Key Aspects of Facelift Surgery

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Author: Dr. Sitapara, Fellow at The Williams Center

When the latest reality TV star’s face looks unnaturally windswept and obviously surgically overdone, nobody cringes more than a plastic surgeon. It gives the facelift procedure a bad reputation, when in reality, all facelifts are not built the same. The term “facelift” is a blanket term used to describe a broad range of surgical procedures to help rejuvenate the lower third of the face and in some instances, the neck as well. Let’s break down some key aspects of the surgery and how our techniques provide natural, long lasting, and exceptional results.

Scarless surgery?

While science has yet to invent a way to perform this surgery without incisions, we hide your incisions in the nooks and crannies around your ear, sideburn, and posterior hairline. We ultimately engineer these incisions so that your hair grows directly through them, rendering them practically invisible after you heal.

Pro-move: Our incisions allow for maximal surgical improvement while never changing your hairline!

The terminology used to describe the type of lift can be confusing for patients and surgeons alike. Some describe specific anatomic structures while other terms are just marketing ploys. Ultimately, your surgeon will base their decision on your particular anatomy and their comfort level in manipulating your particular anatomy.

Superficial musculoapo-WHAT?!

The SMAS (superficial musculoaponeurotic system) is a fibrous muscular layer that is deep to your facial skin that suspends the fat pads within the face. As we age, areas of the SMAS become weak, allowing gravity to pull our fat compartments down.

Facelift techniques differ based on how they manipulate the SMAS layer. Some tighten the SMAS without significant dissection deep to that layer (imbrication, plication, etc.), while some completely reposition the SMAS by dissecting deep to it (deep plane).

We perform both classes of lifts depending on your particular goals and your physical exam findings. However, we have had tremendous success in correcting moderate to severe facial aging with the deep plane technique.

Why choose a surgeon who performs the deep plane technique?

There is no other technique that mobilizes facial fat pads to restore midfacial volume, improve jowling, and recreate a youthful jawline. It can address facial aging to a much more significant extent than the other techniques.

When done correctly, it provides the longest lasting and natural appearing results.

What about my neck?

The lower face and upper neck are intimately related, so we often extend the deep plane technique into the neck by releasing so we can address the aging neck at the same time.
We occasionally will make a small incision under your chin if we need to address additional anatomy in your central neck.

Why doesn’t every surgeon perform the deep plane lift?

Dissection deep to the SMAS can be dangerous in the hands of an inexperienced surgeon. There are numerous nerves, salivary tissue, and muscles deep to the SMAS that deter the average facelift surgeon from performing this technique. However, in experienced hands, the complication rate has been proven to be the same as other techniques at about 1%.

We occasionally will augment your facelift with fat grafting, buccal fat pad removal, or skin resurfacing at the same time. It all depends on your goals and your anatomy!

*Patient Results May Vary
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