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Other procedures that might be performed in conjunction with a facelift are brow lift and eyelid surgery to rejuvenate aging eyes. Fat transfer or fillers may be suggested to replace the lost fatty volume. Skin treatments such as IPL, dermabrasion, peels or laser may be offered to improve the quality and texture of the skin.

A facelift can only be performed surgically; minimally invasive rejuvenation treatments cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate and complement the results of surgery.

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As you get older, skin and tissues naturally lose their elasticity. This leads to sagging and wrinkles. A facelift, also known as rhytidectomy, is a surgical procedure that lifts and tightens these facial tissues.

A facelift is only focused on the bottom two-thirds of the face and often the neck or dcolletage. People get facelifts for lots of different reasons. A common reason is to help disguise signs of skin aging.

A facelift, technically known as a rhytidectomy (from the Ancient Greek (rhytis) 'wrinkle', and (ektome) 'excision', the surgical removal of wrinkles), is a type of cosmetic surgery procedure used to give a more youthful facial appearance. There are multiple surgical techniques and exercise routines. Surgery usually involves the removal of excess facial skin, with or without the tightening of underlying tissues, and the redraping of the skin on the patient's face and neck. Exercise routines tone underlying facial muscles without surgery. Surgical facelifts are effectively combined with eyelid surgery (blepharoplasty) and other facial procedures and are typically performed under general anesthesia or deep twilight sleep.

In the first 70 years of the 20th century facelifts were performed by pulling on the skin on the face and cutting the loose parts off. The first facelift was reportedly performed by Eugen Hollnder in 1901 in Berlin.[4] An elderly Polish female aristocrat asked him to: "lift her cheeks and corners of the mouth". After much debate, he finally proceeded to excise an elliptical piece of skin around the ears. The first textbook about facial cosmetic surgery (1907) was written by Charles Miller (Chicago) entitled The Correction of Featural Imperfections.[5]

At the start of this period in the history of the facelift there was a change in conceptual thinking, surgeons started to care more about minimizing scars, restoring the subcutaneous volume that was lost during the ageing process and they started making use of a cranial direction of the "lift" instead of posterior.[citation needed]

The technique for performing a facelift went from simply pulling on the skin and sewing it back to aggressive SMAS and deep plane surgeries to a more refined facelift where variable options are considered to have an aesthetically good and a more long-lasting effect.[citation needed]

A facelift is performed to rejuvenate the appearance of the face. Aging of the face is most shown by a change in position of the deep anatomical structures, notably the platysma muscle, cheek fat and the orbicularis oculi muscle.[11] These lead up to three landmarks namely, an appearance of the jowl (a broken jaw line by ptosis of the platysma muscle), increased redundancy of the nasolabial fold (caused by a descent of cheek fat) and the increased distance from the ciliary margin to the inferior-most point of the orbicularis oculi muscle (caused by decreasing tone of the orbicularis oculi muscle).[11] The skin is a fourth component in the aging of the face. The ideal age for face-lifting is at age 50 or younger, as measured by patient satisfaction.[12][13][14] Some areas, such as the nasolabial folds or marionette lines, in some cases can be treated more suitably with Botox or liposculpture.[citation needed]

Many different procedures are used for rhytidectomy.[20] The differences are mostly the type of incision, the invasiveness and the area of the face that is treated. Each surgeon practices multiple different types of facelift surgery. At a consultation the procedure with the best outcome is chosen for every patient. Expectations of the patient, the age, possible recovery time and areas to improve are some of the many factors taken in consideration before choosing a technique of rhytidectomy.[citation needed]

In the traditional facelift, an incision is made in front of the ear extending up into the hairline. The incision curves around the bottom of the ear and then behind it, usually ending near the hairline on the back of the neck. After the skin incision is made, the skin is separated from the deeper tissues with a scalpel or scissors (also called undermining) over the cheeks and neck. At this point, the deeper tissues (SMAS, the fascial suspension system of the face) can be tightened with sutures, with or without removing some of the excess deeper tissues. The skin is then redraped, and the amount of excess skin to be removed is determined by the surgeon's judgement and experience. The excess skin is then removed, and the skin incisions are closed with sutures and staples.

In order to correct the deepening of the nasolabial fold more accurately, the deep plane facelift was developed. Differing from the SMAS lift by freeing cheek fat and some muscles from their bone implement. This technique has a higher risk at damaging the facial nerve. The SMAS lift is an effective procedure to reposition the platysma muscle; however, the nasolabial fold is according to some surgeons better addressed by a deep plane facelift or composite facelift.

As well as in the deep plane facelift, in the composite facelift a deeper layer of tissue is mobilised and repositioned. The difference between these operating techniques is the extra repositioning and fixation of the orbicularis oculi muscle in the composite facelift procedure. The malar crescent caused by the orbicularis oculi ptosis can be addressed in a composite facelift.[citation needed]

The subperiosteal facelift technique is done by vertically lifting the soft tissues of the face, completely separating it from the underlying facial bones and elevating it to a more esthetically pleasing position, correcting deep nasolabial folds and sagging cheeks. The technique is often combined with standard techniques, which provide a long-lasting rejuvenation of the face and is done in all age groups. The difference between this and other lifts is that the subperiosteal facelift has a longer period of facial swelling after the procedure.[citation needed]

With the skin-only facelift only the skin of the face is lifted and not the underlying SMAS, muscles or other structures. As the elastin fibers disintegrate, the skin itself loses elasticity in older patients. A skin only face lift requires skill in understanding the extent of safe removal of skin and the Vector of pull to get an optimal result. It can be done with a simple ellipse of skin removed with minimal undermining of skin flaps or more extensively with large skin flaps. It can last 5 to 10 years but some patients may want a touch-up at 6 to 12 months after the procedure. The reason that this option is considered is that it has fewer complications and quicker recovery. One of the father's of plastic surgery Sir Harold Gilles described a simple ellipse of skin excision in a socialite who was pleased with her quick recovery and outcome. Can be done for a simple jowl lift in a 35 to 45 year old patient.[citation needed]

Nerve injury can be sustained during rhytidectomy. This kind of injury can be temporary or permanent and harm can be done to either sensory or motor nerves of the face. As a sensory nerve, the great auricular nerve is the most common nerve to get injured at a facelift procedure.[18][29] The most injured motor nerve is the facial nerve.[18][34]

Skin necrosis can occur after a facelift operation. Smoking increases the risk of skin necrosis 12-fold.[15] Scarring is considered a complication of facelift surgery. Hypertrophic scars can appear. A facelift requires skin incisions; however, the incisions in front of and behind the ear are usually inconspicuous.

One of the most often overlooked (or not discussed) areas of a traditional facelift procedure is the effects on the anatomical positioning and angles of the ears. Most patients are, in many cases, not made aware that the vector forces in a facelift will lower the ears as well as change the angle of the ears. Ear lowering can be as much as 1 cm and change in the angle as much as 10 degrees.

You don't have to leave your youthful good looks behind as you age. In the hands of a skilled, board certified cosmetic surgeon, you can counteract the effects of time and gravity and restore the naturally vibrant appearance you remember from years ago, or even address the early signs of aging before they take hold. Learn more about facelift surgery below.

Depending on the case, a mini-facelift may be performed using local anesthesia with sedation or general anesthesia; your cosmetic surgeon will recommend the best option for your individual needs. A mini-facelift can help you address unwelcome signs of aging before they become too pronounced, postponing the need for more extensive surgery for many years.

A standard or traditional facelift, also known as the superficial musculoaponeurotic system (SMAS) technique, will more fully address moderate to advanced aging around the mid-face and neck. While the surgery is more extensive than those for a mini-facelift, and thus more recovery time is required, the results are more dramatic. Through incisions located just behind the hairline, starting near the temples and around the front of the ear, hidden in the natural folds, a cosmetic surgeon can reposition the deeper tissues beneath the skin and remove excess skin to smooth creases, eliminate jowling and sagging skin under the chin, and restore a naturally youthful contour to the face and neck. e24fc04721