Face and Neck
A facelift restores a clean rested appearance by re-draping facial soft tissue that has shifted due to natural age-related changes from the effect of gravity and facial muscle activity over time. There is a full spectrum of facelifts to consider depending on the extensiveness of surgery required to deliver a natural look. These approaches range from upper limited-scar or mini-facelifts to full facelifts including the neck soft tissue. The ideal facelift restores a more youthful, rested appearance in a subtle manner. Once the facial soft tissue is re-suspended to yield revitalized contours, the incisions, which are hidden in the natural folds of the ears and face, are closed.
One of the unique aspects of my technique is the utilization of your own fat, taken from the abdomen or inner thigh region, to smooth and fill wrinkled or depressed areas of the face. This is called fat grafting and is an adjunct to facial aesthetic surgery used by some of the most highly recognized plastic surgeons in the country, Dr. Timothy Marten, Dr. Sherrel Aston, and Dr. Rod Rhorich. In my training, I was able to perform routine fat grafting for facial as well as breast surgery. I have also published (in peer reviewed literature) a systematic review of fat grafting used for breast surgery.
The facelift is often done in conjunction with brow repositioning and periorbital rejuvenation or eyelid surgery. Occasionally, cheek or chin implants are used to restore facial volume. If indicated, full facial rejuvenation may involve a face and neck lift with fat grafting, brow repositioning with removal of excess eyelid skin, and skin resurfacing with a light TCA chemical peel.
Dr. Rosing recommends two weeks of rest before resuming normal activities.
LOWER FACE & NECK procedure
This is truly what Dr. Rosing does best. Over the years, patient after patient has consistently raved about their results after Dr. Rosing’s lower face and necklift procedure. What you can count on is you will look like yourself, only better! You will not look ‘tight’ or ‘wind-blown’ or ‘strange’. The aim with facial aesthetic surgery is not really to appear so much younger per se, but rather, to look so much better. This is the mantra of Dr. Rosing’s patients; Natural, highest quality results.
What is a facelift?
A facelift, or rhytidectomy, is a surgical procedure designed to smooth and firm the skin providing a fresh, youthful appearance. Surgery for a facelift involves the repositioning of facial and neck skin and underlying tissues, and in some instances, the removal of excess fat deposits.
You may want a facelift if you have:
Sagging skin, muscles, and fat in the face and neck
Excess skin and fat in the neck area
A sagging jaw line
Crease lines along the nose, mouth, and chin
A facelift commonly involves making small incisions just inside the hairline, following the contour in front of the ear, and continuing under the earlobe to the backside of the ear and to the lower scalp. The underlying tissue is repositioned, excess fat is removed, the skin is repositioned, and any excess skin is removed. If the neckline requires attention, an additional incision is made under the chin and the same procedure is again followed. Fine stitches are used to close the incisions and to reduce any chance of scarring.
A facelift may take several hours or longer depending on whether other cosmetic procedures are completed at the same time. Patients who undergo a facelift have stitch removal after a week and experience some swelling and discomfort.
ARE YOU CONSIDERING A FACELIFT?
Have you been thinking about a facelift, but want all the facts before you make your final decision? You’ve come to the right place and you’ll be happy to know that face-lifts have come a long way.
Early on, facelifts just tightened the skin. Now, facelifts involve repositioning the muscle, skin, and fat to restore a more youthful appearance. In addition to the information provided here, Dr. Rosing will provide you with before and after facelift pictures, so you can see how his neck lift procedures achieved youthful and natural looking results.
WHAT IS A FACELIFT?
A facelift is the most comprehensive way to remove or reduce the appearance of wrinkles and sagging of the face caused by age. A facelift, medically referred to as a rhytidectomy, involves the removal of redundant facial skin that increases with aging. While the initial description of a rhytidectomy involved tightening the skin only, the current technique includes elevating both the skin and the muscle and facial layers of the face or the superficial muscular aponeurotic system (SMAS). A SMAS facelift is the current standard for facial rejuvenation and is essential to provide a lasting and natural appearing facelift.
FACELIFT SURGERY OVERVIEW
A patient will either be given general anesthesia or a sedative through an intravenous line and local anesthesia to numb the skin. Dr. Rosing will make an incision that starts in the temple area, extending downward along the natural ear curves, around the ear lobe, and back up to the bone behind your ear ending along the hairline behind the ear (see illustration to the left for my most common incision types).
The skin is then elevated, and the muscle and tissue underneath (SMAS) is tightened. The nuance in face lifting is in the SMAS dissection. Depending on each patients unique facial skin characteristics, soft tissue volume, shape, symmetry or asymmetry, neck obliquity, skeletal contour, and animation characteristics, Dr. Rosing alters the SMAS dissection and tightening to fit these features. Once the SMAS has been addressed, the skin is then re-draped over the facial soft tissue, excess is trimmed, and the incision is carefully sutured. The incision is beveled at the hairline to allow for follicles to grow through the scar and is sewn along a natural crease in order to camouflage the incision area.
Some people are able to have a limited-incision facelift or short-scar facelift. This technique was first described by Daniel Baker, MD and is intended for younger patients without significant submental or neck laxity. The ‘short-scar’ refers to the extent of the posterior (behind the ear) incision length. This surgery uses shorter incisions at the temple and close to the ear.
By default, when performing a facelift that involves elevating and tightening the SMAS layer, the neck is also tightened. This is the result of normal facial anatomy as the SMAS and neck muscle (platysma) are connected. There can be a focus on the neck soft tissue and muscle should this be the main concern of the patient. In this case, the procedure would be called a neck lift, though commonly, the dissection will also tighten sagging jowls (lower cheeks along the jaw line) in front of the ear as the layers of the neck and lower face are in continuity. The neck lift incision is virtually the same as the face lift incision in most cases, starting in front of the ear, around the lobe, and behind the ear into the lower scalp. Facelifts are also effectively combined with eyelid surgery (blepharoplasty).
The surgery usually takes several hours and is an outpatient procedure. In some instances, overnight (23 hour) observation at the surgery center or a private aftercare facility is available for patients that prefer nursing assistance.
WHAT TO EXPECT AFTER FACELIFT SURGERY
Your face will be bandaged after Dr. Rosing completes your facelift surgery. The dressings are usually removed the day after surgery at your initial post operative visit. If a drainage tube has been placed (usually behind the ear), it will also be removed the day after the surgery. Dr. Rosing will remove your stitches in 5 to 10 days.
Dr. Rosing will discuss options regarding prescribing medicine to relieve any pain you may feel after surgery. Dr. Rosing’s staff will review how to use cold compresses to relieve any swelling and bruising of the face that may occur after the surgery. Dr. Rosing will also request that you keep your head elevated and still as much as possible immediately following surgery.
Nicotine in any form can increase the risk for skin and tissue death and will delay your face’s healing process and make scarring worse. With this in mind, it is important to avoid any form of nicotine for at minimum two weeks before and after surgery.
Most patients can expect to return to normal activities 2 to 3 weeks after a face-lift. At first your face will feel stiff, dry or even rough for a few months. Your face may look and feel strange to you, but this is normal. It is important, however, to be prepared for this type of feeling post surgery.
Numbness of the skin may last for months after the surgery given the shifting of skin to new areas of the face. The experience for men differs, in that men sometimes have to shave in new places because the skin has been rearranged, but laser hair removal or electrolysis can be used for beard hairs that have shifted to a new position.
HOW WELL FACELIFTS WORK
Having a facelift can make your face appear younger and healthier. Your face will continue to age after surgery, but a face-lift does “take years off” your face. This may increase self-confidence and reduce anxiety over growing older. A facelift cannot reverse sun damage to the skin or remove all facial wrinkles around the eyes, below the nose, and around the lips. For best results, you may want to have a facelift and then treat the remaining wrinkles with injectables available at Rosing Plastic Surgery.
RISKS OF HAVING A FACELIFT
Problems that may be caused by having a face-lift include:
Adverse reactions to the anesthesia
Bleeding under the skin or hematoma
Damage to the nerves that supply the muscles of the face. This can cause paralysis or spasm in the face, but the effects are usually temporary.
Numbness (in areas of your face) that may last 6 months to a year.
Hair loss (alopecia)
Blood clots in large veins traveling up to the heart and lungs (pulmonary embolism). This is not common.
WHAT TO CONSIDER BEFORE HAVING A FACELIFT
As with all cosmetic procedures, there is also the risk that the results will not be what you expected. But Dr. Rosing is an experienced plastic surgeon and he will spend a lot of time during your initial consultation to set realistic goals for your facelift surgery so you have a very clear idea of what to expect after surgery.
YOUR FACELIFT CONSULTATION
If you’ve decided to explore a face-lift, set up a consultation with Dr. Rosing. At the consultation, you should talk about your goals for your facelift. Tell Dr. Rosing what you want to change and why. Dr. Rosing will also ask you questions about your current health, your medical history, any prescriptions or supplements you take, and whether you smoke.
Dr. Rosing will take all of the information you have provided into account, examine your face, and talk with you about your options. It may be that you don’t need a face-lift because a more minor procedure will achieve your goals.
Dr. Rosing may also suggest additional minor changes, such as a chin implant or eyebrow lift. At your consultation, Dr. Rosing will also review with you all possible risks of this procedure and costs.
DOES INSURANCE COVER A FACELIFT?
Insurance companies do not cover the costs of facelifts. It is important to find out what the total costs of the procedure will be, including fees for the operating facility, the anesthesiologist’s and Dr. Rosing’s fees, medicines, follow-up care, office visits, and other services and materials.
Make sure you ask your health insurance company about its policies and how having the face-lift will affect your coverage. Some insurance companies may raise your premiums after you get cosmetic surgery. And getting a face-lift may affect future coverage. You may want to consider getting a supplemental insurance policy that will cover treatment for any complications of cosmetic surgery if your plan won’t cover that.
RESEARCH ON FACELIFTS
According to a 2011 statistic from the American Society of Aesthetic Plastic Surgery, facelifts were the sixth most popular aesthetic surgery performed after liposuction, breast augmentation, abdominoplasty (tummy tuck), blepharoplasty (eyelid surgery) and breast lift.
In the December issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), researchers analyzed standardized photos of 50 patients who had undergone face-lift surgery an average of 5 ½ years previously.
Three different sets of assessments were performed to determine how well the face-lift results held up over time and it was found that three-fourths of patients still look younger than they did before surgery, according to a long-term follow-up study.
To learn more about getting a Facelift, call our office in Newport Beach at (949) 706-7874 and arrange a private consultation today.