anything i should know before getting a face lift so I won't end up looking all pulled up? I think they call it "wind swept" looking? this is NOT the results I want from surgery!
How Can I Avoid Getting a Pulled Up Look from a Face Lift?
Doctor Answers 101
A Facelift , Facial Rejuvenation Should Look Natural
The word 'rejuvenation' means, literally, 'to make young again'. In each individual, different facial changes occur with age. One person may be unhappy with 'baggy eyelids', while another has 'droopy eyebrows'. One person may be troubled by 'jowls' in the lower face, while another would like an improvement in their 'floppy neck'.
Surgical treatment of facial aging changes must therefore be carefully individualized to match each patient's aesthetic needs and desires. No two 'facelifts', by necessity, are the same. In helping a patient to make decisions about plastic surgery for facial rejuvenation, I always examine and assess how each aesthetic area or 'unit' of the face contributes to an individual's overall appearance: the brows and eyelids, the cheeks or 'midface', the lower face and chin, and the neck. An individualized surgical plan is then developed which addresses each patient's specific concerns and needs.
Plastic Surgery of the Face in the 21st Century
The specialty of Plastic Surgery has been undergoing a 'paradigm shift' in the approach to surgical treatment of facial aging changes over the last two decades. This shift has consisted of a departure from older 'subtractive' techniques to newer 'restorative' techniques.
Surgery which consists mainly of removing (subtracting) skin and fat and pulling tissues tight will lead, in many instances, to a 'skeletonized' and therefore more aged (or "done") appearance. Facial soft tissues (and even the facial bones) actually lose volume and projection with age, and it is thus inevitable that surgery which focuses only on removing tissue will in some fashion 'age' the face. The contemporary approach to surgical rejuvenation of the face consists more and more of an attempt to restore facial volume and contour, in an attempt to emulate youthful facial features. My personal approach to facial rejuvenation is to first maximize repositioning and recontouring of facial aesthetic areas, and to remove only as much tissue as is necessary.
I also find that structural fat grafting, using a patient's own fat from the abdomen or hips, is an extremely effective means to help restore the facial volume associated with a youthful appearance. The importance of restoring facial volume is readily apparent when I review with a patient a number of photographs from their twenties and thirties. The meticulous addition of soft tissue volume by means of fat grafting is one of the most powerful means now available for 'turning the clock back.'
Your surgeon should be artistically skilled in facelift surgery
The pulled look results from many factors, all of them avoidable. As a lay person, you may not be able to list each one, but you know pulled when you see it.
1. Bad direction of pull. When the facelift is directed very high at the side of the face, pull is created preferentially on the side of the face, and nothing is done for the middle of the face. This yields an unnatural change in direction of the skin. It also sacrifices the sideburn, which in women is not replaceable. How to avoid: Pull should be more gently back. Preserve sideburn. Use cheeklift to simultaneously elevate the center of the face to avoid the "hanging curtain" look.
2. Too much pull. The earlobes pull forward. The tragus, the bump in front of the ear, pulls forward. The mouth and nose begin to separate. Scars are bad and wide. How to avoid: Considerable deep restructuring; skin should be a gentle afterthought, closed firmly but not too tight. Use LiveFill for deep volume restoration. Don't try to solve all problems by pulling extremely tight yet not replace lost volume. Keep the ear and earlobe looking natural and unoperated.
3. Aggressive browlifts. Raises the hairline, causing a high forehead. Artificially raises the center of the brow, causing a startled expression. How to avoid: conservative browlifts, concentrating on lateral brow. Avoid hair elevating techniques in patients with high hairlines
4. Hollowed appearing eyes with change in eye shape. How to avoid: cheeklift along with lower eyelid surgery. LiveFill grafts to lower eyelids to replace volume. Fat preserving or fat modifying approach to eyelid surgery. Careful concealment of incisions.
5. Non-artistic work. You know it when you see it: cat eyes, exaggerated lips, strange expression, visible unsightly scarring. How to avoid: look carefully at the before-after pictures of the plastic surgeon you are considering. You will soon recognize which doctors have an artistic touch and eye.
6. Cost cutting. On this website are patient evaluations of their facelifts. You will see a correlation between patients' satisfaction and the care with which they did their research and the involvement of their procedures. There is a reason that facelifts are expensive with noted surgeons, and why you can't solve all the problems of aging in one hour over lunchtime with a marginal practitioner.
The windswept look should not happen after a well performed lower facelift procedure. This usually occurs in settings where either just the skin is pulled tight or the deeper structures are not addressed properly. A facelift aims to reverse some of the signs of aging. Part of the aging process is descent of the tissues of the face including the muscles and other structures which live below the skin. The skin envelope will then stretched to accomodate the descent. By pulling the deeper structures back into proper position, the skin can be easily trimmed to create a very natural appearing, but refreshed look.
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How not to get a pulled look after a face lift
I see that many of my colleagues are telling you to choose a good surgeon. Obviously a good surgeon would know exactly what to do. But i think you are asking a question to help you understand yourself what needs to be done. The wind tunnel appearance is often the result of an uneven or incomplete pull of your skin. For example a person ideally needs a face lift and a brow lift but only a face lift is done. The lower face would be tight but on the side of the eyes, one would notice a crowding of skin. which would give an unnatural appearance. In face lifting Harmony is everything and sometimes just a face lift is not enough. You may have to do the eyes, a brow lift, fat injection etc to get the optimal results. I hope I clarified it for you a little more.
The wind swept look is an old fashioned looking result...
The wind swept look is an old fashioned looking result of a facelift that results from a hard pull on the skin in an upward direction in front of the ears. Old techniques relied on the pull on the skin to lift the sagging facial features. Modern facelift techniques recognize the unnatural look this creates and lift the deeper tissues of the face in a vertical direction but take the skin excess off in a more natural direction and under less tension than in the old techniques.
Make sure you see many pre and postoperative photos of each surgeon's results to be certain the results you want are reflected in the results that doctor creates. This is an art form and no 2 surgeons are the same and neither are their results!!
Avoiding a pulled look from a facelift
The key word to remember is -"vector."
Most patients believe that a pulled look is due to tension caused by excessive skin removal during surgery. Although that is a possibility, most of the time it is caused by the surgeon who pulled the skin or excess skin in a wrong direction or vector.
If facelift is performed with this natural vector in mind, you will NOT have a pulled look to your face.
How To Avoid Pulled Look Or Unnatural Look After Facelift
Thank you for your question. The short best answer is find an experienced, reputable, Board Certified Plastic Surgeon who does many Facelifts.
A properly performed Facelift should create a beautiful natural refreshed look. You should look like your younger self after a properly executed Facelift.
When you see a pulled look, windswept look, weasel look, or obvious Facelift look after a Facelift, the lift was not properly performed.
There are natural directions or vectors for lifting the face that are unique for each individual face. Your surgeon must understand these artistic elements of your face and follow them during the surgery.
This takes experience and surgical and artistic skill. Consult several Board Certified Plastic Surgeons and ask to see photos of their results and choose someone with experience and demonstrated excellent natural results.
Avoiding the windswept look after facelift
Without getting too technical, there are many different ways of doing a facelift and some of these can lead to this look. My best advice is to look at photos of the surgeons work, of patients 1 year after surgery and, if he/she has them, of patients 5 or 8 years after surgery. This will give you some idea of the type of result the surgeon produces. Of course if they use a new technique, the patient he/she operated on 8 years ago did not have the procedure he/she is using now. Ask people like hair stylists who they think is good. They see a lot of women who have had facial surgery. Hope this helps.
Tracy M. Pfeifer, MD, MS
Facelifts should look natural
The goal I have for my patients is for them to look like a younger, refreshed and well-rested version of themselves, not someone else. The key to this is good surgical technique. This will vary with the patient, but may involve a combination of repositioning of deep tissues, volume replacement and skin tightening. The correct procedure for you will depend on examination by a competent, experienced surgeon who understands all of the issues that result in aging of the face.
Motorcycle ride Facelift
The improperly done Facelift may be the most common type of procedure out there. This includes pulling on the skin around your ear in an effort to hide the scar. The truth is that this simply doesn't work.
Look in the mirror and pull on your skin. No matter how young you are, or how good your skin is, it's going to look pulled. Now lay down with a handheld mirror. This is more like what it would look like if every layer on your face was suspended back up against your bony structures. What that means is that if you tighten the deeper structures and just lay the skin down over it, you'll have a more natural result.
Tightening the skin was something they did in 1920. It didn't work then and it doesn't work now. It is quite popular on late night telemarketing ads, it just doesn't make you look youthful because the concept is flawed. I've heard many say that technique doesn't matter, it's how good you are at your technique since several can get you there. That's not true. I've seen many great surgeons and they have had great, great results... and not so great, great ones as well. Usually it's because of a flaw in the plan. With a proper plan, you won't look like you're in a wind tunnel.
You'll need to discuss these concepts with a few surgeons until you find one that really convinces you that he's right.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.