A facelift is one of the most recognized procedures in
aesthetic plastic surgery.....but also one of the most
misunderstood.
The general public's perception of a facelift....based on
TV shows and the internet...is someone after such surgery
being bruised from their eyes to their neck and their face
wrapped up in a big dressing...like they had been involved
in a major accident. And that it will take weeks to even
look good enough to go out in public. In reality, this
perception is flawed at best and even grossly inaccurate at
worst.
The name of the operation, facelift, is misleading. It does
not really describe what the surgery actually does or what
the objectives of the procedure are. More accurately, a
facelift should be called a neck-jowl lift, for this is
what it actually helps. It is a great procedure for
tightening the neck, getting rid of the that neck waddle,
and lifting those sagging jowls. The medical name for a
facelift, rhytidectomy (old plastic surgery meaning cutting
out wrinkles), should be described as a cervicoplasty.
(reshaping of the neck) However, the name facelift persists
and always will as it is embedded in our plastic surgery
nomenclature.
Therefore, when you realize that only the neck and jowl are
affected by the procedure, many of its misconceptions fade
away. In isolation as a stand-alone procedure (which half
of my 'facelift' patients only have), a facelift causes no
bruising or swelling from the nose up. While many facelift
patients get their eyes, forehead, nose and other facial
procedures done at the same time, this is not a requirement
and is only done if one wants the 'total face' rejuvenated.
I find that after an isolated facelift, one can look pretty
good in about a week and can easily be out in public in a
few days with a little make-up in the neck area. Remember,
the eyes are not swollen at all!
One of the great misconceptions about a facelift is what is
actually done in the operation. A facelift operation is all
about tissue layers and vectors of lifting. The lifting off
of the skin from the underlying tissues over the side of
the face (to the cheek area) and across the neck through
incisions placed in and around the ears is obvious in any
diagram of a facelift operation. And movement of loose skin
pulled back and over the ears at about a 45 degree angle to
the face probably accounts for about 80% - 90% of the
result created by a facelift. And often this is the only
tissue moved in a facelift. This is the safest and easiest
approach with the least likelihood of complications. Deeper
layers have also been raised up and moved in more recent
versions of facelift surgery. These deep layer that can be
moved independent of the skin, is a special layer of tissue
over the muscle. This tissue, known as SMAS, is raised and
sutured up in a more vertical direction compared to the
direction of the skin pull, closer to 60 degrees usually.
The public erroneously believes that it is muscle that is
moved which is not possible. The SMAS sits on top of the
muscle. There is considerable debate as to whether the
'deeper' versions of the facelift produce better long-term
results than skin movement only.
The neck-jowl lift, known historically as a facelift, can
lift two different layers of sagging facial tissues in two
slightly different up and backward directions.
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Dr Barry Eppley runs a private plastic surgery practice
through his hospital-based medspa locations at Clarian
Health in Indianapolis. To learn more about the latest
trends in plastic surgery, spa therapies, or skin care, go
to his daily blog, http://www.exploreplasticsurgery.com .
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