WHAT DOES THE FULL FACELIFT PROCEDURE ENTAIL?
Facelift surgery can take between 3 and 5 hours depending upon the type and extent of the changes required. There are seemingly as many variations to the facelift procedure as there are surgeons, but most of the variations, while important, remain subtle. Typically, we will make incisions that preserve a natural appearance, do not alter the hairline, and are nearly invisible in the creases and contours around the ear, all while enabling important surgical maneuvers. The goal of a well-executed facelift is a natural, more rested you, not a pulled or "windswept" tightness that is too often seen.
Each facelift is subtly different and individualized to each person's needs and goals. However, there are common maneuvers that are done to accomplish each lift. This starts with an incision that is typically beneath the temporal tuft (woman's sideburn), or hidden in the hair of the temple, extending into the crease above the ear, down in front of the ear, hidden in additional creases, then beneath and behind the earlobe, onto the back of the ear and then, as needed, curving into the hair-bearing scalp behind the ear. This incision is similar in all of our facelifts as it best hides the scars. Once the incision is made, the deeper layers are approached.
A facelift lasts longer when a layer called the "SMAS" is repositioned and tightened. "SMAS" stands for superficial muscular apponeurotic system, and like a girdle that smooths a body but is not seen beneath a dress, it allows for smoothing and tightening that clearly improves the overall contour. The primary difference between a mini-lift and a full facelift is how the SMAS is treated. In a mini-lift, the SMAS is simply tucked and suspended with sutures; whereas in a full facelift, the SMAS is lifted, trimmed and tightened. At the conclusion of the surgery the skin is adjusted, any excess is lifted and trimmed, and then the incisions are closed with fine silk sutures.
Often, when neck skin is lax, or neck bands are prominent, an incision will be made under the chin to allow access to smooth and tighten the neck at the same time the jowls and cheeks are lifted. We nearly always further refine the facial and neck contours using liposuction, putting the finishing touch on our facelift procedures. When the surgery is complete the incisions are coated with antibiotic ointment, and the face is dressed with a supportive dressing that encompasses the head and stays in place for the first 1-2 days. Typically patients return the next day, the dressing is removed, the wounds are redressed, and a removable elastic supportive facial garment is put in place and worn for the next few weeks.