Facelift
Overview
Many patients will choose to have a facelift operation (also known as a rhytidectomy) to reduce the visible effects of aging. This surgical procedure nips and tucks loose skin on the face while repositioning drooping facial structures for a refreshed, more youthful appearance.
According to the American Society of Plastic Surgeons, a facelift remains as one of the top five most popular aesthetic procedure in the U.S., with more than 128,000 facelift surgeries performed in the year 2024. The skilled plastic surgeon Dr. Paresi, of Contour Plastic Surgery & MedSpa in Downers Grove, IL performs facelifts that refresh the face while keeping a natural appearance.
Choosing the most appropriate technique for the patient’s concerns and cosmetic goals, Dr. Paresi will create their unique treatment plan.
Causes of Facial Aging
There are three basic causes of facial aging that have to addressed to get comprehensive facial rejuvenation. The first cause is related to changes in skin texture and elasticity. As we age, the facial skin will demonstrate fine wrinkles, and less tone, resulting in loose skin which does not conform to the facial shape. The changes can be addressed with treatments like; medical grade skin care like Alastin. At Contour Plastic Surgery and MedSpa, we start all patients pursuing facial rejuvenation on Alastin Regenerating Skin Nectar as a pretreatment for facelift surgery. We also offer microneedling treatments with PRP and/or exosomes, and fractional CO2 laser resurfacing to address more severe facial skin aging. These treatments can be done before or after the facelift procedure.
The second cause of facial aging is loss of volume. The loss of volume is most apparent in the cheeks, nasolabial folds, corners of the mouth, prejowl sulcus, infrabrow area, and temples. These areas are addressed at time of the facelift with microfat facial fat grafting. The fat grafting is done at the end of the facelift procedure to add volume to the areas where the patient is volume deficient. The areas most commonly treated are the cheeks, nasolabial folds, and corners of the mouth. The microfat is most commonly taken from the area around the belly button, but can be taken from the inner thighs as well. These areas are chosen because of their high concentration of stem cells. Patients often notice an improvement in skin texture in the areas of fat grafting, in addition to the volume improvement.
The third cause of facial aging is structural changes to the face. The structural changes are changes in the facial anatomy that result in a more aged appearance. In the neck, these structural changes take the form of platysmal banding (Turkey Neck), submental fat, neck skin laxity, and jowls. These anatomical changes can only be addressed by surgical intervention as part of a facelift. In the face, the upper part of the jowls, the lack of jawline definition, descent of the cheek fat pads, deepening of the nasolabial folds, lengthening and thinning of the upper lip, and demarcation of the lower eyelid;cheek interface are all structural changes that lead to facial aging. Some of these issues can be addressed by manipulating the SMAS (Superficial MusculoAponeurotic System) layer of the face by a variety of facelift techniques. The lid;cheek interface and upper lip can be addressed by lower eyelid blepharoplasties and lip lift, respectively at the time of the facelift.
Facelift Results
Surgical Technique
There are various techniques used to complete a facelift. Facial anatomy, skin laxity and the end cosmetic desires of each patient will determine the optimal approach. Every procedure will be unique for the patient and will vary based on the type and location of the incision, the depth of the tissue layers involved, the axis of elevation and the level of impact.
Skin Only
The skin only facelift has been used since the early 1900s. This is known as a cutaneous face lift. This method is less invasive with limited impact, affecting the skin alone. Given that there is no intervention on the SMAS layer of the face, there is little to no effect on the jowls, cheek fat pads, nasolabial folds, and neck bands. The final result of this surgical technique is subtler than all of the newer SMAS tightening procedures. On the other hand, it offers a lower risk and involves a faster recovery time. At Contour Plastic Surgery and MedSpa, we do not offer this technique to most patients given its limited improvement on facial aging.
SMAS Plication
The SMAS facelift is the most common technique used. This surgery, while more surgically advanced, creates results that are a step or two more impressive and have more staying power than a skin only facelift. The method involves manipulating a group of muscles below the skin known medically as the superficial musculoaponeurotic system (SMAS). The SMAS layer controls your expressions. The SMAS plication can raise the cheek fat pad, correct the deep nasolabial folds, correct the jowls, and improve the jawline. The best results are obtained when combining the SMAS plication with a corset platysmaplasty of the neck. This is the preferred method for patients at Contour Plastic Surgery and MedSpa. The SMAS Plication, corset platysmaplasty of the neck, and microfat grafting to the face gives patients natural, aesthetic pleasing results.
Deep Plane Facelift
The deep plane lift facelift involves elevating the SMAS layer of the face in the ‘deep plane’. It is better suited for those with severe sagging and drooping and is usually reserved for older patients. While this procedure can offer certain advantages over a SMAS plication facelift, surgeons must be skilled and act with caution so facial nerves are not damaged during the surgical process. The facial nerves are located in the deep plane. A disadvantage of this technique is that the SMAS and skin layers cannot be corrected in different vectors which may result in less skin removal. At Contour Plastic Surgery and MedSpa, the best technique is selected and customized depending on patient concerns and goals.
Mini-Facelift
A mini-facelift or short scar facelift indicates the type and length of the incision around the ear that is used for the facelift procedure. A short scar facelift involves a 3 cm incision in the temporal hairline which camouflages in the front of the ear in a retrotragal fashion. The incision then extends into the crease of the earlobe, and extends halfway up into the crease behind the ear. This incision is shorter than the traditional facelift incision which extends behind the ear into the hairline. This incision pattern combined with a SMAS plication is what is called a Mini or Short Scar facelift. A Mini or Short Scar facelift does not include addressing the neck with a corset platysmaplasty. The best candidates for a Mini-facelift have minimal neck skin laxity and no platysmal banding of the neck. Correcting the neck skin and muscle laxity, if present, is a crucial part of achieving a good facelift result. At Contour Plastic Surgery and MedSpa, we use the short scar incision in the majority of our facelift patients.
After Surgery
Anesthesia
Patients have the option to choose the type of anesthesia they prefer for the facelift procedure. For patients that are having the facelift only, they have the option to do the procedure under local anesthesia. This involves the use of tumescent solution to numb the areas and an oral sedative like Valium. Patients who choose to have local anesthesia must be able to handle injections and lying on their back for about four hours. For patients who do not want local anesthesia, we offer general anesthesia at our fully accredited surgical facility. Dr Paresi will discuss the options for anesthesia with you at your initial consultation.
Facelift FAQs
Nonsurgical Alternative?
BOTOX®, injectable fillers, microdermabrasion and chemical peels are examples of some non-surgical procedures that can assist in smoothing out wrinkles, improving fine lines and adding facial volume. These procedures also help to even out skin tone. However, these are treatments that will only affect the skin’s surface. Patients with loose skin, drooping jowls or a sagging neck will need to consider surgery if they want these features improved.
Will I Look Fake?
In the days immediately following facelift surgery, patients will feel tight and pulled. These are some short-term effects, but they will subside. It’s important to find a reputable surgeon skilled in facial surgery. Surgeons who know what they are doing will make every effort to work within the confines of the patient’s bone, skin and muscle structures so a younger, more natural look can result.
Visible Scars?
Facelift surgery does require a long incision. However, in almost all cases, these scars are well hidden as they fall just along the hairline and around the ears in the natural folds of the scalp. In most cases, the scars should be barely visible to the naked eye.
Best Age?
Still have a question?
At Contour Plastic Surgery & Med Spa, our expert team is here to guide you every step of the way. We’re happy to answer your questions and help you feel confident in your choices. Contact us today to schedule your consultation — your journey to looking and feeling your best starts here!