Avoiding the pulled look with facelift

A pulled look is produced when the skin is pulled tight in order to smooth out the face.  This most often occurs when patients demand a mini-facelift since the only thing being done is pulling on the skin.  In a traditional facelift, the skin is elevated and the underlying tissue is elevated in a superior or oblique vector (direction), the skin is then gently placed back in place over the rejuvenated facial structures.  This is what would give the most natural look.

The best way to achieve a natural result in face lift surgery is to approach things in a balanced way. 

1. There should not be excessive pulling on the skin during surgery.  The lifting should be accomplished by repositioning the underlying SMAS and muscles rather than relying on the skin to do all the work.
2. The loss of facial volume contributes to sagging of the facial skin.  The face can be compared to a table and table cloth.  As the table shrinks, there is a relative excess in table cloth and it has no where to go but down.  Supporting the table by re introducing facial volume via fat injections or fillers goes a long way in smoothing out excess skin (table cloth).  Less surgical lifting is needed during the face lift creating a more balanced natural result.

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