A traditional full facelift (rhytidectomy) historically was the only option to surgically address the signs of facial aging. Currently, the numerous face-lifting techniques available allows individual surgeons to customize facelift procedures to more discreetly and more accurately address the individual patient’s areas of concerns. With more options available for facial rejuvenation, Dr. Moses, guided by the concerns of each individual patient, carefully curates a plan to obtain a result that more closely realigns one’s inward image with the outward reflection to provide a natural, timeless result.
A traditional or standard facelift does not stop or halt the aging process but instead turns back the clock through addressing the more visible signs of aging, including skin laxity, fat accumulation, and weakening of the underlying facial musculature. Through addressing these areas and redraping the overlying skin, a natural, more youthful result is obtained.
A facelift may also be combined with other procedures to further attend to additional areas of concern; this includes eyelid surgery (blepharoplasty), liposuction, and chin augmentation, to name a few.
Dr. Moses’s goal with facelift surgery, and truly any facial rejuvenation procedure, is a natural, timeless result. Her years of training and extensive experience with nationally acclaimed facelift surgeons allows her to deliver a result that “everyone will notice but no one will know.”
Am I a Candidate?
During the consultation visit, which is a critical part of the facelift process, each individual patients’ areas of concern and facial aging are identified and thoroughly evaluated in order to formulate the most well-suited technique for addressing his or her own signs of aging. There is no “correct” or “standard” age for a facelift or any plastic surgery. Any adult with concerns of sagging facial skin or other signs of facial aging is potentially a candidate. Many individuals have this procedure performed during their 50s and 60s but there is a wide range of ages on which this procedure may be performed spanning 40s to 80s. One thing that is frequently mentioned after surgery by patients is that they wish they would have done it sooner!
Additionally, during the consultation visit, together you and Dr. Moses will review your medical history, including prior surgeries, allergies, and medications. She will examine the face and neck, focusing on your facial frame and build in order to provide the best options for you to obtain your treatment goals. Photos will be obtained as well. Through your discussion with Dr. Moses, your candidacy for facelift will be determined along with any additional facial cosmetic concerns that were identified during the consultation. This conversation is driven by the patient and Dr. Moses keenly listens, reviews all information with you and ensures you have the knowledge and comfort level to make an informed decision.
Instructions for the proposed facelift procedure are then provided. Prior to surgery, patients return for at least one more visit (the “pre-op” visit), to review imaging, review the history and any changes or concerns as well as to obtain any prescriptions for medications. This provides the opportunity to take time and sit down to review any questions or revisit any concerns.
Surgical patients will need to be cleared for surgery by either Dr. Moses, the Anesthesiology team, or one’s individual primary care physician or specialist as needed. Certain medical conditions, pre-existing ocular conditions, and patient medications may complicate surgery itself or the recovery process – if present, these are addressed during the initial consultation as well. Lastly, our practice may request medical records, blood tests, and X-rays to ensure the best possible patient experience.
The modern facelift is designed to look and feel as natural as possible while minimizing downtime and avoiding any of the stigmata of facelift techniques of the past (including avoiding unnatural tightness, pulling, visible incisions). You can expect a surgical result that restores a natural, youthful contour and a refreshed, clean cheek and jawline. The art of facelifting was not designed for certain areas of the face, including the nasolabial folds or the eye. After a facelift, you will notice the nasolabial folds are softened but given that even young children have these lines, an attempt at complete removal of this fold results in an unnatural, overdone look.
Following surgery, patients can expect the following:
1. Improved contour along the cheek and jawline, with repositioning of the jowl to a more youthful position
2. Reduction and resolution of sagging skin while simultaneously avoiding a “pulled” or “tight” face
3. Restoration and repositioning of the skin and underlying muscle
4. Improvement in overall skin laxity
The art of facelifting begins with the incisions. These are carefully planned prior to surgery and specifically marked in the pre operative area the morning of surgery. Dr. Moses utilizes incisions hidden in already existing creases and curves of the face and neck. The incision begins in the area near the temple in order to address the deflated cheek area and by lifting this area, is able to achieve a more natural, youthful look. The incision the continues around and slightly in the ear before continuing around the earlobe. This extends behind the ear in the existing crease and lastly extends into the hairline. After the incisions are healed, patients should be able to confidently wear any hairstyle, ponytail, or updo desired without concern that the incisions are visible to the naked eye. Once the incisions are made, the area is then undermined, degree to which varies between patients.
Dr. Moses then surgically addresses the actual muscle layer (SMAS, or superficial aponeurotic system), lifts and permanently repositions this supporting structure of the face. The direction of repositioning depends on the deformity to be corrected and is individual to the patient. Once repositioned, suturing is performed on this layer. This provides the longevity of the facelift and also allows us to customize the lift respective to the patient’s needs. Also, by physically “lifting” the areas that have aged or descended due to age, the result lasts for a longer period of time as compared with other facelift techniques. Further surgical details and extent of surgery may vary for each patient and this process extends back to the first office visit. Following the repositioning and lifting, the incisions are closed in meticulous fashion utilizing fine suture and fine, controlled suture techniques. Dr. Moses does not utilize surgical drains in her facelift, necklift, or combination mini-lift cases and a surgical dressing is applied at the end of surgery that is worn overnight.
The length of time for the procedure varies depending on several factors: extent of surgery, degree of facial aging, surgical goals, and patient-specific conditions. Following surgery, the patient is observed for a period of time in the post operative recovery room prior to discharge home under the care of a friend or family member.
Facelift is most commonly performed under a light general anesthetic and is administered by our board-certified Anesthesiology staff at each of our surgical locations and ensures that our patients are relaxed, comfortable and feel no pain during the surgery. Medications prescribed by Dr. Moses are used in the period after surgery on as needed basis to maintain a certain level of comfort.
Patient Recovery and After Care
Surgery is performed at the Palmetto Surgery Center or Prisma Health Parkridge and average downtime for facelift procedures is about seven to ten days. Surgery is performed on an outpatient basis therefore, following surgery and a period of observation, patients are drive home by a friend or family member the same day. It is recommended that the patient have a friend or family member spend the night of surgery and the following day with the patient.
Recovery time depends on if a standard facelift or mini-facelift was performed as well as if the procedure was combined with other surgical options, such as a necklift or liposuction. While a mini-facelift takes advantage of a shorter recovery period, around 5-7 days, a traditional facelift may take 7-10 days, and up to 2 weeks depending on if any adjunct procedures were performed. Most facelift patients return to work after 10 days but some activities will need to be avoided for a minimum of two weeks after surgery (bending, lifting, exercise). Saunts, hot tubs, steam rooms etc should not be used for at least 2 months following surgery. The degree of swelling and bruising also factors in to the recovery period but this usually results in only social downtime. Discomfort is usually minimal but pain medications are prescribed. Swelling is a part of the normal recovery process and patients should sleep with the head elevated to help reduce additional swelling. A dressing is placed at the end of surgery that remains in place overnight. Dr. Moses does not use surgical drains during the recovery process. The morning following surgery patients are seen in the office where the dressing is removed and incisions are inspected and cleaned. The post operative care instructions are provided to the patient during the pre operative appointment which are then also reviewed during the post operative appointments to ensure everyone is on the same page. Sutures are removed on post operative days 5-6 as well as days 8-10.