-Win Pound, M.D.
Remember when you were a kid and you had those chubby cheeks that
Grandma used to pinch? Where did those chubby cheeks go? Well, as
you got older, you lost elasticity in your skin and the fat cells
under the skin lost volume. The tissue in your face began to descend
forming deep lines from the base of your nose to the corners of your
mouth (nasolabial folds) and the formation of jowls. The skin in
your neck also started to sag along with the main muscle of the neck,
the platysma muscle. This led to the formation of bands under your
chin and in the front of your neck.
If the elasticity of the skin is good and the main problem is simply
a loss of volume over the years, this volume can be replenished with
filler material, either fillers that are commercially available or
fat extracted from the patient. By replacing the volume in the
cheeks, we can improve the depression of the nasolabial folds as
well. Some people refer to this as a “liquid facelift.”
If the drooping goes beyond what can be easily remedied by the
addition of filler then a surgical facelift may be indicated. This
involves incisions around the contour of the ears with undermining of
the skin out over the cheeks and neck. If only the skin was pulled
back, the effect of the facelift would be lost within a matter of a
few weeks. It is therefore necessary to lift the deeper, tougher
layer of tissue underneath the skin called the SMAS. Elevating the
SMAS leads to a longer-lasting facelift. The excess skin can then be
removed without any tension on the suture line which leads to a
better, less-noticeable scar. Sometimes an incision under the chin
may be necessary in order to tighten the loose edge of the platysma
muscle and eliminate banding of the neck.
The head is bandaged following a facelift. Some physicians insert drains as well. The bandages come off and the drains are removed within a matter of days following a facelift. Patients may experience some bruising, especially in the neck area following a facelift. In my practice, patients are allowed to shower immediately after the bandages are removed. They are also allowed to resume normal activities as soon as they feel up to it, more strenuous activities after three weeks.