A facelift refers to the surgical restructuring of the face to create a more youthful appearance with any combination of skin removal and tightening, fat re-positioning, and fat addition.
Dr. Neavin performs several different face lift techniques that are all customized to the patient’s desires, expectations, and acceptable downtime. The techniques range from skin and SMAS repositioning, mid facelift, fat grafting, and often a combination of all three.
Most commonly, Dr. Neavin applies a volumetric approach aimed to remodel the face and alter the architecture to create a younger facial form. With these goals in mind, there is a focus on repositioning tissues that have descended and rebuilding areas of deficiency, particularly in the top third of the face. Skin re-draping is considered for appropriate candidates that have significant skin laxity. Large-volume fat grafting is almost always essential, and nano-fat grafting is ideally used for lower lid rejuvenation. Often, lower lid blepharoplasty, a lip lift, and rhinoplasty are considered for complete facial rejuvenation.
It depends who you ask. A mini-lift usually refers to a facelift with a limited incision and dissection (and as a result, sometimes limited results). When patients have reasonably good skin elasticity, smaller incisions may be an option that allows access to tighten the underlying tissues. This is the “mini” part of this label. A mini facelift is not a good substitute for a full facelift in those who would benefit from a full facelift. The full or traditional facelift, involves incisions from above the ear into the hair-bearing temporal area, down the front of the ear hidden along its natural lines, to the back of the ear into the hair-bearing region of the posterior scalp.
Some may refer to a mini facelift as one that does not require the tightening of the neck.
Thus, a mini-lift is really just a full facelift minus some component like jowl correction, SMAS tightening, a neck lift, etc.
A mid facelift is a surgery that will elevate the cheek to a higher position on the face. It is often referred to a cheek lift. The mid facelift is reserved for those men and women with reasonably good skin elasticity but have a tired appearance from descent of the malar (cheek) fat pad. The surgery involves an incision inside the mouth and in the hairline above the ear. Internally, the cheek is suspended and secured with either stitches or endotines. Fat grafting to the temples is often incorporated to recreate a younger shaped face.
A liquid facelift refers to the use of dermal fillers to create the illusion of a lift. The fillers will obliterate shadows on the face that have developed from tissue descent and fat loss. Rather than lifting the tissues that have descended, the shadows (concavities) are filled with hyaluronic acid products such as Juvederm (r), Restylane (r), and Voluma (r), or hydroxylapetite such as Radiesse (r).
A MACS lift refers to minimal access cranial suspension. It is a type of facelift where the incision and dissection is generally less than a traditional facelift. Some may refer to this as a mini-lift, given the less invasive approach. The tissues under the skin are suspended with stitches in two to three areas to correct the fallen cheek and jowl. Skin may be excised as well.
Facelifts that are performed mainly to pull skin tighter will have a pulled or fake result. Pulled skin does not mimic a younger face; it simply mimics a face that has pulled skin. A facelift should re-drape the skin over an elevated underlying tissue (SMAS), with or without the addition of fat into areas where fat was lost and cannot be corrected with elevation (such as high cheeks, temples, and forehead)
The results of a facelift should be long-lasting. However, the skin will continue to age. When the skin and face does age, it will always be ahead of the curve since there was a rejuvenating procedure that already removed years of aging.
It depends on the facelift. A mid facelift may take a little over an hour while a traditional facelift with fat grafting may take up to six hours.
SMAS stands for superficial muscular aponeurotic system. SMAS is the fatty tissue layer that lies beneath the skin and is adherent to the underlying muscles. SMAS gets ample attention because it is one of the main components of a facelift that is targeted during surgery. SMAS is elevated to recreate the cheek which has fallen, or, suspend the jowl that has developed with aging.
The scars of a traditional facelift start in the hair-bearing area above the ear, down the natural crease from where the ear attaches to the face, and behind the ear in its crease to the hair-bearing area above the back of the ear.
A mini-lift or a MACS lift may spare the incision into the hair-bearing area above the ear.
A mid facelift includes incisions inside the mouth and in the hair-bearing area above the temples.
Surprisingly, the face does not become terribly painful after surgery. Because fat grafting is included in almost every facelift, the area of fat harvest such as the abdomen or love handles will generally hurt the most. Pain at these sites lasts about two or three days.
The most serious surgical risks from a facelift include bleeding and nerve injury. Thankfully, the bleeding from a facelift is almost always non-life threatening, but may prompt a return to the operating room for evacuation. Permanent nerve injury remains very, very low in experienced hands. Temporary nerve weakening of the marginal mandibular branch that innervates the lower lip is more common and tends to return to normal function within three months.
Smoking, and for that matter any consumed nicotine product, will constrict small vessels of the skin and impair healing after surgery. Decreased circulation can lead to skin necrosis near the ear. For this reason, Dr. Neavin advises all of his patients to be off nicotine products for a minimum of four weeks prior to surgery.
The bags under the eye are not corrected with a facelift. Bags under the eye, and any excess skin accompanying the bags of the lower eyelid, must be addressed by a lower lid blepharoplasty. Not all facelift candidates have lower lid skin laxity or bags. However, a lower lid blepharoplasty can easily be added to the facelift surgery to complete the facial rejuvenation and avoid a patchwork like appearance.
No. A facelift will not raise the eyebrows. The eyebrows can be raised by a brow lift. Brow lifts can be performed several different ways and are often combined with a facelift. For more on the brow lift click HERE.
Yes. The goal of a facelift is to reshape the face to a younger, more youthful state without sending any signals to the casual observer that a surgery has been performed. This is best accomplished by proper diagnosis of the aging symptoms and develoment of the appropriate plan to address the problem area(s). A single technique, also known as the cookie-cutter approach, will improve some faces and alter others in an unfavorable way. Thus, the role for a mid face lift, MACS lift, traditional facelift, and facial fat grafting must be in the plastic surgeon’s repertoire.
Every facelift approach will have its own expected post-operative edema and one can expect a minimum of one week with significant swelling. The mid facelift in particular can cause persistent swelling for up to six weeks or more in some cases. A liquid facelift, one where only fillers are used to remodel the face, generates little to no swelling.
One can safely return to a desk job after three or four days. However, safety is not always the only motive for remaining at home after this surgery. There are aesthetic concerns to consider. The swelling after most facelifts will persist for weeks.
Most of the swelling will be gone within one week, bandages will be removed, and the stitches will be out. Thus, seven days is a safe time for most people to wait to return to work without obvious signs of surgery. Physical labor should be avoided for at least two weeks to avoid blood pressure and heart rate elevation, which can prompt a late bleeding episode (particularly in men).
Facelifts can be performed safely under local anesthesia or general anesthesia. The larger the dissection, the more convenient it may be for both the surgeon and patient to opt for a general anesthetic. It can be uncomfortable and anxiety-provoking for the patient to sit still for up to six straight hours. Likewise, it can be anxiety-provoking for the surgeon to work on a patient that is having trouble relaxing.
Shorter facelift procedures, those under three hours, are the more common type of facelifts performed under local anesthesia.
No. Insurance will not cover a facelift.
The cost of a facelift is determined by the following factors:
- Surgeon experience and reputation
- Type of facelift procedure
- Office support and physical availability
- Surgeon demand
- Complexity of the procedure
- Combinations of accessory procedures
- Type of anesthesia
A facelift by Dr. Neavin will cost on average somewhere between $12,000 to $60,000 depending on the type of facelift and accessory procedures.
If you are ready to reverse those telltale signs of aging, a facelift might be the right choice for you. Learn more about this procedure by scheduling your personal consultation with Dr. Neavin at 310‑858‑8811.