augmentation procedure. We sometimes need to enhance the cheek bones in order to give the face better definition, which is done through cheek augmentation (implant).
Naturally, as we age, the muscles in our face lose tone and elasticity and they begin to sag causing jowls to form along the jaw line and a “turkey-gobbler” to appear under the chin. By repositioning the sagging muscles through a “deep plane” approach, we are able to improve the appearance of the jowls and prevent the mask-like appearance that can occur when only excess skin is removed. When the neck muscle (called the platysma) under the chin begins to sag, bands can form. Fat frequently accumulates in this area further exacerbating the problem. This fat is often removed by liposuction during the procedure. The muscles in the neck are tightened by performing a platysma cervical lift, or essentially a removing and tightening of the bands. The “turkey gobbler” appearance is then eliminated.
The next step in assessing the individual’s needs in the natural aging process is to evaluate their skin. Aging and sun damage cause the skin to loose elasticity, which results in the creation of folds or lines on the face. Excess skin is removed during a facelift procedure and this improves those lines in certain areas. In some cases, a facelift does not address this issue and we will recommend that a patient undergo chemical peeling or laser resurfacing in conjunction with a facelift to correct these problems. These procedures are managed by our skin specialists at the adjacent Spa and Laser Center. Injectable fillers and fat augmentation or fat grafting are also possible alternatives for treating these problems, depending upon the location and depth of the wrinkles.
The amount of improvement with surgery depends upon the extent of sagging, the bone structure of the face and wrinkling of the skin. The goal of this surgery is to provide our aging face patients with a more rested, vibrant and natural look – not a pulled, mask-like appearance. Remember the best plastic surgery is often times unnoticed.
After your treatment, an unique cooling mask that assists to reduce bruising and puffiness will be placed on your face, and little tubes might be placed underneath the skin to prevent fluid buildup. Dr. Rosenblum will see you the next day where his personnel will examine your cuts and wash and dry your hair, getting rid of the demand for a beauty parlor appointment and shielding your confidentiality. If you like, Dr. Rosenblum will offer a visit to your home by either himself or a cosmetic surgery nurse who is trained to assist you with your recovery. The registered nurse will monitor your recovery, alter any dressings, help you with your medication, and provide Dr. Rosenblum with the latest updates on your condition.
Following surgical treatment, the most swelling that you will experience is within the first 24 to 48 hours, though moderate swelling may last for weeks; preserving a flat or non-elevated position of the head is helpful to minimize the initial puffiness. Bruising usually diminishes within 2 weeks. Many of the stitches can be removed 5-7 days after surgical procedure. Clients are generally able to return to work in 2 weeks and return to workout and other exhausting activities in about 6 weeks.