The facelift is one of the most common procedures that people think of when they hear plastic surgery and can take from 5 years to over a decade off one’s appearance. This very popular procedure has been around for a long time but throughout the years has had a few of its own facelifts, and even evolved into a variety of spin-off procedures. Today, we hear many different names such as mini-facelift, mid-face lift, S-lift, minimally invasive facelift, SMAS lift, Deep plane facelift, composite facelift, and a plethora of other names that add letters or words to facelift. While differences do exist between some of the techniques, the core procedure is still a facelift and the goals remain the same; to resuspend the facial structures that have descended with age and tighten the overlying skin, thus achieving a rejuvenated appearance.
|PATIENT GOALS:||Look 10+ years younger|
|SURGICAL GOALS:||Resuspend skin and soft tissues|
|ANESTHESIA / SURGICAL LOCATION OPTIONS||General (Hospital or Surgery Center)
Local with IV Sedation (Hospital or Surgery Center)
Local (In Office)
|PROCEDURE LENGTH||3 – 5 Hours|
|RECOVERY TIME||1-2 Weeks|
|PAIN LEVEL||Minimal to Moderate|
Facelift Before & After Photos
View before-and-after pictures of real patients of Dr. Ruslan Zhuravsky
The Most Common Concerns That Patients Have About Facelift Surgery
If this procedure gives patients such great results, then why is there so much hesitation and fear that surrounds it? There are several common concerns that Dr. Z hears on a frequent basis:
Patients often discuss celebrities or friends that have had facelifts leading to an unnatural appearance. The most common features they point out are the distortion of facial structures like the mouth and eyes, as well as skin that is too tense. This is NOT what a facelift is about, and does NOT have to be the case with a properly performed surgery. The goal is for results such that those that did not know you prior to surgery, would not know that you have had a facelift, and those that have known you are impressed with your natural rejuvenation.
GOING UNDER THE KNIFE
The word surgery itself eludes a certain fear in many patients, some concerned about the anesthesia, others about the actual act of surgery itself. Anesthesia has come a long way and is generally safe for most patients, plus every patient undergoes a medical clearance to make sure such is the case. Alternatively, this procedure can be performed with the patient awake without general anesthesia. This is called “local anesthesia” and involves injections of lidocaine to numb the patient much like a dental procedure (but without the drilling). Patients are also given a medication for pain and one for anxiety to make the process more relaxed and to help them deal with the thought of surgery, some even nap through parts of it.
THE POTENTIAL COMPLICATIONS
Patients often have trouble expressing exactly what concerns them about the surgery itself, but after in depth discussion, Dr. Z believes these concerns center around knowing that there are possible complications but not knowing what they are. For the vast majority of cases there are no complications and all goes well. However, rare complications are always a possibility. Fortunately, most of these (rare complications) are minor and treatable without long term issues. The major complications are even more rare. Nerve injury is perhaps the one we worry about the most. It occurs approx. 1% of the time and usually involves movement of the corner of the mouth or forehead and eyelid region, but this often self-resolves within weeks to months.
NOT KNOWING WHICH PROCEDURE TO CHOOSE
A wide variety of facelift procedures are marketed today, as well as alternatives to facelifts, and this can be very confusing for patients. The burden should not be completely laid upon the patient to choose, rather the surgeon should help guide the patient based upon their exam and patient’s goals. Dr. Z believes in this strongly. He has performed facelifts on those that have gone elsewhere with unsatisfactory results, and has also turned patients down that he did not believe would benefit from a facelift, even if it meant referring them out for a treatment that he could not provide.
– Written on April 4, 2019
Great Doctor with great knowledge. Extremely personable and compassionate about providing detailed information. He is truly invested in what is best for his patients. I would highly recommend him!!!!!!!!!!!!
Facelift Vs. Other Less Invasive Procedures
Alternative options such as fillers, fat grafting, lasers, radiofrequency, and other technology focused on rejuvenation have been advertised as alternatives to facelift. We have to keep in mind that the primary objective with a surgical facelift is to lift and tighten. Generally speaking, alternative modalities offer a smaller degree of tightening and lift, with shorter term results, thus are better suited for the milder cases. On the other hand, such modalities can help correct other signs of aging and can be used in combination with a facelift (see below). The surgeon should base their nonbiased recommendations primarily on patients’ goals, skin laxity, skin quality, amount of volume loss, budget, and general state of health.
When Should a Facelift Be Done in Combination With Other Procedures?
One very important point to understand when discussing facelift surgery is that while the descent and drooping of facial structures is a major component of facial aging, we are also dealing with skin texture changes, as well as the loss of facial volume from fat and bone. A facelift will support the facial structures, bringing the fat pockets back up to their youthful positions and will tighten the skin, but it cannot always be used as the sole procedure to improve ALL aspects of aging. In such cases, facelifts can be combined with fat grafting or fillers to add volume, as well as resurfacing to improve skin quality. There are even cases where volume loss is the predominate issue, and a “facelift effect” maybe achieved with fat grafting or fillers alone.
Whats the Difference Between the Various Types of Facelifts?
A very important concept of facelift surgery is that we are not pulling on the skin itself, but rather on the supporting layer below called the SMAS (submucosal aponeurotic system). This layer supports the skin, as well as the fat pads of the face and is the key to facelift surgery. The biggest difference between the types of facelifts is how aggressively they approach the SMAS and how much of the skin is elevated.
While this is not a forum for the ongoing debate among surgeons regarding facelift techniques, it is reasonable to say that not every technique is always the right option for every patient. Thus, it is important that patients do not put themselves on an assembly line for a specific type of lift.
Generally speaking, the less invasive approaches boast faster procedure times, with potentially lower rates of complications, but also smaller degree of improvement. The more aggressive approaches provide a greater ability for lift and repositioning, but longer surgical times, and potentially more complications.
Dr. Z is a strong believer that each patient should be evaluated individually and the approach chosen after a thorough physical examination and discussion with the patient.
During your Consultation
Some of the more important points to communicate to your surgeon are as follows:
- The areas that bother you most
- Your expectations (what you expect to, or would like to look like after surgery)
- Expected recovery period / Downtime
- Your general level of health and ability to tolerate surgery
Based on this information, as well as a thorough exam, the surgeon should be able to provide recommendations for procedures that would best suite your needs. The above information, combined with a thorough evaluation by the surgeon will allow them to help guide you in the right direction and recommend the procedure, or combination of procedures that is right for you.