Facelift

Conveniently located to serve the areas of Beverly Hills and Los Angeles

Description

Candidates for a facelift surgery (technically referred to as rhytidectomy) seek to improve a number of visible signs of aging in the face and neck. These signs include:

  • Sagging in the middle of the face
  • Deep creases below the lower eyelids
  • Deep creases along the nose extending to the corner of the mouth (nasolabial folds)
  • Fat that has become displaced or fallen
  • The appearance of “jowls,” and deep creases between the base of the nose and corners of the mouth due to a loss of muscle tone in the lower half of the face
  • The appearance of a “double chin” due to loose skin and excess fatty deposits under the chin and jaw

Facelifts are often performed in conjunction with other facial rejuvenation procedures, such as a brow lift or eyelid surgery.  Facelifts can tighten or reposition underlying facial tissues and muscles, smoothe loose skin on the face and neck, remove excess fat in the face and neck regions, diminish creases and wrinkles, and restore the natural contours of the face.   Facelifts are one of the most popular procedures performed in plastic surgery today and each facelift Dr. Gabbay performs is customized to meet your individual needs.  There are many variations to the facelift procedure and the technique Dr. Gabbay chooses will depend on your features and overall aesthetic goals.

Before & After Photos

Options

The facelift procedure has continued to evolve, as advances in technology have enabled plastic surgeons to perfect the procedural details, resulting in far more natural results and shortened recovery times. Facelift procedures of the past focused on simple skin tightening, which often left patients with distortions of the facial features that appeared to be pulled back, or stretched too tightly. Today’s facelift incorporates more complex, deeper tissue lifting techniques, that result in a natural, “refreshed,” “well-rested,” or “rejuvenated” appearance. Dr. Gabbay prides himself on staying current with all of recent the surgical advances made possible by new technology, and believes that education is a constant process that does not end after the completion of medical school.

During your consultation, Dr. Gabbay will determine the optimal type of anethesia for your facelift surgery–-either intravenous sedation (twilight) or general anesthesia. The facelift procedure usually lasts 2-5 hours, and involves incisions in front of, and behind the ear. Dr. Gabbay takes great care to ensure that surgical incisions are very inconspicuous, and are carefully hidden around the ear. Each patient’s face lift is a unique procedure, depending on the goals you would like to achieve from your surgery. Muscle tightening, as well as liposuction of the neck and jowls, may be performed, and excess skin is either removed or repositioned.

After your face lift surgery, you may be permitted to go home after a few hours, although some patients may need to stay overnight in an aftercare facility.  It is essential to understand that the amount of time it takes to recover from facelift surgery varies greatly between individuals. Elevating your head after surgery is extremely helpful in reducing the initial post-operative swelling. The majority of facial swelling is generally noted in the first 24 to 48 hours, and can take 3-4 weeks to completely subside, while most bruising resolves within 2 weeks.

Dr. Gabbay looks forward to evaluating and discussing how the facelift procedure could benefit you, as well as if any additional surgery in the chin and neck areas would improve your optimal outcome.   The goal of facial rejuvenation surgery is to produce a balanced result centered on your facial anatomy, and to improve, but never change who you are.   Many satisfied patients will attest to Dr. Gabbay’s personable and compassionate manner, as well as to the results they achieved.  If you would like more information about face lift surgery, please contact Gabbay Plastic Surgery and we will be happy to answer any and all of your questions, and to schedule an initial, complimentary consultation with Dr. Gabbay. You may also click the link below to read a more in-depth description of the face lift procedure.

Evaluation

Facelifts are one of the most popular procedures performed in plastic surgery today, and each facelift Dr. Gabbay performs is customized to meet your individual needs. Facelifts can tighten or reposition underlying facial tissues and muscles, smooth loose skin on the face and neck, remove excess fat in the face and neck regions, diminish creases and wrinkles, and restore the natural contours of the face. If you are interested in learning more about facelift surgery, please call Gabbay Plastic Surgery and let us schedule your personal consultation with Dr. Gabbay.  During your meeting, Dr. Gabbay will discuss your overall expectations and aesthetic goals, in order to determine whether facelift surgery is a suitable option for you.

You should come to your consultation prepared to discuss your medical history (including any past surgeries), present medical conditions, allergies, and medications.  It is imperative that you are honest and provide complete information, as numerous medical conditions can potentially increase the risks and complications associated with surgery.  If Dr. Gabbay feels that you are a good candidate for facelift surgery, he will explain the different techniques, costs and potential side effects before scheduling your procedure.  When choosing Dr. Gabbay, you can be assured that you are in the hands of a surgeon who has undergone extensive training and is highly esteemed by his colleagues and patients alike.

Option Details

There are many variations to the facelift procedure, and the technique Dr. Gabbay chooses will depend on your facial bone structure and your overall aesthetic goals.

Facelift variations performed at Gabbay Plastic Surgery include:

  • Standard, Conventional or Traditional Lift:  a traditional rhytidectomy involves lifting and tightening the skin around the face in order to smooth out folds and lines, and the removal of excess skin.  The incision lines for this procedure are usually made along or behind your hairline.
  • Contemporary Face Lift: the contemporary facelift involves manipulating and sculpting the underlying fat and musculature of the face in order to produce a comprehensive and natural result.  During this procedure, the descending facial fat is removed and restored to a more aesthetically desirable location on top of the cheekbones, thereby creating more youthful facial contours.
  • SMAS (Sub Muscular-Aponeurotic System) Lift: The SMAS is responsible for an individual’s facial movements, expressions and animation. This SMAS or “superficial” facelift technique involves a two-layer lift and the manipulation of the underlying foundation of the skin and prevents the creation of an “over-stretched” result. Specific SMAS techniques include: 
  • Lateral SMASectomy: the skin is resected and tightened over the parotid gland.
  • Conventional SMASectomy: the skin is lifted vertically as a flap towards the cheekbones
  • Extended SMASectomy: the skin flap is extended over a larger area towards the nasolabial fold in order to provide comprehensive correction of the mid-face.
  • SMAS-plication: a tissue-sparing technique wherein the SMAS layer is folded in on itself to restore youthful contours in the face with less fullness
  • S-Lift: this technique was developed in the late 1960’s and utilizes an incision made directly in front of the ear, and the lateral manipulation of the skin layers. The upper facial areas and eyes are not affected by the S-Lift procedures, making it a suitable technique for patients seeking to rejuvenate the lower third of the face (i.e. jawline, jowls, and neck).
  • MACS-lift (Minimal Access Cranial Suspension) and Short-Scar Facelifts: these procedures are often referred to as ‘mini’ facelifts because they are less invasive and were designed for patients with fewer requirements for facial rejuvenation.  Mini facelifts rely on a limited facelift incision, conservative skin flap creation, and MACS-lift—the use of sutures in a loop configuration (purse-string) to lift the deeper tissues.  Mini facelifts are less effective for patients with sagging skin in the neck or more severe wrinkles and folds; however, they are ideal for younger patients with good skin elasticity and mild facial aging.  The mini-face lift addresses the appearance of the cheeks but does not include the neck, as a full facelift would.
  • Subperiosteal Midface Lift: this technique was designed to lift the sub-orbital area, as well as the midface, and offers the benefit of not leaving any visible scars. It is performed for cheek elevation when the neck and jowls do not need lifting.  An incision may also be made intraorally, similar to performing a midface implant procedure, and this technique is often combined with an endoscopic forehead lift.
  • The Deep Plane and Bi-Plane Facelift: these techniques are ideal for patients who need lifting and tightening of the neck and cheeks. The incision is the same as the short-flap facelift but extends into the hairline behind the ear.  During this deep plane facelift, the SMAS muscle is either elevated (separated from the underlying layers) and lifted with the skin, while the bi-plane face lift involves an elevation of the SMAS muscle as a separate layer.  These facelift procedures are similar to the SMAS lift technique, but also address the nasolabial area (the grooves that run from the side of the nose to the lips).
  • Secondary Facelifts: secondary facelifts are beneficial for patients who are dissatisfied with the results of their original facelift, or whose original facelift results have been marred by the natural aging process.

Some facelift results can be maximized by the addition of gentle liposuction, in order to remove extra fat from the face and neck, while other results may benefit from fat injections in order to restore youthful volume to the cheeks.

Procedure Details

Dr. Gabbay and the professional staff at Gabbay Plastic Surgery are committed to making every effort to ensure that you have a safe and comfortable facelift experience. A facelift normally takes from 2-5 hours to perform and utilizes general anesthesia (less extensive facelifts may be performed with IV sedation).  Medications will be prescribed pre- and post-operatively, in order to make you more comfortable, reduce postoperative side effects, and shorten your recovery time.

After administering anesthesia and making the initial incision, Dr. Gabbay will tighten and lift the facial skin and subcutaneous facial tissues, remove the excess skin, and then close the incision with a combination of sutures and small clips. Following the completion of your surgery, a pressure-dressing bandage will be applied around the side of your head and you will be released to a family member or friend after a few hours of rest in our recovery room. After your procedure your eyes may feel tight and quite tender when the anesthesia wears off, but any discomfort can be managed with pain medication.

Recovery

After your facelift surgery, some degree of swelling and bruising can be expected, and you should sleep with your head elevated for the first week and use cold compresses to keep swelling to a minimum.  Most swelling will subside within two weeks, and all sutures and staples will be removed within 5-10 days. You will be instructed to avoid physical activity and to report any undue discomfort.  Recovery usually takes 2-3 weeks and your scars may be concealed with makeup until the healing process is complete. Although rare, potential facelift complications include: infection, hair loss, scarring, bleeding, skin necrosis, pigment changes, sensory nerve injury, motor nerve injury, and contour irregularity.

Frequently Asked Questions (FAQs)

What is a facelift?

Also known as rhytidectomy, a facelift operation is designed to reduce sagging and wrinkling in your lower face and neck.  It does not correct problems around your eyelids, at the corners of your mouth (unless a mid-face lift is used), or the creases at your lips.  This operation may be chosen to help prevent the advancement of aging, or it may assist a patient who already has saggy and wrinkled skin.  The amount of improvement depends upon the degree of imperfections already present, and if minimal, results can be very dramatic.

How should I prepare for my facelift surgery?

It is important to follow Dr. Gabbay’s instructions when preparing for facelift surgery to ensure the best possible results, and the guidelines may include:

  • Refraining from smoking for several weeks before and after surgery
  • Avoiding certain medications and herbal supplements
  • Arranging for help following surgery including a ride home and in-home care for at least 48 hours
  • Sleeping with your head elevated to minimize swelling
  • Avoid strenuous work or exercise

Is there pain after a facelift surgery?

Most patients only take pain pills 24-48 hours following their surgery.  The most likely discomfort that you may have is a very mild neck and backache from sleeping with your head elevated, and this can be controlled with over-the-counter medication.

What can I expect after Facelift Surgery?

Soon after your facelift surgery has been completed, you can expect some swelling and bruising and surprisingly, you will have very little pain or discomfort.  The vast majority of patients complaints are mostly having a tight sensation, which is normal; and as your healing progresses, you will notice that your swelling and tightness subsides usually by the fifth day.

When will I be able to go into public again?

For the most part, even complex facial procedure will not keep you from going into the public for more than one week. With make-up, many patients report that no one even notices that they had surgery.

What doesn’t a facelift correct?

Facelift surgery will not address the fine lines around your mouth and lips, and it will not improve the excessive skin and bulges surrounding your eyes.  Facelift surgery will also not correct the inner part of your brow or the lines between the eyes.  All of these issues can be addressed with a brow lift, which Dr. Gabbay will discuss with you during your consultation.

Can a facelift be performed on African-Americans, Asians, or Hispanics?

Yes.  African-Americans, Asians, Hispanics, and other ethnicities have unique considerations that will be discussed during your facelift consultation with Dr. Gabbay.  While African-Americans and Asians have an increased chance of keloid scarring, this is something that is typically avoidable and in general, the face ages in the exact same manner between every race.

What is revision facelift surgery?

Revision facelift surgery is usually performed on those patients that have had facelift surgery in the past and want to maintain a certain appearance, or for patients that have had a previous facelift procedure, and they are unhappy with the results.  The advantage to revision surgery is the procedure is usually shorter, and the discomfort is much less than the first time.

What is the natural-look facelift?

The natural look facelift is a facelift that will not look stretched, pulled, or “plastic.”   During a natural-look facelift procedure, Dr. Gabbay will address only the issues of your face that cause the signs of aging, and he will actually manipulate the deeper tissues that have caused your aging to occur, and address them as well.

Where are the incisions in a facelift and will I need to have the sutures removed?

Incisions are typically hidden in the hair behind your ear, and along the hairline above your ear.  Facelift incisions are made around the ear and dip inside your ear in the front to break up the suture lines. Stitches in front of the ear are removed after 5-6 days, and skin clips in the scalp are removed in approximately ten days.

How long will my facelift last?

Plastic surgery of the face corrects visible signs of aging, but it does not stop the aging process.  The degree of improvement and duration of your results are based on your own individual aging process that can be affected by heredity, overall health, sun exposure, poor diet, exercise, alcohol intake, smoking, and personal lifestyle.  In other words, the better you take care of yourself, the longer the results will last. A face and neck lift should effectively correct the visible signs of aging for at least 5-10 years.  Although a facelift surgery cannot prevent aging, a person will always look better in the years to come, than if they did not have their facelift procedure at all.

How soon will I see my results of my facelift?

People who undergo facelift surgery must understand that healing is a process and it will take time.  For that reason, you may not see the final results of your surgery for several months but patients report it is worth the wait.

Are there any differences with men having facelifts?

Men and women have a number of anatomic differences, and this must be taken into consideration to assure the best results during a facelift procedure.  Due to the vascularity of the beard, men are at slight increased risk for bleeding, but they also heal more quickly with less bruising and swelling.  Facelift incisions need to be placed differently with men to avoid hairy ears, and issues regarding shaving. This will be discussed during your consultation with Dr. Gabbay and he will explain the options to men who desire the improvements facial plastic surgery offers.

What does a facelift entail?

There are many variations to the facelift procedure and the technique Dr. Gabbay uses for you depends upon your individual features and aesthetic goals.  Dr. Gabbay will discuss your options during your pre-op consultation, and he will typically hide the incision in the natural contour of your ear, extending it around your earlobe and into your hairline, for easy concealment.  Using these facial incisions, Dr. Gabbay will separate the facial skin from the underlying tissues and remove any excess skin while repositioning deeper tissues, if necessary, to improve your facial contour.

Will my head get shaved prior to facelift surgery?

One of the major advantages of how Dr. Gabbay performs facelift surgery is that he does not shave any of your hair.

How do I know if I am a candidate for a facelift?

If you are in good physical and emotional health, you have realistic expectations about your outcome, and you want to eliminate the sagging skin from your face and neck, you may be a good candidate for a facelift.  This will be determined during your thorough consultation with Dr. Gabbay, along with other considerations.