San Mateo Facelift doctors

This is really an excellent question and one that every person seeking plastic surgery should understand.  There are two aspects to this answer.  The first is the evaluation of the photography technique. Many seemingly improvements are the result of subtle photographic techniques. Second is an evaluation of the surgical result. 

Technique

1. lighting- watch to make sure that the same amount and direction of  the light is the same in the before and after.  If the photo is underexposed (darker) then wrinkles look worse and conversely if the photo is overexposed (lighter) then wrinkles and scars tend to disappear. It the flash is off to the side in the before photo it will make the wrinkles look worse and if the lighting is "straight on" in the after photo it will make the wrinkles/scars look better. The appearance of the color should also be the same.  (This is the color saturation and white balance which is easy to manipulate with digital photography.) 

2. focal length- watch to make sure the distance from the camera is the same in both photos.  While this may not be as important in evaluating facial surgery it is very important in body surgery.  A common "trick" is to make the before photo closer and the after photo further away making the patient look thinner. 

3. position of the head- this is very important in facial surgery.  If the preop photo has the head tilted down and the post operative photo has the head tilted up the result will look better just by photography alone.  When plastic surgeons take photos we strive to have the head in same "neutral"  position.  (it is called the Frankfurt line) in the before and after photos. 

4.timing of the photo- the photos should be at least six months after the surgery so that by that time any swelling (which will hide fine lines) has gone.

5. make up-  Is the before photo devoid of make up and the post operative photo with full make up. Make up can make a very dramatic result by itself. 

Surgical result

1. does the result look natural?  Is there improvement in the appearance of the neck, cheek, jowls. Is there any evidence of distortion. Look carefully at the corners of the mouth.

2. appearance and placement of the scars.   Are the scars fine and well hidden?

3. appearance of the hair line. Has the hair line been distorted?

4. look carefully at the ear position and appearance of the ear lobes to make sure they are not distorted.

With all of these points in mind don't worry to much about "what is good" - you will know. Remember beauty is in the eye of the beholder.

47 is an ideal time to have a facelift because there is far less loss of facial fat and less skin laxity compared to someone in their 60's. Elevation of the midface and jowl with or without fat grafting gives a pleasing result.

While there are myriad techniques to accomplish this, a simple minimally-invasive approach with limited undermining and SMAS plication works well.  If there is mild laxity in the neck, then the neck can be corrected without a separate incision under the chin and undermining of the neck skin. With less undermining, recovery is quicker.

In your effort to get a good result, ask your plastic surgeon exactly where the scars will be, for example, along the helix, behind the tragus, and under the lobule with a small platform of skin to replace the cheek flap without tension. Examine before and after pictures to see if the ear is in normal position or if the lower ear is pulled forward. Decide if the trade-off of a scar that is anterior to the sideburn hair that prevents the hairline from moving up is right for you vs. a less visible scar inside the hairline that can result in elevating the hairline.

This depends on both the patient’s ability to heal and the surgical technique utilized. Our technique and approach is what most people commonly refer to as a SMAS facelift, in which the muscle layer under the skin is also tightened. This approach gives very long-lasting results, however when we manipulate and tighten this tissue, there is bound to be some minimal but noticeable swelling. Sutures are removed one week after surgery, and at that point the swelling starts to diminish, and on average most people have very little if any swelling left at 2 weeks. But some people heal faster than others. Patients should expect to feel some lumps and bumps for at least 3-4 weeks after surgery, if not longer, but they will all resolve over time. Keep in mind however, although you may feel these lumps and bumps, no one else notices them and you will already be looking rejuvenated and refreshed.