Facelift / Necklift

What is a Facelift?

A facelift is a cosmetic surgical procedure designed to restore a youthful appearance to the lower face and neck. Other terms for facelift include "rhytidectomy", "necklift", "platysmaplasty", or "mini-facelift". It corrects drooping jowls, a sagging jaw line, neck bands, and the "turkey waddle" under the chin.

Facelift History

The original facelift procedures in the early 1900's simply tightened the skin of the face. Skin-only lifts lead to an overly tight appearance, and the skin would quickly stretch so the results did not last very long. This type of lift was common until the 1970's when Dr. Skoog (from Sweden) and Drs. Peyronie and Mitz (from France) discovered that the deeper muscular tissues of the face could be lifted, resulting in a more natural and longer-lasting result.

The Modern Facelift

Today, nearly all facelifts involve tightening of the deep facial layers (also called the SMAS) and then redraping of the overlying skin. There are several facelift varieties, including mini-facelifts (or short-scar facelifts, rapid lifts, or so-called "lunchtime lifts") which use smaller incisions than full facelifts. The more extensive deep-plane and SMAS-flap facelifts elevate the deep facial muscles, allowing for improved longevity.

Facelift DiagramIn the area under the chin where people tend to develop loose skin, fat, and/or muscle, a facelift will help to rejuvenate these aging signs. Loose neck skin is lifted along with the lower face and jowls during facelifting. Excess fat deposits are sculpted during a facelift with liposuction or direct fat removal to create a more pleasing contour. A sagging neck muscle (platysma muscle) that causes neck banding is improved with a corset platysmaplasty. This part of the facelift procedure tightens the neck muscle centrally with cinching stitches placed under the skin. This maneuver can elevate a sagging neck resulting in a sharper, younger neckline.

New Advances

There are some new techniques that can enhance the look of a facelift.

Adding volume: It is now understood that we lose fat in our faces as we age. This leads to more sagging, drooping, and an overall older appearance. Fat lost with age can be replaced during a facelift with fat transfer or injectable fillers (e.g. Restylane, Perlane, Juvederm, Sculptra). In cases with fat deficiency, replaced volume results in a more pleasing, natural look.

Lasers: Lasers are often used to make the surface of the skin look younger and smoother with more even tone. Several types of skin resurfacing lasers can accomplish this at the same time as a facelift, such as the fractional CO2 laser (e.g. ActiveFX) or the erbium laser (e.g. Fraxel). Some lasers can also be used under the skin (e.g. CoolLipo) to help sculpt fat and stimulate collagen growth at the same time as a facelift. Cosmetic surgeons sometimes refer to this as a laser facelift.

Is a Facelift for Me?

A facelift is for people who want to have a younger appearance in the lower face. It can be combined with other facial procedures, such as laser skin resurfacing for wrinkles, upper and/or lower eyelid lifts for aging eyelids, and brow lifts for droopy brows. It helps to correct signs of premature aging and sagging in the neck and jowls. Most people undergoing the procedure say they want to look as young as they feel. There is no specific age that is right for a facelift. Anyone from the age of 30 to 90 could be a potential candidate for a facelift. Determining factors include health status and pre-procedural expectations.

Does a facelift hurt?

Minimal discomfort and minimal downtime are hallmarks of the modern facelift performed at Allure Medical Spa in Michigan. An anesthetic solution (tumescent) consisting of dilute lidocaine and epinephrine, as also used in liposuction allows for a safer and more comfortable procedure with minimal bruising. Monitored sedation is also administered for comfort. Stitches are removed in one week, and most patients are comfortable enough to do light household chores the day after surgery.

What about scarring?

The incisions are expertly hidden around the ear, into the hairline, and sometimes in the crease under the chin, so they are often well hidden. The incision is usually placed in a crease around the ear and behind the tragus, the small bump in front of the ear opening. This placement is more desirable than an incision in front of the ear, which can be an obvious facelift "giveaway".

Will I look too tight?

The best cosmetic procedures are those that look natural, without the "operated-on" look. The most current facelift methods create a natural, rejuvenated appearance without the "windswept" signs. Other telltale facelift signs to conscientiously avoid are the "pulled-down" ears, irregular hairlines, too-high sideburns, and obvious scars.

How long will it last?

A facelift generally "sets back the clock" five to ten years. It can take five to ten years to return to the "before surgery" appearance, although a facelift can last longer than 10 years in some cases, especially in people who maintain their results with good skin care, lifestyle choices, and non-surgical enhancements (e.g. laser skin resurfacing, injectable fillers).


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