- What is a Facelift
- What a Facelift Does and What It Does Not Do
- The History of Facelifts
- Facelifts in the 1980's and 1990's
- How do you know if you are ready?
- Are you a candidate?
- What causes facial aging?
- Reasons for having a facelift
- The Workplace
- How young will I look?
- How long does a facelift last?
- Redoing a facelift
- Restoring facial volume with simultaneous fat injection
- Separating Fact from Fiction
- Minimally Invasive Surgery
- Alternative Procedures
Most of us know of people who have had not just one facelift but two or three. The perception is that these people must be unbearably vain. But this is not necessarily the case. These people do not have a second or third facelift because they enjoy having facelifts. Rather, it is because the benefits have been lost. Their early facelifts may have been skin only tightening procedures. These procedures can produce a temporary drawn tight look. There is some benefit, but this is followed by skin sagging only a few years later. The skin is notorious for its ability to stretch. This was the impetus for the development of techniques that pulled tight on the inelastic connective tissue layer below the skin.
In fact, I have redone many such facelifts (See L.B. in Patient Photographs), some as soon as one to two years after the original, which was probably a skin only lift with minimal or no deep plane dissection. Even on some of my own patients treated using the deep-plane lift, I have done secondary facelifts for patients with particularly resistant jowls.
- Fortunately, a facelift can be redone. The original scars are included in the skin which is removed. It is often possible to improve the scars by reducing tension on the earlobe and tucking the scars in closer to the ear and into the hairline to help make them less conspicuous. The surgery proceeds much as a primary facelift does and, perhaps surprisingly, does not pose much greater difficulty for the surgeon (unlike a redo rhinoplasty). Usually a smaller amount of excess skin is removed, sometimes just the scar. The emphasis is on the deep-plane lift, which may not have been done before or perhaps not as extensively.
Avoiding Skin Tension
It is important when operating on the face to avoid tension on the skin because the skin stretches easily. Most people have no trouble understanding this, and the reason for using another tissue handle (the SMAS) for elevation.
People who have had three or four facelifts are not doing it because they enjoy having surgery. They are doing it because the results of a skin-only facelift have (predictably) not held up over time.
