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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
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.
Back to facelift procedures
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…
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(Nonsurgical Facelift) Threads are
placed under the skin of the face, neck, and eyebrow to lift sagging
tissues producing 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.
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Back to facelift procedures
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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.
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