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Michael C. Fasching, M.D.

Board Certified Plastic Surgeon

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Look Like Yourself After a Facelift (How to Get Natural-Looking Results)

Submitted by Dr. Fasching on Wed 03/28/2018 - 17:28

Are you interested in having a facelift, but find yourself feeling concerned about looking like a different person afterward? If you are, then we have good news for you: Facelift techniques have come a long way in the last two decades. Modern facelifts are practically invisible to the untrained eye; the “stretched” look of yore has been replaced by results that are impossible to tell apart from extremely graceful natural aging. There are, however, still a few things you should know before you book a consultation. Knowing how to select the right type of facelift to meet your needs will help you get the best possible results.

Understanding the Role of Facelift Surgery

If there’s one question that most patients have about facelift surgery, it’s this: “With so many injectable anti-aging treatments available, why should I have plastic surgery? Isn’t that just taking an unnecessary risk?”

While this is certainly a valid question, it’s based on the erroneous assumption that injectables are meant to “replace” surgery by providing safer, more affordable alternatives to conventional procedures. This isn’t quite the case: While younger patients can use nonsurgical treatments like Botox to delay the need for a facelift, facelift surgery still has an essential role to play in the fight against aging. Facelift surgery is used to address structural issues associated with aging, like loose skin and sagging muscles and connective tissue. There is no injectable treatment that can accomplish these deeper interventions. In order to access these tissues, your plastic surgeon needs to make incisions in the skin. Injectable treatments, on the other hand, are designed to handle the more superficial signs of aging, such as wrinkles and hollows under the eyes and cheeks. For best results, patients with advanced signs of aging should therefore consider using injectable treatments to complement facelift surgery. Neither type of procedure (surgical or nonsurgical) is meant to replace the other; instead, they’re meant to meet different objectives.

Using injectables and facelift surgery together often produces the most natural looking results. When patients only have surgery, they can sometimes be left with lines in certain areas (usually on the forehead and around the mouth). Trying to use more surgery to smooth out these lines is a surefire way to produce an unappealing “stretched” look. Stretching the skin in these areas tends to raise the brows and the corners of the mouth too high, creating the windswept appearance that was associated with historic facelift methods. Using injectables to fill in these lines and relax the muscles, on the other hand, tends to produce excellent results. Conversely, when patients overuse dermal fillers and Botox in an attempt to avoid having surgery, they can end up looking bloated in the face or oddly expressionless. Using both surgical and nonsurgical treatments in careful moderation is therefore considered essential to patient satisfaction.

Patients should also be aware that, contrary to popular belief, facelifts are not dangerous. While every procedure carries some slight risk of complications, modern surgical methods have improved the safety of virtually every form of surgery (medical or cosmetic). Facelift surgery has a very low risk of complications because there’s no chance of harming any vital organs during this procedure.

Furthermore, a protective round of antibiotics is prescribed to all patients to ward off infection. As long as the patient follows the recovery protocol set forth by his or her plastic surgeon, he or she will usually be ready to head back to work within one to two weeks (depending on the type of facelift he or she has had). Additionally, it’s important to know that facelift recovery is not very painful. Some mild soreness and swelling are to be expected, but most patients are surprised by just how low-pain this procedure is.

Given the various advantages offered by facelift surgery, the popularity of this procedure is on the rise. The amount of people seeking facelift surgery increased by 28 percent between 1997 and 2015, according to the American Society for Aesthetic Plastic Surgery. Research shows that most patients start with nonsurgical treatments like Botox, then decide to try facelift surgery once they begin to realize the potential benefits of plastic surgery.

Which Different Types of Facelift Surgery are in Use Today?

Virtually all board-certified plastic surgeons now avoid using the outdated “skin stretching” facelift technique, but it’s still a good idea to familiarize yourself with the different surgical methods that are considered current. Today, several different facelift techniques are used to achieve variations of the same goal: Rather than pulling the skin tight, plastic surgeons now “release” and lift the facial muscles. They then drape the patient’s skin over the repositioned muscles and carefully trim away any excess.

Not only does this approach produce much more natural looking results, it’s dramatically increased the longevity of the facelift. Today, the most intensive form of facelift surgery (the deep plane facelift) has been shown to produce results that can last up to 15 years. Furthermore, patients can often use a minimally invasive procedure known as a “mini facelift” to touch up any skin laxity that they develop five to ten years after having a full facelift. Mini facelifts can often be performed under local anesthesia and require very little “down time” in which to recover.

Generally, the older a patient is, the more intensive a facelift he or she will require. The most popular facelift methods in use today are listed below, starting from the most invasive to the least:

The Deep Plane Facelift

The deep plane facelift is considered the “gold standard” of modern facelift techniques. During a deep plane facelift, incisions are made along the patient’s hairline and around his or her ears, allowing the surgeon excellent access to the deeper tissues below. These incisions are usually hidden within the natural folds of the ears and the hairline in order to disguise any scar tissue that forms. The muscles along the cheeks are then released and lifted. Furthermore, during a deep plane lift, the fat “pads” and other connective tissues beneath the superficial muscular aponeurotic system (SMAS) are also carefully raised. This can help to correct problems associated with advanced aging, such as jowls and hollows under the eyes and cheekbones. Finally, excess skin is trimmed away.

In many cases, the deep plane lift is combined with other lifting procedures (such as a brow lift, neck lift, and/or eyelid lift) to produce uniform results. This type of procedure is often called a “full” facelift as it addresses the advanced signs of aging in every area that they typically occur.

The SMAS Facelift

The SMAS facelift is essentially a slightly less invasive version of the deep plane lift. During a SMAS facelift, the superficial muscular aponeurotic system is released and lifted, then excess skin is removed. Unlike a deep plane lift, no alterations are usually made to the tissues below the SMAS during a SMAS lift. There are different SMAS facelift methods in use today, however, so you should always take the time to ask your chosen surgeon exactly how he or she performs SMAS lifts.

SMAS lifts are usually used on patients under the age of 50 to 55, as these patients usually do not have very severe skin laxity or muscle sagging. The SMAS lift can be combined with dermal fillers in order to fill in any hollows that remain after surgery (seeing as the fat pads in the face are not usually repositioned during this procedure). Some patients prefer this approach as it’s less likely to produce noticeable scarring and boasts a slightly shorter recovery time (and less swelling and bruising) than a deep plane lift. Most people recover from their SMAS lift within about one week, whereas the initial recovery period following a deep plane lift can be as long as two weeks.

The Mini Facelift

There is no one type of “mini” facelift procedure; instead, this term refers to virtually any facelift that can be performed under just local anesthesia. Mini facelifts are also typified by a lack of visible scar tissue as they involve very small incisions (or no incisions at all, in the case of “thread” lifts). Here at Fasching Plastic Surgery, we use a highly innovative and sought-after technique known as the “endoscopic” facelift. During an endoscopic facelift, Dr. Fasching makes tiny incisions in the skin (too small to produce visible scars), then uses specialized endoscopic instruments to adjust the SMAS. This technique produces much more dramatic and longer-lasting results than a thread lift, all without causing significant pain or swelling. It’s similar to the “keyhole” technique that’s used for some medical surgeries in order to ensure that the patient experiences no significant pain and heals very quickly.

While the endoscopic technique is highly effective as far as minimally invasive procedures go, it’s not able to produce the same kind of results as a deep plane facelift. This is because it’s not possible to remove a large amount of excess skin without making longer incisions. As such, we usually recommend this type of mini facelift for patients who are under 45 years of age.

Facelift Recovery Tips for Better Results

In addition to picking the right kind of facelift to meet your needs, following correct recovery protocol can minimize scarring and ensure even, thorough healing. Your plastic surgeon will provide you with special supportive garments, bandages, and a list of steps to take while healing. However, in case he or she misses anything, it’s a good idea to review the tips below:

  1. Avoid sun exposure while your incisions are still pink.

While the skin is healing, it’s extremely susceptible to sun damage. Being exposed to direct sunlight can cause incisions to develop thicker, darker scar tissue that never fully fades away. As such, it’s extremely important to stay indoors as much as possible during the first week after your surgery. Furthermore, for at least three weeks after your surgery, you should make sure to keep your incisions covered by high-SPF sunscreen and protective garments (like hats and sun scarves).

  1. Use a nourishing ointment recommended by your surgeon.

Several medical-grade healing ointments are available to help speed the healing of wounds and minimize the risk of scarring. Ask your surgeon for advice on which healing ointment you should use and when it’s okay to start using one.

  1. Do not smoke or drink alcohol for at least three weeks after having a facelift.

Smoking and drinking alcohol can impair the healing process. This puts you at greater risk of infection and can make scar formation more likely. You should not smoke at all for at least three weeks after surgery, and you should avoid alcohol for at least two weeks after surgery.

Face Forward: Surgery Leads the Fight Against Aging

There’s never been a better time to have facelift surgery. With facelift methods improving all the time—and with several different options available to suit patients of all ages—you’re virtually guaranteed to experience natural looking and long-lasting results. If you would like more information on the various types of facelifts offered at Fasching Plastic Surgery, feel free to get in touch with us at any time. We’ll be happy to answer any questions you have or help you book a consultation.