We have yet to find the fountain of youth, but technologies such as Botox, Fillers, and other non-invasive procedures have been able to slow down Father Time. However, there is only so much that these treatments can do. Eventually gravity, age, and sun damage will cause changes to the face and neck leading to loss of volume, poor skin quality, and sagging of the skin. A facelift, or rhytidectomy, is a surgical procedure that helps to lift, tighten, and reposition the skin, fat and muscles of the face in order to produce a younger, more vibrant, and less tired look to the aging face.
What does a Facelift or Necklift treat?
When we think about aging and facial rejuvenation we can break it down into three main categories: Skin, muscle, and fat.
This is probably the first thing that people think about with a facelift. As we age the skin becomes thinner, less elastic, and begins to sag and wrinkle. A facelift involves separating the skin from the underlying tissues, pulling it tighter and into the right position, and then trimming the excess skin in order to produce a more youthful look to the face.
This is arguably the most important of the three. For years, “skin only” facelifts were performed. The problem surgeons found was that the results would only last a few years at best. That is when the SMAS was discovered. The SMAS (Superficial muscular aponeurotic system) is the layer of muscle and tissues below the skin. This layer starts up at the level of the head, extends throughout the entire face, and down into tissues of the neck. This layer is crucial in supporting the overall skin layer, and in most circumstances a tightening of the SMAS layer is crucial to extend the longevity of the procedure and give a more youthful and natural look.
Fat is the new kid on the block. For years, facelifts were done to try and thin the face, and often fat was removed. However, that would often lead to a skeleton like face that appeared to thin or gaunt. Today, we are realizing the importance of fat and volume in the face and how that interacts with the aging process. In many cases, Dr. Arslanian will actually harvest fat from somewhere and inject it into the tissues of the face to add volume and a more youthful appearance.
The ideal candidate is one in good health without significant medical problems. They should be have reasonable expectations of outcome and understand the potential risks and complications that may occur. There is no specific age requirement for this procedure. It will depend on the extent of facial aging that you have incurred to this point. Patients typically have tried non-invasive techniques as well as a professional skin care regimen before pursuing a facelift.
During your consultation, you will meet with Dr. Arslanian and his staff and have the opportunity to discuss your individual situation as well as your concerns and aesthetic goals. Dr. Arslanian will will take a detailed history and perform a complete examination of your face and neck. Photos will be taken to help Dr. Arslanian point out certain things and explain his approach to Facelift/Necklift. If you are deemed a good candidate, he will discuss the various options available and make sure you are happy with your decision. He will also show you photos of other patients before and afters to help determine what you are looking to achieve. After answering all your questions, you will then sit down with the surgical coordinator to discuss timing, pricing, and any other questions you might have.
The face can be broken up into three main areas: the brow and eyes, the mid face, and the lower face/neck. In most patients, these areas all age simultaneously. Oftentimes patients may be seeking a facelift, but do not want to treat their eyes or their neck. This can then lead to a disharmony in the face as one area is rejuvenated while other areas are not. In many patients, a consideration must be taken treat all three areas to create the most natural looking total facial rejuvenation possible. Dr. Arslanian may discuss treatments with you such as: upper or lower blepharoplasty, a brow lift, neck liposuction, mid face lift, laser, peels or other ancillary procedures.
Prior to surgery you will be given instructions on the day, time and location of your procedure. You will be given your prescriptions that Dr. Arslanian prescribes, and all of your paperwork including consent forms will be signed. In some cases you may need to obtain medical clearance from your physician or specialist, and possibly meet with the anesthesiologist and undergo additional lab work depending on your medical issues and personal situation. In addition, you will be prescribed Dr. Arslanian’s recommendations on skin care. You will need to complete a pre-operative skin care regimen in order to prepare your skin and tissues for the process of a facelift. This will help to maximize your results and minimize your complications.
The procedure will be performed as an outpatient in an accredited surgery center with a board certified anesthesiologist in the safest conditions possible. Depending on the extent of surgery and your other medical history, it may be advisable to stay overnight in the surgery suite for monitoring. The surgery will be performed under general anesthesia. Pre-operative markings will typically be made the morning of surgery.
After you are asleep, Dr. Arslanian will start by making his incision. The incisions are typically hidden around the ear and in the hairline. He will then raise up the skin layer to the appropriate amount. He will then address the SMAS layer either through a tightening of the layer (plication), or by a resection of a portion and then closure (SMASectomy). The skin will then be pulled to the new position and the excess skin trimmed and then closed. The same procedure will be performed on the other side. In addition, a small incision may be placed just under the chin to access the neck and perform the necessary tightening of the neck muscles and tissues. At the end of the case some fat may be injected into the facial tissues as needed. Drains may be placed, and you will then be placed into a compressive face bandage. You will be awaken from anesthesia and transferred to the recovery room.
You will go home the same day of surgery or the morning after. You will be given pain medicine to help with the first week. You will likely be swollen and have some bruising. At 1 week any sutures will be removed. You will keep your head elevated and ice as needed to minimize swelling. At 10 days you should be able to go out in public and start wearing makeup. Swelling can take a good 4-6 weeks to resolve. Even then, it can take up to 6 months for all the swelling to resolve, the scar tissue to soften, and the fat grafts to take their final shape and position. Patience is very important in this procedure as results can continue to change over the course of the year.
Patients can expect to initially look somewhat tight, but this usually relaxes within several weeks to a much more natural, but youthful appearance. This can be a dramatic and emotionally difficult procedure for patients given the change of appearance of the face. It will take several months, in many cases, for patients to be used to the new appearance of their face. That is why a strong emotional health is just as important as physical well being going into this procedure. Longevity of the facelift can vary from anywhere from a few years to as many as 10-12 years.
Facelifts and necklifts are frequently combined with other procedures and the cost will depend on these other procedures as well as the extent of the patient’s operation. We will be happy to provide the patient with an accurate price estimate at the time of their consultation.