Aging of the face is a process that involves many factors. The two primary factors are the downward pull of gravity and the loss of fullness (fatty tissue) in the face. Gravity causes jowls to form due to sagging in the jawline. It also causes the neck to droop which is sometimes called “turkey neck.” The loss of fatty tissue can accentuate the “smile lines,” and cause a hollow appearance in the cheeks and around the eyes. Each person is different in how he or she ages and the approach for each patient needs to be individualized for the best result.
Dr. Miller and Dr. Heller trained under some of the top facial plastic surgeons in the country, and they have brought their time-tested methods to Associates in Plastic Surgery. Dr. Miller and Dr. Heller will analyze your face during your consultation, and, together with your input, they will determine the best plan for your facial rejuvenation or facelift. We use computer imaging to help you understand what a particular procedure might do for you. It is extremely important that our patients have realistic expectations. This means that a facelift is not a procedure that makes a 55-year-old look 25 again. The procedure tries to re-approximate what the patient looked like 10 years ago in a natural manner.
The facelift procedure can be done by itself or in conjunction with other procedures. For example, fat injection is often done at the same time to improve the smile lines and creases between the nose and lips. This improves the loss of fullness that occurs with facial aging. A cheeklift can raise the sagging cheeks at the same time as the facelift. Eyelid surgery and browlifting can also be done to completely rejuvenate your face. Let's look at some examples.
The facelift procedure
This patient only wanted improvement of the neck and jawline. Her face is still fairly full, so it doesn’t need fat injection, and she was still happy with her eyes. We performed a facelift, and you can easily see the nice improvement of the jawline and neck.
This patient not only desired improvement in the neck and jawline, but also the folds between the nose and lips and the heaviness around the eyes. For her, we performed a facelift plus fat injection, which gave her an excellent result.
is performed in our accredited surgery suite under either IV sedation or general anesthesia. Every effort is made to make the procedure undetectable. The incision is started in the hairline and when it comes down toward the ear, it goes inside of the ear a little bit. This allows there to be no incision seen on the cheek. As it goes behind the ear, the incision stays in the crease and gently courses back into the hairline so it is hidden. After the skin is lifted, the muscle and fatty tissue is significantly tightened. In the middle of the neck, excess fat is removed and the muscles are tightly sutured together, which treats the bands that many patients have in their neck. Then the excess skin is trimmed while putting NO tension on the skin. Since there is no tension, the resulting incision lines should practically disappear. Also, since the skin is not pulled tight, our patients do not get that “wind tunnel” appearance. When the surgery is complete, patients are discharged home the same day, usually only in minimal discomfort. Multiple facelift procedures
are available which include:
- Deep plane facelift vs. SMAS facelift
- Mini-facelift or S-lift or weekend facelift
Deep plane facelift vs. SMAS facelift
The same incisions are used for the deep plane facelift and the SMAS facelift. Dr. Miller and Dr. Heller are specialists in deep plane facelifting. The deep plane facelift lifts tissue in a deeper plane before tightening, while the SMAS lift simply tightens without additional lifting. Therefore, the deep plane facelift gives consistently better results that are longer lasting, especially in patients with heavy jowls and neck. Recovery is the same, and if done correctly, has no greater risk than the SMAS facelift. Additionally, the deep plane lift is safer for patients who smoke, although it's preferable for all patients who smoke to quit smoking 30 days before a procedure.
Mini-facelift or S-lift or weekend facelift
Mini facelifts are only useful in a small percentage of the population. These procedures typically use shorter incisions, are done under local anesthesia, and have less recovery time than other types of facelifts performed in our New Jersey offices. The skin is lifted for a short distance, the deeper tissue is tightened, and the excess skin is trimmed and the incision is closed. If a patient has significant jowling or a heavy neck, this procedure will never give a long lasting result. Also, if the surgeon tries to pull the skin too tight, it may result in noticeable scars. Therefore, this procedure is useful in patients with minimal jowling and neck sagging. Contact Associates in Plastic Surgery in New Jersey about mini facelift options.
A necklift, as its name implies, focuses only on the neck. This procedure would be done in a patient who has a heavy neck but no jowling. The incisions are not as long as a full facelift and recovery is shorter. Excess fat is removed from the central neck, and the muscle is tightened in the middle. The neck muscle is also tightened from behind, so a tight sling is created, allowing the neck to look much more youthful.
Different procedures can be done to lift the cheeks. Long stitches are placed under the skin of the face, neck, and eyebrow to lift sagging tissues, which produces a refreshed appearance without major surgery or anesthesia. This procedure has been performed for several years and a nice, long-term improvement has been noted.
Threadlift can easily be performed with fat injection, upper eyelid surgery, and chemical peel, all under local anesthesia to provide a nice rejuvenation.
After surgery, patients will develop some swelling, and bruising, but the pain is usually minimal. Cold compresses will help the swelling which will start to improve in a couple days. Usually in 10-14 days, the patient is doing well and can go back to work. Since the incisions are carefully hidden, it should be difficult for anyone to notice you had surgery performed. Other people may think you had a good vacation or that you changed your hair. Strenuous activity should be avoided for 2-3 weeks. Finally
, keep in mind that facelift surgery should rejuvenate your appearance in a natural way. Our goal is not to make you look like a different person. You will still look like yourself – just better. Please view some additional pictures and contact Dr. Miller's or Dr. Heller's office for your free facelift consultation. Also, you can find Dr. Miller's answers on facelift questions on RealSelf.