In all my years of practice, no other procedure brings more trepidation and fear than the facelift. Everyone seems to have this notion of a horrific operation with a “mummy” bandage, and bruising and scars and a weird , stretched look like Joan Rivers. I can’t blame them, because that is usually what they see in the media and tabloids.

When we age, at around the mid-century mark (the 50’s) the tissues of the face start to sag. This is due to three things:

The skin and supporting soft tissue of the face has lost it’s elasticity and support.

The volume of facial fat decreases ( not everyone )

The facial bones and the jaw begin to recede.

What are the issues people have with facelifts?

Fear of undergoing such a “BIG” operation. The pain, the bruising, the scar.

“ Isn’t it …dangerous…?”

That it must take a long time to heal.

That it may not turn out right, it won’t look natural, and they will look like they’ve had a “facelift”.

The proper facelift today addresses the causes of the aging face:

Re-draping and tightening the supporting structures (SMAS) and skin.
Re-store lost facial fat volume with fat transfer
Restoring the receding bone volume with facial implants
Re-surfacing the skin with a chemical peel or laser.

If you want to see if a facelift will help you, lie down and look up into a mirror. That it a close approximation of what a good facelift can do.  

A skilled facial cosmetic surgeon can perform a good facelift by:

Proper dissection in the right plane to minimize bruising, swelling and potential complication of nerve injury. This minimizes post-operative pain and bleeding.

Hide the incision so that people can’t notice a scar. The earlobe should not be pulled down into the jaw. There shouldn’t be “ bunching “ in front of the ear. The earlobe should look natural and round on the bottom. There should not be hair loss because of the incision

Retracting and redraping the tissues so that the face looks even and smooth without “stretch marks”.  

The jawline should look clean and straight. The “marionette line” and jowls should be improved. 

The cheeks will be rosy , full and round.  

The forehead and brow should be elevated when relaxed.

Fat transplantation and or facial implants are used to restore volume.

A facelift will take anywhere from three to six hours depending on how much is done. When performed correctly, a facelift is not as bad as you think. Pain is not an issue. The patient should look presentable by one to two weeks, but complete recovery will gradually take a few months.  

A good facelift will keep looking better and better as the years go by.  

The photo gallery has good examples of putting everything together for a facelift.