What is a facelift, and what does it do?

When it comes to the gold standard for treating the signs of aging in the face, there is a lot of confusing information out there about facelifts. It seems that every week there is a new technique or treatment touting to be a way to non-surgically lift the face. For some individuals, some of these may be viable alternatives like the EmbraceRF system. Unfortunately, many of these less invasive options do little more than lighten the wallet.

To understand what a facelift can do, it is important to understand what the word facelift actually means. The Greek word for wrinkle is “rhytid.” The suffix -ectomy means “to remove.” Thus, rhytidectomy is the medical term for the operation designed to remove or lift wrinkles and sagging tissues from the forehead, face, and neck. The term “face lift” is often used incorrectly in the media. This may be to help market some new fad or it can be used to describe a total facial rejuvenation, which, in reality, consists of an eyelid surgery, a face lift, and possibly skin resurfacing. While a true face lift provides the foundation for the rejuvenation process, other procedures may add the finishing touches. By no means, however, does this mean that every patient who requests a face lift should have any additional procedures.

Why does the face begin to droop and sag? The changes associated with aging do not occur all at once. They happen in a slowly progressive manner, involve all components of the face and body, and at different rates in different people. Patients frequently first become aware of the changes related to aging in their mid-thirties which becomes more noticeable over a 2-4 year period in their early forties. They often say that it seems as though things were holding up well and seemed to “fall” almost overnight. This is never truer than following a period of prolonged stress which, along with sun exposure and smoking, are known to advance the aging process. The best example of this is to think how much the presidents seem to age over their terms in office.

With aging, the facial bones become slightly smaller, some fat is absorbed and other fat sags, and the skin loses much of its elasticity which used to keep it tight. This causes the tissues, particularly in the face and neck, to droop and sag. This phenomenon results in a series of events, including deepening of the lines of facial expression in the forehead and at the sides of the mouth, sagging of the eyebrows which causes the eyes to appear smaller and tired, “crow’s feet” form at the corners of the eyes, pouches or jowls develop along the jaw line, and the well-known “double-chin” develops as a result of a new fatty tissue deposit in this area. At the same time, the skin also shows its age. In some faces the skin becomes etched with wrinkles. This frequently occurs in those repetitively exposed to the sun and wind as the damage to the skin is cumulative. The muscles and tissues around the eyes eventually lose some of their tone so that a portion of the fat normally located inside the orbit around the eye bulges forward, or herniates, to produce the commonly seen “bags.” This condition is often seen in younger people before many of the other signs of aging have developed. “Circles” under the eyes may be a result of a shadow falling in the crease between these bags and the cheek. Finally, because of absorption of tissues in the upper lip and gums, the lips become thinner and the tip of the nose drops causing it to appear larger and longer.

A face lift is designed to counteract many of these forces by lifting the tissues and restoring them to their more youthful position. This includes not only lifting the skin but more importantly the underlying muscles and fatty tissues. It is important to realize that a face lift does not correct problems in the upper or lower eyelids, or the wrinkles or creases in the lips—other treatments are required for these conditions.
When is the best time to consider facial cosmetic surgery? The best answer is when the slack in the skin of the face and neck or “bags” around the eyes are no longer temporary conditions relieved by rest, or when they become increasingly difficult to camouflage with cosmetics. There is no magical age when people should be considering surgery. Younger patients around age forty contemplate surgery to help prevent the advancement of aging, i.e., to help them to appear to stay young. For others the right time may not be until the signs of aging have advanced in their fifties and sixties and later. For these patients surgery helps reverse these more advanced signs of aging to improve their face and skin giving a younger and more rested look.
As the life expectancy lengthens, most people feel vigorous and energetic long after their appearance begins to change as a result of advancing age. The emotional impact of looking older than one feels can be disconcerting and facial plastic surgery can bring your looks and how you feel back into harmony. Because of this, the face lift has become one of the most popular cosmetic operations performed in the head and neck. Men and women from all walks of life are seeking ways to look as good as they feel. As facial experts, treatment by a facial plastic surgeon can produce “natural” and “un-operated” looks.

The operation itself may be divided into three parts: the forehead or eyebrow lift (the upper one-third), the cheek lift (the middle one-third), and the neck lift (the lower one-third). Many people require all three components, while in others only one or two portions are needed or recommended. The most common isolated request is a “neck lift.” Most people seeking “neck lifts” require some lifting of the cheeks to maintain harmony. In select patients, it is possible that a neck lift is all that is required.

However, not all face lifts are the same – nor should they be! The reason is that not all faces are the same. And, at different ages, the same person has different conditions of aging that develop. The facts are plastic surgery is very much an art form and can be tailored by an experienced surgeon/artist to meet the needs of each individual who presents for treatment. Dr. Guy, a double board certified, fellowship trained facial plastic surgeon has been trained extensively in the various surgical approaches for rejuvenating the face to give you the best aesthetic outcome. At your consultation you can learn about the expected outcomes, for which treatment you are the best candidate, the treatment timeline, and what to expect during and after treatment.

W. Marshall Guy, MD
Facial Plastic & Reconstructive Surgeon

128 Vision Park Blvd #150, Shenandoah, TX 77384
832.956.1040

drguyfacialplastics.com