What is a Facelift Procedure? Here’s All of the Information You Need to Know

Facelift Procedures are designed to improve the signs of facial aging that can make a person look (and feel) tired and … well, old.

Although many different types of procedures fall under the “Facelift” umbrella, they should all have the goal of making a patient look refreshed and rejuvenated. Patients today are often living longer and healthier lives. Often, they complain about feeling younger than what they are seeing in the mirror.

Gone are the days of the windswept, tightly pulled, ‘surgical’ look. Today’s patients are looking to bring into balance the way they look with the way they feel. They want to achieve natural-looking results without excessive costs and excessive downtimes. And that is what modern Facelift Procedures are designed to accomplish. 

What does a Facelift do? 

The natural aging process can create a number of unwanted facial features, including:

• Wrinkling and laxity of the face and neck

• Deepening of nasolabial folds (masculinizing look)

• Descent of the corners of mouth (sad look)

• Jowling (old look)

• Generalized deflation of the temples, cheeks, and lips

It is important to realize that this aging process encompasses two very important features. First, it involves a progressive laxity of the skin and its supporting structures, giving a sagging look to the entire face. Second, and just as importantly, it involves a relentless loss of volume in the deeper tissues of the face as a whole, producing a look of deflation (and adding further to the appearance of sagging).

Because of this, effective Facelift Procedures cannot just pull and tighten. They must also reposition and restore tissue volumes in order to achieve a more youthful look (as opposed to a ‘pulled’ surgical look).

What are the Different Types of Facelift Procedures?	

The term “Facelift” actually encompasses a wide spectrum of procedures that are designed to soften and minimize the effects of the aging process itself. And because different patients can exhibit distinctly different features of the aging process, one size procedure cannot hope to fit all. This has led to the evolution of a number of different procedures that all fall within the ‘Facelift Procedure’’ category:

1. Mini-Facelift (Weekend Lift, S-Lift, etc.): these procedures incorporate shorter scars and more limited tissue undermining to achieve correction of relatively mild to moderate signs of aging, including early jowling and early skin laxity. As such, they are most applicable to patients in their 40’s and 50’s.

2. MACS Facelift (Minimal Access Cranial Suspension): these procedures can address more pronounced signs of aging, such as cheek flattening, pronounced jowling, and lower face and neck laxity. The lower facial tissues are elevated by means of internal suspension sutures, as opposed to relying upon deeper dissection of the facial tissues.

3. SMAS Facelift: Instead of using suspension sutures, the deeper layers of the face (SubMuscular Aponeurotic System) are elevated and plicated with internal sutures to address the jowls and jawline.

4. Deep Plane Facelift: Further deep dissection is utilized to reposition the SMAS and associated structures to achieve more elevated and youthful positions. This requires longer, more invasive, and more delicate surgery, along with extended periods of recovery.

5. Full Face & Neck Lifts: In patients with extensive laxity of the facial and neck tissues, it may still be necessary to fully undermine those tissues to achieve adequate rejuvenation. In doing so, it will also be necessary to extend the required incisions to the posterior hairlines. Incisions are longer and dissections are more extensive, but sometimes the added surgery is necessary to achieve the desired results.

In addition to the above Procedures, there are many non-surgical “Facelifts” that are now currently in vogue. These include less invasive procedures that may rely upon barbed percutaneous sutures (Thread Lifts), facial fillers (“Liquid” Facelifts), microneedling with platelet rich plasma (“Vampire” Facelifts), and others.

In the final analysis, one Facelift Procedure cannot and will not fit all patients’ needs, all of the time. The exact procedure being decided upon must be tailored to that individual patient’s own physical features and desires for improvement, at what cost (in terms of both time and money) that will be acceptable. 

What Is Involved in a Facelift Procedure? 

Dr. Lober performs all Facelift Procedures under IV Sedation. General Anesthesia can make these procedures easier and faster for the surgeon to perform, but it is certainly not required. In fact, it can be counterproductive.

General Anesthesia can lead to a higher rate of postoperative nausea and vomiting, which is the last thing wanted in a patient who has just undergone facial surgery. More importantly, however, is the fact that General Anesthesia is not a completely benign process in the older population (i.e, the very same patients who are concerned about looking ‘old’ to begin with). General Anesthesia can lead to prolonged “grogginess” and mental haziness in such patients. This is rarely, if ever, seen with well-controlled IV Sedation. 

The procedure itself involves the elevation of the soft tissues of the face, typically via incisions placed immediately in front of the ears, and extended behind the ears as necessary. Once the superficial tissues have been elevated, the deeper tissues can be removed, redistributed, or sculpted to modify the underlying three-dimensional structure of the face. Excess tissues are removed from the elevated flaps, and the flaps are secured with sutures to redefine the midface, jawline, and neck using a combination of absorbable and non-absorbable sutures. Drains are rarely if ever used.

Further volume enhancement can then be achieved using the patient’s own fat, harvested with a mini cannula. Finally, a TCA peel is usually applied to the finer wrinkles that will not be affected by the surgical tightening.

How Long Does Recovery Take After a Facelift?

The exact recovery time depends on the patient’s age, health status, and the procedure performed. Younger, healthier patients who undergo minimally invasive procedures typically heal faster than older patients undergoing more comprehensive procedures. 

At 1 Week

At one week, any bruising and swelling should be well on the way to resolving, the incision locations will be healed, and the non-absorbable sutures will be removed. Most patients feel comfortable enough to return to work or be out in public after a 1–2 week recovery period. 

At 2–4 Weeks

Patients may return to driving and light activities as soon as they are comfortable doing so (usually by 5-7 days). Strenuous exercise, however, should be avoided for at least the first 2-4 weeks in order to give the tissues time to settle down adequately.

If you get a facelift with Dr. Lober, he will provide you with a detailed custom recovery plan. Following it will help reduce recovery time. Even after recovery, we recommend all patients keep their skin healthy by using sunscreen and maintaining a healthy skincare routine. 

Call Stephen Lober Plastic Surgery Today

Our Stephen Lober Plastic Surgery team will answer any questions you have about facelifts or other aesthetic services we provide. Contact us today to learn more or to schedule your facelift.