
Facelift (Rhytidectomy) and Neck Lift
Facial rejuvenation is a multimodal approach to improving the changes that develop with age. It’s more than just pulling the skin tighter. It starts with an assessment of the quality of the skin. The skin may thin with age and develop irregular pigmentation, fine lines, and wrinkles. Dr. Feiner performs a comprehensive facial assessment as part of every facial evaluation. Interventions often start younger in life as part of preventive maintenance. This includes sunscreen and a quality skin care regimen to protect from sun damage and maintain quality skin. With aging, neurotoxins such as Botox may be employed to weaken muscles of animation to prevent the formation of lines and wrinkles. Fillers may also be used to restore the volume lost in the aging face. Laser treatments and chemical peels may be used to improve the quality of the skin and tighten fine lines and skin laxity. As aging progresses, surgical intervention becomes necessary to correct progressive facial laxity and volume loss. The effects of age include thinning of the skin and loss of facial fat/facial fat sagging.
The targets of a facelift are:
- Sagging skin of the lower face and neck
- Deepened folds between the corner of the mouth and nose (Nasolabial creases)
- Jowl formation along the cheeks and jaw
- Loss of facial fat and facial fat descent with gravity.
- Excess skin and fat of the neck and under the chin
Other facial regions may be targeted in combination with a facelift. These may include a browlift, rejuvenation of the eyes, and treatment of the neck. No surgery can stop the clock. Preventive maintenance and skin care are essential to maintain and prolong your results. Facelift procedures vary in their invasiveness and are carefully chosen to suit your particular situation and goals
- Minifacelift: Designed for individuals who desire correction of the lower face and neck through a short scar with less downtime. This may be done under sedation or general anesthesia. The incision is a shorter S-shape in front of the ear. Limited excess skin is removed via the natural creases. The underlying facial muscle is tightened. The result is a refreshed appearance that is more subtle and less durable than a full facelift. A drain is typically not required. Recovery is quicker and less overall downtime is required.
- Facelift: Facelifting must address skin laxity, facial muscle and fat laxity, and fat loss. A combination of techniques will be used to get the best aesthetic result. The incisions are hidden along the hairline where excess skin is removed. The incision is longer than that of the minifacelift and may extend around the ear to the hairline. The underlying facial muscles must be addressed to gain longevity in your result and a variety of techniques may be used. The goal is the repositioning of facial muscles and the tightening of any laxity that has developed. Fat grafting may be used to contour areas of excess fat and add fat volume back to restore a youthful facial shape. Pain is minimal with this surgery and some bruising and swelling can be expected. Typically, a compressive dressing is used to support the facial skin and help control swelling. A small drain may be placed to prevent fluid accumulation.
- Facelift and Neck Lift: The neck is often treated with a facelift, but direct treatment may be required to tighten the neck muscle (platysma), remove and contour fat and occasionally resuspend the salivary glands when they droop and become prominent.
- Liposuction and Fat Grafting: Liposuction is often combined with the procedures mentioned above to refine the result. Fat that is removed during liposuction may be grafted or injected into areas such as the cheeks or temples to correct volume loss.
- Noninvasive Skin Treatment: The quality of the skin may also be treated to correct irregular pigmentation, and fine lines and to tighten thin skin. Chemical peels or laser treatments may also be used to improve the skin and fine-tune the facelift result.