What is a facelift?
Sagging in the middle of your faceA facelift, or rhytidectomy, is a surgical procedure that improves visible signs of aging in the face and neck, such as:
- Deep creases below the lower eyelids
- Deep creases along the nose extending to the corner of the mouth
- Fat that has fallen or has disappeared
- Loss of skin tone in the lower face that creates jowls
- Loose skin and excess fatty deposits under the chin and jaw can give even a person of normal weight the appearance of a double chin
The loss of youthful contours in the face can be due to a variety of factors, including heredity, gravity, environmental conditions, and stress. Rejuvenation procedures typically performed in conjunction with a facelift are brow lift, to correct a sagging or deeply furrowed brow, and eyelid surgery to rejuvenate aging eyes. We also recommend dermal fillers to enhance the look of your refreshed look!
Here’s a recent patient:
What a facelift won’t do
As a restorative surgery, a facelift does not change your fundamental appearance and cannot stop the aging process. A facelift can only be performed surgically; non-surgical rejuvenation treatments cannot achieve the same results, but they may help delay the time at which a facelift becomes appropriate and complement the results of surgery. Age-related descent of the lower face causes the youthful triangle formed by the chin and jaw to revert to a more square configuration formed by the jowls. A facelift can elevate the jowls and reverse the early changes of lower facial and upper neck aging. Other rejuvenative procedures can be performed at the same time to include: dermal fillers for facial folds, chemical peeling for superficial skin related pigment issues and fine wrinkles, Botox, and other eyelid/forehead procedures.
Fillers have become extremely popular as they can often provide improvements to areas better than surgery (e.g., nasolabial folds and marionette lines around the mouth). Fillers also can help restore volume to facial areas that have become deflated with age (e.g., the cheek fat pads). Dr. Burroughs has applied the techniques which has made him an expert as an eyelid, forehead, and mid-face surgeon to correcting the lower facial aging changes.
Dr. Burroughs performs mini facelift (short-scar facelift) techniques whereby patients actually recover more rapidly than from cosmetic eyelid, forehead, or mid-face surgeries. This has made Dr. Burroughs a sought after cosmetic surgeon as his techniques provide very quick recovery with minimal downtime. It is important to realize that a “mini-lift” doesn’t mean a “mini” result. The surgery can be customized to not only address the lower face jowls but also neck related sagging. The mini facelift won’t address a neck with a lot of fatty tissue, but for most patients, an outstanding and natural result is achieved.
Frequently asked questions about facelift surgery
1. Why does the face droop with the passage of time?
There are several reasons that include the effects of gravity and weakening of the facial support tissues over time. The structures that attach the skin to the bony skull elongate, causing skin to sag. Also, the loss of skin elasticity causes sagging, and a final important reason is loss of volume. Our faces lose volume with time, and this facilitates wrinkle formation and facial descent. An analogy is a balloon. If a round balloon is fully inflated, it will be perfectly round and without lines on the surface. If some of the air is let out, it will no longer be round and develop lines (“wrinkles”) on the surface.
2. Why do patients get mini facelift surgery?
The primary reason is to regain a more youthful and rested look. As we age, our facial tissues sag downward, causing soft tissue to droop below the jaw line (jowls). Younger patients have a well defined and rounded jaw line, whereas older patients with jowls have a more squared configuration with loose tissue hanging below the bony jaw line. A mini facelift elevates these jowl areas and restores the youthful, rounder contour.
3. Which is better, fillers or surgery, to make my face look younger?
Aging causes both loss of volume (“deflation”) and drooping of the cheeks and lower face, so patients benefit from addressing both. Dr. Burroughs often performs mid facelift surgery, mini facelift surgery, and dermal filler volume restoration. Restoring facial volume with fillers often improves the overall result and recovery by addressing focal areas that are not as well or naturally addressed by surgery and by often lessening the amount of surgery that is needed.
4. Is mini facelift surgery painful and what kind of anesthesia is needed?
Generally, the surgery is not painful at all, and Dr. Burroughs most commonly performs this procedure in the office using just oral sedation and local anesthesia. The office setting often provides a more relaxed environment that reduces anxiety, allows for patients to eat a light meal before surgery, and reduces the cost for the procedure substantially. Mini facelift surgery is often more comfortable and less stressful than eyelid surgery.
5. Where are the incisions located, and when are the stitches removed after facelift surgery?
The incisions are placed primarily right in front of the ears with slight extension behind the bottom of the ears and sometimes there is some extension into the hairline superiorly. The skin sutures are removed between 10-14 days after the surgery.
6. Is there much swelling and bruising?
Most patients have very little swelling and bruising as the skin is thicker than eyelid skin and hides these issues better. When bruising does occur, it is usually resolved by 2-3 weeks after the surgery.
7. Will a mini facelift surgery effect my hairline?
The surgery technique used by Dr. Burroughs has little effect on the hairline or sideburns. In fact, the sideburns can help camouflage the incisions during healing.
8. Is it possible to substantially lift the face without surgery?
No, but in some patients, the primary problem is facial volume loss with little to no sagging of the facial tissues. These patients do well by having volume restored to the needed areas, especially in the mid face and, to a lesser degree, in the lower face. Radiesse is a dermal filler that is an outstanding facial volume restorer and deep fold reducer that lasts between 1-2 years. Some subtle elevation of the mid-face tissues can be achieved by restoring volume in the high cheek areas but, in many circumstances, is best addressed by surgical approaches. Subtle eyebrow descent can likewise be improved with botulinum toxin injections but is best addressed by a brow or forehead lift (an “upper facelift.”)
9. What is the difference between a mini facelift and a neck lift?
If jowl formation is the primary concern, then the mini facelift is the ideal procedure. Some patients, however, also have excess skin in the neck. As long as the neck skin is thin and the amount is mild to moderate, then the mini facelift is still a great choice. Thick, heavy, and considerable excess neck skin is better improved by a neck lift. Furthermore, patients with considerable fullness of the neck from excess sagging fat also require a neck lift and liposuction. A neck lift is sometimes called a full facelift, but a neck lift differs from a mini facelift as the incisions extend much further behind the ear and the surgical dissection required is extensive. Therefore, most neck lift patients require surgery under general anesthesia. The neck lift recovery is also substantially longer than a mini facelift.
10. Will a mini facelift help my neck?
Yes, in many patients with thin but sagging neck tissue will see substantial improvement. Patients, who will tolerate a slightly larger incision, can get a more substantial neck lift.
11. What causes poor results from a facelift?
Oftentimes, poor results are caused by too much skin removal, over-pulling, and by not addressing facial volume loss. This causes an unnatural, pulled back, “wind swept” appearance. When needed areas of facial volume loss are addressed simultaneously as a facelift, the amount of skin removal is lessened and allows for a quicker recovery and more naturally appearing result.
12. Are their risks associated with facelift surgery?
Yes. All medical procedures have risks associated with them, but mini facelift surgery is generally much safer than a deep plane facelift and neck lift. You should discuss the risk of facelift surgery with Dr. Burroughs so that you can make an informed decision. Dr. Burroughs can show realistic estimates of the desired result and will refer you to another surgeon if he determines this to be in your best interest and goals.
13. Why do patients get mid-facelift surgery?
A mid-facelift surgery addresses the cheeks primarily and helps patients look younger with a happier facial expression. With facial aging, descent or drooping of the cheeks in the mid-face occurs. This causes a facial expression of a greater sad appearance. Cheek descent also contributes to under eye dark circles and to deepening of the folds between the cheek and lips (“nasolabial folds”). Mid-face lifting of the cheeks can improve the dark circles, the nasolabial folds, and provide a more cheerful facial expression.
14. How long is recovery for mid-facelift surgery?
Mid-facelift surgery is most commonly and best performed at the same time as eyelid surgery. Some mid-face elevation (lift) can also be achieved from a temporal pre-hairline approach. Bruising and swelling usually resolves in about 3 weeks after the surgery.