FACE LIFT & NECK LIFT

The term facelift refers to a surgical procedure where the upper, middle or lower portions of the face and neck are repositioned to place the skin and tissues under the skin closer to the location they were when the patient was younger. In my opinion, the key intention of the procedure is to make the results look natural, an aim accomplished by repositioning these tissues in the right direction. In too many cases, the tissues are repositioned in more of a horizontal direction rather than a vertical direction.

In a proper lift, the vector or direction of repositioning or pull is more vertical than previously believed. It is the improper repositioning of the tissues that makes people look unnatural or gives them a "pulled too tight," appearance. Others have described the look as someone appearing to be standing in a wind tunnel.

In my practice, the facelifts are performed primarily under local anesthetic. This surprises some people and even some surgeons who believe that it is not possible to keep the patient comfortable and pain-free with only local anesthetic during such a procedure. We do sedate our patients, but we don't put them to sleep. In fact, under local anesthetic the patient is completely comfortable and feels no pain at all. The reason we do it this way is for safety and rapid recovery. I believe there is no reason to administer a drug, to sedate a patient intravenously, for such a procedure and thus to entail greater risk.

If done properly, the facelift serves as a fantastic procedure for producing excellent, natural-looking results, something we have found to be the case in our practice. Our patients will attest to the fact that a properly done facelift is one of the most rejuvenating procedures in all of cosmetic medicine.

The procedure can be done with what we call a short incision, extending from in front of the ears and up into the scalp, or a longer incision, which extends behind the ear and into the scalp behind he ear. The determining factor in the length of the incision, in my opinion, depends on the looseness of the neck skin, particularly along the jaw line. Although you can achieve a significant tightening of the mid portion of the neck with the shorter incision, there are times when a longer, extended incision is more effective. When properly placed, the incisions can be almost invisible, especially if the wounds are sutured together so there is no tension placed on them and they don't spread and become a wide scar. After the procedure, some bruising and swelling can be expected with the amount bruising and swelling varying from person to person.

One of the other advantages of using a local anesthetic is that it has a small amount of adrenaline or epinephrine mixed in with it. This decreases bleeding during the procedure to almost nothing and, in addition, decreases the amount of bruising after the procedure. The other thing that surprises patients about our facelifting technique is the minimal amount of post-operative pain they experience. Almost nobody requires pain pills even though we give them to the patients in case they may need them for minor discomfort.

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