Hi, I have performed many facelifts over the past 30 years. Whether the Facelift Surgeon performs the facelift under a local anesthetic is a personal choice often based upon the individual patient and the length of the procedure. I have included information about my minimally, invasive SMAS facelift that I often perform under local anesthesia in 90 minutes or less. It's important to mention that endoscopic procedures typically do not allow for removal of excess skin (require incisions around the front of the ears) and often use suspension of SMAS folding techniques that do not last. Non smiling photos of your face from the front and side would help in the evaluation. I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts. Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face. If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin. Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.
If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed.
My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
- very small incisions
- minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
- can be performed in 90 minutes or less, with or without general anesthesia
- no incisions within the hair = no hair loss
- excess fat can be removed
- excess skin removed
- cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
- most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
Hope this helps.