Face Lift Surgery: Trends
Face lift surgery trends have moved from tightening to re-draping of skin with volume addition. The Joan Rivers “pulled ear to ear” look can and should be avoided, unless of course, your patient is Joan Rivers.
The term “face lift” is a bit of a misnomer. The surgery itself does indeed “lift” skin that has fallen. Skin falls due to several factors, aging being the most significant. Other culprits of saggy skin include smoking, sun exposure, and rapid weight loss.
Modern face lift surgery must combine both additive and subtractive components to re-shape the face, not just lift it. That is, in some areas fat is removed. In other areas it is added.
That is, the idea of face lift surgery is to SHAPE the face, not lift it. Face lift surgery must restore the SHAPE OF YOUTH, and this cannot be accomplished simply with skin tightening, or even SMAS elevation. SMAS stand for “Superficial Muscular Aponeurotic System”. It is the fatty layer of tissue below skin.
The Top Heavy Face is Youthful
Face lift surgery ideally converts a bottom heavy face into a top heavy face. Meaning, older faces are bottom heavy. The aging faced is marked by loss of cheeks and formation of jowls. Younger faces possess high cheeks and full temples. In young faces, most of the volume is in the middle to upper third of the face.
Facial remodeling is accomplished through the elevation of underlying SMAS, with a gentle re-draping (not tightening) of skin. The subtractive component of face lift surgery includes the excision or suspension of jowls and fat deposit along the jawline, with tightening of the muscles along the neck.
The additive components include resuspension of underlying tissue (SMAS) to a higher position on the face, and redistribution of fat from baggy under eyes to the junction of the lid and cheek.
Lastly, fat grafting to the cheek and cheek bone and temple area restore balance to a youthful top heavy face. When these components are performed together, natural long lasting results can be achieved while avoiding that “done” face tightening look.
For more on face lift surgery, check out the FAQ page here.
For more on fat transfer follow this link.