Do you find yourself looking in the mirror and seeing an aging face with saggy loose skin? Facial aging is inevitable, but when the changes that you see start to bother you-think sagging skin, looseness in your neck and poorly defined jawline-you may want to consider a facelift, the only rejuvenation that will provide you long-lasting improvement. There is a variety of different types of facelifts that together we can choose from depending on what areas are bothersome to you. The end result will always be a more refreshed, more youthful version of yourself. Together, we will look at your face as a whole and the areas that are affected by the signs of aging to decide which techniques are best for you.
The goal of any facial rejuvenation is to look as good as possible without looking unnatural. There is a multitude of products and procedures that we have available today that can dramatically improve patient’s appearance and reverse many of the signs of aging.
“I perform facelifts in such a way that my patients still look like themselves, just refreshed and rejuvenated.“ – Dr. Ducic.
Which Type of Facelift is Right for You?
As the name implies the most important thing to remember about mini-lifts is that they lift and suspend tissues just a little. They are predominately meant for somewhat younger patients with early laxity. If there is a lot of jowling, heavy cheeks and/or laxity of the neck, then a traditional facelift and neck lift is more beneficial.
The major advantages of mini lifts are minimized downtime and generally, shorter less visible scars. Typically, incisions are made just in front of the ear and sometimes around the earlobe to behind the ear. Swelling lasts 7- 10 days and most patients can resume near normal activities within two weeks with minimal swelling.
The midface or central third of the face is an important esthetic highlight of the face. Youthful cheeks are those that are full and well suspended. Over time, as aging progresses, the cheeks lose volume. This loss of volume results in worsening pull with gravity causing the cheeks to fall and forming prominent creases between the lip and cheek (so called basil animal fold). Also, most of us are asymmetric between the two sides of our face. Generally, it is the honey skeleton that is most different between the two side. As the cheers drop the honey asymmetry becomes more obvious.
So, the goals are to prevent the above. Your genes you can’t control. But limiting sun exposure, maintaining good hydration, avoiding smoking and having a great skin care regimen will all help. As volume decreases, fillers such as hyaluronic acid (naturally found in the skin), fat grafting and Sculptra® (polylactic acid that stimulates your body to deposit your own collagen) are all good options to reverse it.
Once you develop laxity, as suspension procedure is needed. Often there is an associated laxity of the lower face (jowls) and neck, and a facelift and neck lift may be required to allow for a smooth natural transition. Some patients, however, develop very isolated laxity of the midface and maintain good support to lower face and neck. Most of these patients seem also to have laxity around the eyes. If this is the case a brow lift and blepharoplasty may be needed in addition to midface surgery. The midface is most directly addressed with the midface lift. This may be done through the lower eyelid but this approach does result often in prolonged swelling sometimes lasting weeks or even months. Most often it is performed through an incision in the temple hair bearing scalp with an endoscope (small camera) in a minimally invasive manner. Occasionally, a small incision inside the upper lip may be needed. The results are generally pleasing. I like to perform this type of lift to target concerns in the middle of the face and cheeks with very small incisions that are about 1-to-2 centimeters in length, which makes for a minimally invasive operation. Recovery time is 7-14 days until return of most activities. The midface lift may be combined for best effect with fat grafting to address the loss of volume at the same time as suspending the cheek. Fat grafting, as opposed to other fillers, results in pleasing improvement in not only volume but also in the quality of the overlying skin.
The traditional facelift addresses the aging face as a whole for the most dramatic improvement you can get. It’s time for a full facelift if you have moderate to severe sagging and want dramatic results that will make you look 10 years younger. When I perform a full facelift, I hide the incisions in the contour of the ear, around the earlobe, and/or in the hairline. A small incision under the chin might be necessary if fat needs to be removed and if the muscle in the neck requires additional smoothing. For the most natural look, I use the SMAS (superficial muscular aponeurotic system) technique, in which the deeper layers of tissue and the muscle below the skin are tightened and excess skin is removed, which smooths out deep wrinkles.
Dr. Ducic ’s Philosophy:
I have a basic philosophy when treating patients. I always try to treat each as I would a member of my family and talk to them as I would a friend. I have to keep in mind that for us as facial plastic surgeons, these procedures are routine but for the patient, it is a unique experience. My goal is to decrease any stress by educating them on what to expect and providing realistic expectations. I have to keep in mind that for us as facial plastic surgeons, these procedures are routine but for the patient, it’s a unique experience. My goal is to decrease any stress by educating them on what to expect and providing realistic expectations. There are many patients that come see me for surgery that we turned away as they are not good candidates. It is very important to have empathy for a patient’s concerns but also to be completely honest with them. We should always provide the patient with the available menu of options and help them decide which is best for them. Ultimately, a patient coming for cosmetic surgery is not sick. By doing things to them to improve their appearance such a surgery, they incur a cost, suffer some discomfort and have a certain amount of downtime. We have a duty to make it worth it for our patients when they look back on their procedure after they have recovered. That is the most important goal I have for our patients.