How can I improve the results of a facelift?
A facelift is one of the biggest investments you can make to enhance your
appearance typically performed by specialty trained doctors facelifts are
performed in operating rooms with the team of people in addition to the surgeon over the course
of several hours with so much time resources and money spent on a facelift
why are there people who are disappointed with how they look after
facelift surgery I’ll discuss what kind of results should be expected from a
facelift as well as the facial aging issues that a facelift alone does not
address I’m Dr. Amiya Prasad I’m a Board-certified cosmetic surgeon and
Fellowship-trained oculofacial plastic and reconstructive surgeon I’ve been in
practice in New York City and Long Island for over 25 years I routinely
perform all types of facelifts from short scar mini lifts to more extensive
deep plane or subs mass facelifts I often perform a combination of face and
neck lifts for people who are more advanced facial aging since facial aging
also affects the appearance of your eyes I often perform eye rejuvenation such as
upper and lower eyelid surgery at the same time in many of my face lift
surgeries I make it a point to address the volume loss of aging seen in the
lips and facial support structures through strategic placement of selected
hyaluronic acid fillers to enhance the lips and vertical lines in addition to
the cheekbones chin and jaw angles one of the core principles in my
practice is to first define the problem before determining the optimal strategy
to reach a solution it’s therefore important to first identify what
specific problems can be addressed by a facelift a facelift involves a surgical
restoration of the cheeks and jawline soft tissue which has become loose and
descended downward due to facial aging these anatomic features are not just
skin but they exist in layers which include the skin soft tissue and the
connections to the deeper facial muscles the connection to the deeper facial
muscles is often referred to as the muscle and is referred to in our
profession as thus mass which stands for the superficial muscular aponeurotic
system thus mass serves as a critically important foundation for the skin to be
supported by skin only lifts and procedures such as thread lifts do not
have the level of support of a properly performed facelift and consequently
don’t work very well as I mentioned earlier aging changes are not limited to
the cheeks and jawline but also affects the eyes for example aging can cause the
upper eyelids to appear hooded or sagging as the skin above the eyes
stretch and become redundant with age the lower eyelids can also have a puffy
appearance which is often referred to as eye bags puffy eye bags are due to fat
that is normally around the eyes prolapsing forward combining eyelid
surgery with face of surgery is something I recommend to help you look
your best as a combination when appropriate the recovery time overlaps
the face of surgery and you get the most value
out of the cost of the operating room facility and staff in our office there
are two important factors in facial aging one is the descent of the skin and
soft-tissue which is addressed by facelift surgery the other is volume
loss at the bone and soft tissue level youthful facial volume can be
appreciated by the fullness and projection of the cheeks the jaw line
definition and the overall facial harmony seen in a younger person many
facelift patients often report that they really liked their results during the
first few months after surgery and then they feel that their facelift doesn’t
look as good after one year this is a misconception since during the early
recovery period the swelling which is temporary can create an appearance of
having more youthful volume as the healing process progresses this
temporary fullness caused by swelling disappears so how do I address your
facial volume deficiency if I’m performing your facelift as a surgeon I
have used two strategies in the past to help my patients one was to place facial
implants made of silicone such as cheek and chin implants at the bone level the
other was to harvest fat and perform fat grafting patients often resisted having
facial implants and fear of looking overdone they were generally willing to
have a small chin implant but often objected to having cheek implants I
found myself concerned about two things with the placement of cheek implants one
was whether the patient would be satisfied with the outcome or would they
feel that the shape wasn’t what they wanted or if the implant was either too
small or too large the other concern for me was whether the patient
then skin would eventually or at the same time reveal an outline of part of
the implant particularly as aging continued and bone loss and skin
thinning could make the implant appear more visible further if the patient
wanted the implant to be removed it means they have to undergo another
surgery I also try to enhance the facial soft tissue loss with fat grafting this
involved my performing liposuction and taking the fatty tissue and placing the
fatty tissue into the areas of facial volume deficiency unfortunately the fat
survival rate was too unpredictable and patients needed more surgery in order to
try and restore the lost volume from the first surgery in addition aged skin is
intrinsically thinner and weaker than younger skin this means that whether
it’s fat or filler the skin has a limited weight bearing capacity I made a
significant paradigm shift in my approach to facial volume deficiency
several years ago this was the result of a synergy from combining the principles
of facial implant surgery with the technological advances of recently
introduced thicker and longer lasting hyaluronic acid fillers such as Juvederm
Ultra Plus and Juvederm Voluma I place these fillers without surgery using
blunt cannulas at the bone level of the cheeks jawline and chin I cannot
overstate the importance of technique many doctors and so-called injectors
believe that if their needle contacts the bone that there at the bone level
the needle may be touching the bone but the filler is generally not going where
they intend the material to be placed while facial fillers have a reputation
for appearing doughy and unnatural I use my knowledge and experience as a
facelift and facial implants urgent to precisely place filler at the bone level
below the facial muscle layer which results in a more defined and sculpted
appearance I call this technique Structural Volumizing because it adds
structure and definition to the face as I mentioned earlier about technique I
use very few entry points to place the hyaluronic acid filler so bruising is
rarely an issue many of the so-called master injectors do demonstrations on
social media platforms with needles piercing the skin multiple times in just
one small area only to be repeated several times more for the other areas
to be addressed that’s a lot of poking which means more swelling and more
bruising by performing Structural Volumizing I’m able to be much more
precise with volume and shape allowing me to make micro adjustments for
asymmetric features unlike a facial implant which would require additional
surgery should there be a need to reverse the filler all I have to do is
use an enzyme called hyaluronidase in my exam room and the filler is completely
dissolved I routinely use structural volumizing for people who’ve had
facelift surgery performed by other surgeons who want to look better these
patients are often delighted to learn that they don’t need another facelift
and are very impressed by how good they look in less than 30 minutes in my exam
room if you’re considering a facelift you
clearly care about your appearance and you expect to look significantly better
afterwards while faceless surgery is effective for lifting sagging
cheeks and jowls I counsel my patients about facial volume loss and the
appearance of their eyes and lips when planning a comprehensive treatment
strategy for them my patients appreciate this integrated approach by me as they
are a beauty doctor rather than having to go to multiple people for different
services whether I address volume at the same time as a facelift or afterwards
restoring structure improves the balance and definition of your face in a way
that completes the intended outcome of a beautifully performed facelift I hope
you found this information helpful thank you for your question