Tightness of facelift results controllable?

To a certain extent, the tightness that the face skin is pulled is variable and a surgeon can pull "tighter" if desired. Best of luck.

The tightening of the lift is something that is determined during treatment of the underlying SMAS layer. The results of the tightening are immediately visible to the surgeon as the jowls are decreased, there is a visible improvement in the jawline and the neck profile is improved. Results vary between patients depending on underlying anatomy and type of procedure performed, so no two patients will get the same results. You should discuss with your surgeon your expectations and they will let you know what is possible.

Facelift operation involves a few critical decisions and those will determine whether one achieves a great result or just "natural" result. How much to tighten the SMAS and or platysma and which direction to do it in will make the skin resection much easier and obtain a great result.

The "wind tunnel" look with facelifts is a result of doing primarily a "skin tightening" procedure on a face that has a lot of deeper sagging tissue to lift and support.By doing a deeper surgical dissection and lift (a "deep plane" facelift), a much greater amount of lifting can be done, and therefore a more significant change/rejuvenation can be achieved, while maintaining little tension on the skin -- and therefore maintaining a very natural, un-stretched look.Up to a certain point (usually around age 45 -- although excessive sagging occurs at different ages due to genetics and lifestyle) a minimalist, "mini" or skin-tightening procedure can produce a very natural change, since there isn't that much to change in the first place.However, past the age of 45, the deeper structures of the face (fat, muscles, fascia, glands) are sagging significantly as well as the skin. If a surgeon tries to elevate and support all this deeper weight by just tugging on the superficial skin, then that weight pulling down and the surgery pulling up will create a lot of tension which starts looking unnatural. When the deeper structures are released from their underlying attachments, elevated and supported independently of the skin, then the skin can be elevated and repositioned with very little tension.A word of caution with deep-plane facelifts: A similar result can be achieved just by using multiple (not just one or two) sutures, placed into the SMAS (not just the subcutaneous fat), in front of and in back of the ear, that simply pull on the deeper structures. This "snagging and pulling" of the deeper stuff takes tension off the skin as well and simulates, for a shorter amount of time, the results achieved with a deep-plane facelift. However, this type of lift will last only 6 or 7 years vs a TRUE deep plane facelift, which will last 10 to 12 years. A TRUE deep plane facelift doesn't just snag the deeper stuff and hoist it up and anchor it. ATRUE deep plane facelift will actually dissect EXTENSIVELY UNDER all this deeper stuff (fat, muscles, facia), then will elevate and support all this stuff while it heals/fuses down over a LARGE area, thus significantly stabilizing it for the long term. Ask your surgeon which technique he/she uses. If it only takes your surgeon only 1 to 2 hours to complete their facelift, you already know the answer: They are doing a minimalist superficial surgery that not only won't look much better than before their surgery, but it won't last very long either.

I believed there is a misunderstanding in the face lift operation. The results that look pull are produce for
the tension in the skin flap. To obtain
better results the key is to resolved
the deep plane first and removed
the redundant skin only. This warranty great and natural results

The result of a facelift does not rely on how tight is the skin.
Nevertheless, it is possible to create dramatic youthful change with an expertly
performed facelift. Your observation is correct – some surgeons deliver a
“natural” look where you do not see significant difference in before and after
photos. A goal of a world class facelift is to create beautiful results, with
significant youthful changes in the before and after photos, and yet without any
artificial look. It is imperative to use certain specific surgical maneuvers
to create these changes. Seek out an expert facelift surgeon. Ask to see the
before and after photos that show the results you desire. In our practice, we
encourage prospective patients to meet with our prior facelift patients to see
first hand what a well executed facelift can achieve.

All of your individual preferences of your surgery can be discussed during your consultation. We typically do this with patients setting in front of a mirror and gently lifting their skin to simulate how they will look after surgery. Some patients want a little bit less, some a little more! Ultimately, it's up to you.

It's important to select a surgeon who specializes in facial surgery and spends the time with you during the consultation to really get to know you and Identify your needs. Best of luck in your search!

Does anyone else see the humor of the facelift question coming from Great Neck, NY???You're correct, we can certainly alter the amount of tension of the skin, but more tension can lead to widened scars. The ideal is a compromise between good skin redraping and the right amount of pull to give a tight but not "done" look. Some surgeons will suggest a "tuck up" surgery to lift loose skin a year or two after the facelift. Tell your surgeon your goals so you have good communication and realistic expectations.

This is an excellent question. Most people want to look as young as possible, while also looking like themselves. Removing too much skin and leaving one with a windswept look is not the way to make a person appear youthful. I often ask patients to bring photos from their youth to a consultation. The goal is not to make a 55 year old 20 again, but to examine the way facial features have changed during the aging process. Often a big change is that there is a loss of facial volume. This can be corrected with expertly administered fat grafting. Just as a person does not want the result of surgery to make them appear as though they have been through a wind tunnel. Nor do they want to look over-filled and distorted. Look at many, many before and after photographs to find a plastic surgeon who can provide you with a natural looking result that will make you look as youthful as you feel. 

Facelift results are primarily determined by the work that is done under the skin; re-positioning the muscles layers that hold the skin. It is not as simple as pulling the skin tighter. The degree of correction is determined by the surgeons style and preferences with the patients guidance. You need to find a surgeon who is very experienced in doing facelifts on faces with different degrees of laxity, and who can show you many examples that resemble what you want.