Dr. Matthew Schulman: A face lift is designed to lift the face in order to put things back in the position they were in when you were 20. So, what that means is when people age the normal perception is that everything drops, but we know that things don't really drop. We've looked at some photographic evidence and if you look at someone when they're 20 and they have a mole here, and then you look at them when they're 80, and everything looks like it's hanging on the floor, the mole is still in the same position. So, that's very interesting. That means something has to be going on.

What we've come to learn is that it's not just descent of the tissue, so it's not just sagging. It's actually loss of volume. So, as you lose volume in your cheeks and your face, everything sinks in, and then gives the appearance of drooping. So, any properly performed face lift needs to target the cause of the problem. So, when I do a face lift, I lift up the skin and I take those areas that are under the skin, the fat pads that have lost volume and descended, and put them back where they're supposed to be.

What that means is that you get a youthful appearance to your face and the amount of skin that's actually removed is surprisingly little. Most people are thinking of the old fashioned face lifts where everything is just pulled real tight. The problem is, that gives you a very pulled wind swept look and a lot of people don't like that. I as a plastic surgeon don't like that. I don't want my patients walking around looking like that because I think it looks bad for them and it clearly looks bad for me.

So, what I do, I perform rejuvenation of the deep underlying structures of the face and then the skin just redrapes over top of it. And I will remove some of the excess skin, but like I said, the power of the face lift that I perform is not based on pulling the skin. The incisions will vary slightly between patients depending on how much of a lift you need. The incision will be around the front of the ear and up the back of the ear to a small extent. I commonly perform what's called a short scar face lift. So, the scar will be just from the front, just to the earlobe.

In patients who require more of a lift, this scar up here may extend into the hairline and the scar behind the ear may go up further back, and sometimes into the hair in the back. But again, the scars really depend on the specific face lift technique that I'm performing on you and how much of a face lift you need.


Doctor Matthew Schulman discusses Facelift.