Many of my patients come to me with questions regarding the aging of their face. Here are my answers to the top 3 facelift questions:

  1. How long does a facelift last?

    Facelifts don’t have an expiration date. This surgery can set your clock back ten to fifteen years. You will simply continue aging, but continue to appear years younger than you currently are. According to Bloomberg Business Week, “A face lift can make a person look seven years younger, according to a study that asked volunteers to guess the ages of patients who had cosmetic surgery” (http://www.businessweek.com/news/2012-02-21/plastic-surgery-really-does-turn-back-the-clock-study-finds.html).

  2. What is the downtime for facelift surgery?

    Facelift surgery is outpatient, meaning you will go home after your surgery. Patients will leave the hospital with a head wrap and return to our office one day after surgery to follow-up. Patients are asked to move like a robot, to not put pressure on the incisions around the ears.

    Most bruising and swelling is gone in 1-1/2 to 2 weeks. Minor swelling may persist for a few weeks to months. Patients generally feel very comfortable and return to normal activities in 1-1/2 to 2 weeks with the exception of heavy cardio and lifting.

    At six weeks, patients are approved to return to any exercise or daily activities they choose.

  3. What is the difference between a facelift or the other types of “mini” lifts that I hear about frequently through marketing and the media?

    Facelifting techniques have been around for many years. The original techniques were “mini” lifts because only the skin was treated. These did not last long and they left visible scars due to too much tension on the wrong tissue layer (skin).

    Techniques evolved into a better understanding of treating the superficial musculoaponeurosis (SMAS) of the face. Lifting this deeper sturdier layer, which is like a ligament of the face, gives longer lasting more natural results by putting the tension on it (SMAS) and not putting the tension on the skin. This SMAS or deep plane facelift was and still is considered the best technique by those in the know. It requires a substantial amount of training to understand the anatomy and protect important structures such as the facial nerve. This is still the “gold standard” for long lasting results with a natural appearance. The “modernization” of the facelift by making it more of a “mini” lift sounds appealing to the prospective patient because it sounds less invasive. Frankly, many of these techniques are really a de-evolution of the modern facelift. Many do not treat the SMAS enough. Like the original techniques of skin lifting, results are short lived and may result in visible scars with too much tension on the skin. I know this because many patients have consulted with me shortly (6 months to 1 year) after a “mini” lift done elsewhere and were disappointed at the lack of a result. My personal feeling is that there is not enough training obtained by many current facelift surgeons to give them the comfort to perform SMAS lifting. It is a technique that requires a high level of skill, great attention to detail and a true artistic eye. I feel any competent facelift surgeon should be required to have experienced additional training in cosmetic facial surgery through a fellowship (after typical residency and board certification). With enough experience, a SMAS lift can be performed very cleanly with the same limited down time as a “mini” lift.

In summary, traditional SMAS lifting when done by a well trained (facial fellowship) surgeon, gives the longest lasting most natural results.