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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 trained at
Tulane University under some of the top facial plastic surgeons in the
country, and he has brought their time tested methods to Associates in
Plastic Surgery.
Dr. Miller will analyze your face during the consultation and
together with your input will determine the best plan for your facial
rejuvenation or facelift. Computer imaging is also used as a tool to
help you understand what a particular procedure might do for you.
It is extremely important that the patient has realistic expectations.
This means that a facelift is not a procedure that makes a 55 year
old look 25 again. The
procedure just tries to re-approximate what the patient looked like 10
years ago in a natural manner.
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The facelift procedure
can be done by itself or in conjunction with other procedures.
For example, fat injection (link this) 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.
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Case 1:
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.
So a facelift was performed and you can easily see the nice
improvement of the jawline and neck.
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Case 2:
This patient not only desired improvement in the neck
and jawline, but also the folds between the nose and lips, and
heaviness around the eyes.
So a facelift plus fat injection and eyelid lift was performed,
giving her an excellent result.
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The facelift procedure
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
The
same incisions are used for each procedure.
Dr. Miller is a specialist in deep plane facelifting.
The deep plane facelift lifts up tissue in a deeper plane before
tightening while the SMAS lift just 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 with respect to the skin in
patients that smoke (although it is preferable for all patients who
smoke to stop smoking 30 days before a procedure).
Back to facelift procedures
Mini-facelift or S-lift or weekend facelift
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These
procedures 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. The skin is lifted for a short distance, the deeper tissue is
tightened, and the excess skin 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 someone with only minimal jowling
and neck sagging, and for these patients it is a nice option. |
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Back to
facelift procedures |
(Click on
pictures to see larger version)
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Necklift
A
necklift is a procedure that focuses only on the neck. This
procedure would be done in a patient who has no jowling, but a heavy
neck.
The incisions are not as long and the recovery is shorter.
The 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 which allows the neck to look much more youthful.
Back to facelift procedures
Cheeklift
Different procedures can
be done to lift the cheeks. Read
more…
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 below and contact Dr. Miller’s
office for your free facelift consultation.
You can find Dr. Miller's answers on
facelift questions on RealSelf.
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