There are several important points that need to be discussed regarding facial rejuvenation. Facelifts improve the aging process by picking up the underlying tissues and skin. The facelift, however, does not address the quality of the skin. Resurfacing techniques improve the quality of the skin, but do not do much to improve the loss of elasticity. This loss of elasticity is the limiting factor when it come to rejuvenation of the face. At this point there is nothing that addresses this effectively.
This is a great question and I like working with patients who have clear aesthetic goals. Everyone's face ages a little bit differently, but there are some common themes. These include the effect of gravity on the cheek and jowl areas, sagging of the muscles in the neck, and changes to the skin from sun damage and repetitive movements. Each of these things can be addressed during your procedure, but may require addition of some resurfacing (such as lasers or peels).
In terms of getting the maximum result (looking the youngest possible) without looking unnatural, the key is the DIRECTION of the lift. Gravity is vertical. So the facelift should be predominantly vertical. In fact, I have published a study that shows a detailed analysis of the direction of the facelift that gives the maximum rejuvenation while still looking natural.
Best of luck moving forward!
The best facelift possible is different for each person. Every person has individual goals and ages differently. To ensure the best facelift possible here are some tips:
- -seek a surgeon who focuses on the face- a face specialist, either a board certified facial plastic surgeon or board certified plastic surgeon who works on the face
- -look at the type of lift- each facelift is quite different. some lifts are quite limited in their extent and quality while others are more extensive. learn about why certain lifts may be better than others
- -additonal procedures- some patients will benefit from fat grafting, laser resurfacing, eyelifts, and other procedures which can enhance your overall result
- -bring in photos of yourself when you were younger- this can help serve as a reasonable guide to help your surgeon
The face ages in 5 ways:
- Loss of elasticity
- Effects of gravity
- skin changes such as wrinkles and pigment issues,
- loss of facial volume
- Dynamic lines from overactive muscles
A facelift addresses the first two conditions, but most people have all 5. We often do fractional laser resurfacing at the same time to correct #3, skin texture and color.
The fourth is treated by filler or fat injection and the last with Botox.
Getting the best facelift for you starts with finding a surgeon that understands your goals of rejuvenation including the consideration of laser resurfacing and possibly fat grafting. The fact that you are open to a complete facelift and laser resurfacing, is more than half the battle. Often patients don't understand the value of restoring volume or repairing the canvas (the skin) in rejuvenation surgery. I believe that as the face ages, all three components of aging take a toll on the way one appears. By addressing all three components of aging, ie the effect of gravity, volume shifts and losses, and the effect of the environment on your skin, a significant improvement should be noted. There are surgeons who specialize in this type of rejuvenation. My suggestion is to do a little homework and find a surgeon that meets your needs
If you are age 65 and look your age or older, a facelift is probably what you need. Do not settle for an abbreviated type of procedure sometimes called a "mini lift". Have a real, thorough facelift done by an experienced surgeon. This will improve the sagging of the lower cheeks, jaw line, jowls and neckline. Be sure you go to someone who is experienced and can show you before and after results of people with similar situations.
Laser resurfacing ,in my opinion, is useful only for improving fine lines, wrinkles and age spots. It will not tighten aging, loose tissues to any significance.
To find the plastic surgeon to provide the best results for you, start by looking at many photos to be certain you find a surgeon who shares your aesthetic ideal. I personally believe that even if a person wants a dramatic result, that no one should look like they have had a facelift at the completion of the recovery period. This means no pixie ears, no alteration of the hairline, no wind-tunnel look, and no over-filling of the face. I often ask patients to bring photos from their youth. This will allow us both to evaluate the changes that have taken place over the years. Sometimes patients don't notice some small details, like hollowness of the temples or changes in the chin or jawline.
It is critical to take a lot of time finding the plastic surgeon to perform a facelift. In addition to looking at many photos, carefully check the credentials of a plastic surgeon, his staff and his facility. Be certain that the procedure is explained in detail and that you feel comfortable with the surgeon, and his staff.
I agree that laser or chemical resurfacing during or after the time of facelift can dramatically improve overall aesthetic result. Talk to several surgeons in your area and look at lotus of before and after photos before making up your mind.
For full face rejuvenation, more than just a facelift may be necessary (brows, upper/lower eyelids, and overall skin texture are features to consider as well). That being said, the most important step you can take is to consult with an experienced surgeon who will sit down and take the time to examine your face and discuss the most appropriate procedure with you. A surgeon who "does the most facelifts" in your area doesn't necessarily make them the best. Facelifts take time, and just because a surgeon is quick, doesn't directly mean they're good. Ask to see photos of their work, and ask to see simulated digital before/after photos of your face (but keep in mind there are many highly regarded surgeons who don't offer digital imaging, so don't rule them out just based on this). Usually a combination of CO2 laser resurfacing with a full facelift (aka rhytidectomy, NOT a mini lift, or S-lift) will yield the most robust natural-appearing results.
The best way to start is to seek consultation with surgeons who are experienced in face lift procedures. A thorough history and physical examination will determine the most effective treatment strategy.
A facelift addresses sagging of the muscle underneath the skin as well as loose skin. Loss of volume can be addressed with fat transfer or other fillers. Laser resurfacing can help with fine wrinkles and sun damage. Botox can help with dynamic wrinkles.
This is a brief overview. Seek out multiple consultations with experienced surgeons and look at before and after pictures. Then, choose surgeon you are most comfortable with.