Posts Tagged ‘facelift’
Saturday, July 17th, 2010
Q: My friend who just had a facelift had a slim face before and it’s even slimmer after the facelift. I am considering a facelift but I don’t want to lose any volume in my face or lose my round face. I think a round face keeps you looking younger. I have that St. Bernard look and is why I want a facelift. Could you explain better the SMAS part of a facelift? I want to have the volume that is now around my mouth back up in my cheeks without having that “alien” look (inverted triangle). That to me is the tell tale sign of a facelift. I want a smoother transition between my cheeks and my lower face and not all the fat in my cheeks. In other words, I don’t want to lose my round face. Would you mind explaining this some more to me please. The best facelifts I have ever seen is when the volume is added to the outside of the cheeks (side closest to ears) making the face wider hence more volume. Is it possible to ask the doctor where to reposition the fat as he marks up my face next week for my nip tuck?
A: A facelift fundamentally works by pulling the skin and the underlying tissues back up along the jaw line and neck towards the ear. In thin faces, tightening these tissues can often make it look even slimmer or more gaunt. That is a simple function of having very little subcutaneous fat between the skin and the muscle. It definitely can give the impression of being pulled too tight even though it really isn’t.
The SMAS part of a facelift is the separation and lifting of the tissue layer between the skin and the muscle. It s usually lifted up in a more vertical direction than the way the skin is moved back. (which is up and back at about 45 degrees) It can help add volume to the side of the face if the SMAS layer has enough bulk. In thin-faced patients, it is quite thin.
In really round faces, a significant slimming effect will not happen after a facelift…even if you wanted it too. It will make the neck and jawline better shaped (which is the lower face) but it will not change what most people interpret as the ‘meaty’ part of the face, the cheeks and side of the face. The change in the neck is what creates the impression that you have lost weight, which is what many people comment on afterwards. (provided they didn’t know you had a facelift)
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, facelift, facelift results, indianapolis, plastic surgery
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Thursday, July 15th, 2010
Q : I am scheduled for a facelift next week. My friend had hers last week. We both go to the same plastic surgeon who is well known. I was shocked today when I saw my friend. It appeared she had been beaten up and looked horrible. Granted it has only been six days but is this normal? When I asked the plastic surgeon about the swelling, he said my friend was still swollen. He does the SMAS lift and pulls the skin as tight as he can knowing that in 3 months it will look normal. Is this routine? I really want a natural look and now am not sure what to do. Please advise. Thanks.
A: Your concern is understandable and let me provide you with this analogy. Facelift results are a lot like getting a haircut. Sometimes in the beginning it looks bad right after, you think it looks good during the middle part of its growth cycle, and then dislike it again once it is too long or outgrown. That is analogous to a facelift because it is not a static result over time.
Meaning…if you have don’t do too much (conservative facelift) then your swelling will be more mild, recovery will be quicker, and your result will look more natural from the getgo…but the result may not last as long. If an aggressive facelift is done, one will have a lot of bruising and swelling (i.e., look awful) and look overdone in the beginning…but will relax into a more natural reesult much later and the results may last a little longer.
As you can see, the facelift operation is balance of how much recovery one can sustain for perhaps a longer lasting result. While everyone wants the best result possible that lasts the longest, the reality is that the initial and short-term recovery period from doing the most aggressive/extensive facelift is not for everyone. Unfortunately, plastic surgeons generally use whatever facelift technique that they prefer on everyone.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, facelift, facelift recovery, indianapolis, plastic surgery
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Thursday, July 8th, 2010
Q: I am 58 yrs old and in good health. I have never smoked, drank alcohol or done any drugs. While I am an upbeat person, I have had a difficult past and been exposed to a lot of physical and mental abuse. I just want to have a natural smile. My mouth has always had a natural turn down which makes me appear angry and unhappy. (which I should be because of my past but am not) I can pull my cheeks up at my ears and have a great turned up smile and the jowls disappear. I read about the thread procedure and thought this might be possible for me. Anxious to hear from you.
A: In reading your e-mail, by your own description, you have the classic signs of face and jowl laxity. By pulling the skin up by your ears or cheeks, you are creating the classic results of what a facelift can achieve.
Your inquiry regarding a Threadlift suggests that you believe that this may produce a result similar to a facelift or maybe approximately so. Unfortunately, this is not true. While the Threadlift concept has a lot of appeal in the mid-2000s, it is a procedure which has largely disappeared from clinical use. The original ‘threads’ are no longer even manufactured. When an initially popular and marketed plastic surgery procedure ‘disappears’ within five years from when it comes out, that is because it has basically failed to work. Such is the fate of the Threadlift.
Even of the Threadlift procedure was still available, it was never intended for severe facial skin laxity. In other words, it does not sound like it would have worked in you anyway. Some form of a facelift is what you need. Even a limited facelift, or jowl lift, would be better than any form of a Threadlift.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, facelift, indianapolis, plastic surgery, threadlift
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Wednesday, June 16th, 2010
Q: I would like some information about facelifts. Do you do lower face/neck lifts.? How much is the average facelift? Do you have financing for facelift procedures?
A: Very detailed information on facelift surgery can be found on my blog, www.exploreplasticsurgery.com. Just search under facelift and more than 50 articles on various aspects of facelift surgery will come up on the topic. From what a facelift is and its different types, to how it affects the facial aging process and how long they last, and to recovery and postoperative instructions after a facelift are covered in detail in these articles.
The cost of a facelift can range from $5500 to $9500 depending on the type of facelift done. More limited facelifts, like Lifestyle Lifts cost less while more complex full facelifts cost more.
All facelifts are really neck-jowl lifts and affect only the lower third of the face. It is a common misconception that it is a procedure that treats the entire face, from the forehead down to the neck. Many facelifts are done at the samed time as other facial procedures such as blepharoplasty (eyelid surgery), browlift, rhinoplasty and chin augmentation.
The financing of cosmetic surgery is common and many companies offer this service. Plastic surgeons essentually act as referral sources to these companies as both a service and convenience to their patients. One of the most popular is Care Credit although there are many others. Plastic surgeons do not offer the financing directly but provide needed financial information so that you can apply.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cosmetic surgery financing, dr barry eppley, facelift, indianapolis, plastic surgery
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Friday, June 11th, 2010
Q: I am interested in a brow lift or botox treatment…maybe a facelift. I am 43 years old and I believe I look ten years older. Do you know if I could try one procedure now and then gradually work up to a progressive series of surgeries?
A: The wonderful thing about the many procedures for facial rejuvenation is that both small and big changes can be done. And the procedures can be customized to how much one wants to do, how much one wants to spend, and how much recovery one can allow. Since facial aging is a progressive phenomenon, younger patients will need smaller procedures while bigger changes are reserved for those with more loose skin and wrinkles.
Since you have never had any of these cosmetic procedures before, it is understandable that one often does not know where to start. To ‘put your toe in the water’ so to speak, doing something non-surgical like Botox or injectable fillers is a good way to start. One can venture ‘further into the pool’ with laser treatments and even facelift surgery at a later date. A progressive approach to facial aging treatments is both reasonable and prudent.
Always start with the facial concerns that bothers you the most. To get started, it is helpful to meet with a plastic surgeon and have an educational session about what is appropriate now and what may be beneficial in the future.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: botox, dr barry eppley, facelift, facial aging, facial plastic surgery, indianapolis, plastic surgery
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Saturday, June 5th, 2010
Q : I had a facelift right after this past Christmas. While it turned out great and I wouldn’t change a thing, I forgot to ask my plastic surgeon how long it would last. What is your take on the longevity of facelift surgery? What can I expect to look like five years from now? Will I eventually look like I did right before the facelift?
A: The simple answer is…you will eventually outlive the results of your facelift. In fact, I would argue that is your goal, to be able to live long enough to need some type of tuck-up or secondary facelift. In that answer lies an important truth…facelift surgery is not permanent. Its lack of permanency is because the surgery treats the symptoms of the problem but not the problem itself which is unstoppable aging.
The complex answer is that it is very difficult to predict how long the results of a facelift will last. The rate at which people age is highly variable and depends on the interplay of numerous factors including heredity, sun exposure, stress, smoke and environmental poison exposures and nutrition. The quality of one’s skin, its thickness and elasticity, and the shape and support of the underlying facial bones play a major role in the stability of a facelift result.
The age at which a facelift is done is also an important factor as aging accelerates at different stages of life. As an example, the results of a facelift performed at age 50 can be expected to last longer than the results of a facelift done in a 65 year-old.
But for those that like numbers, on average, most patients will get at least five to seven years of good longevity of a facelift. Some patients make take as long as ten to twelve years to see a significant return of jowling and loose neck tissue again.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: dr barry eppley, facelift, facelift longevity, indianapolis, plastic surgery
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Sunday, May 30th, 2010
Q: I am 65 years old and am extremely bothered by my turkey wattle. I do not look my age except this makes me very self conscious. I want to get rid of it with some type of neck procedure. What do you recommend?
A: Sagging or drooping of one’s neck is one of the most bothersome features of facial aging. While some people would never consider undergoing a ‘facelift’, they want some type of neck procedure to deal with their most troublesome age-related issue.
Aging necks are referred to many uncomplimentary names such as turkey neck and neck wattle. Some people become initially aware of it when they see themselves in profile in a photograph. Others notice it, particularly men, when wearing certain shirts and certainly in a shirt and tie. Others do not like, understandably, that it can be felt to move or flop when turning their head. (in more advanced aging)
Interestingly, some people would consider a necklift but wouldn’t dare undergo a facelift. This comes from a misunderstanding of the two procedures, not realizing that they are largely one and the same. I have found only a handful of patients in my Indianapolis plastic surgery practice who actually knew what a facelift really was.
A facelift is primarily a necklift. The type of facelift determines how much improvement in the neck is obtained. A limited facelift (aka Lifestyle Lift) has a minor effect on neck sagging and is best for just minor neck problems. It is primarily a jowl changing procedure. A full facelift is a powperful changer of the aging neck. The differerence between the two is the location and extent of the incisions around the ears. To really change the neck in more significant wattles and sagging, the facelift must have an incision that goes up behind the ear and back into the occipital scalp. It is the pull from behind the ear that changes the neck. You can demonstrate this quite simply with your fingers in front of a mirror. A manuever that many patients with aging faces have done regularly.
Dr. Barry Eppley
Indianapolis Indiana
Tags: dr barry eppley, facelift, indianapolis, neck aging, neck wattle, necklift, plastic surgery
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Friday, May 28th, 2010
Q: I am tired of looking older. My jowls are getting bigger and my neck is starting to really sag. I hate to consider the thought of a plastic surgery procedure like a necklift but I am going to have to do something in the near future. I don’t mind getting old per se, I just don’t want to look old! I have read that there are different types of facelifting procedures. How do I know which one will work for me?
A: A facelift is a plastic surgery operation that changes the lower third of the face, the neck and jowls only. So it is a good match for the jowl and neck issues which bother you. Like many plastic surgery procedures, there are different ways to do them and they come in different ‘varieties’. No one type of facelift is right for everyone. Your plastic surgeon must ‘match the solution to the problem.’
Fundamentally, a full facelift changes both the neck and jowls and is best for someone whose primary problem is their neck. The jowls get improved as well and get swept alone in the changes that occur far away in the neck. The mini-facelift, aka Lifestyle Lift as called by some, changes the jowls primarily and a little bit of the neck. Any limited improvement in the neck is the result of the changes that have occurred in the jowls. The mini- or limited facelift is best for someone whose primary concern is in their jowls. Since jowling proceeds any significant changes in the neck, one can appreciate why a limited facelift is for younger people who have less signs of facial aging.
Another way to think about it is by looking at the incisional pattern around the ears. Mini-facelifts have use an incision that runs into and around the front the ear. Pulling upward from there only impacts the jowls primarily. A full facelift uses incisions in front of and behind the ear. By moving tissue upward from behind the ear, excess neck skin can be worked out to be cut off behind the ear.
Dr. Barry Eppley
Indianapolis Indiana
Tags: dr barry eppley indianapolis, facelift, lifestyle lift, mini facelift, plastic surgery
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Monday, May 24th, 2010
Q: I’m a 62 year old female interested in widening a narrow face with a chin/jaw widening implant that would also help with jaw lifting and mild jowls. Is this possible for someone my age?
A: It is unusual for a female at any age to desire a wider lower face. This is almost always a male procedure for the obvious reason of making the jaw line more prominent to create a masculinizing effect. It would be particularly rare, and the first time in my Indianapolis plastic surgery experience, to have an older woman make that request.
I suspect that the real reason for this request is to help improve the classic signs of facial aging which is that of jowling, loss of the jaw line, and neck sagging. While it is true that jaw line enhancement at the chin and even more posteriorly at the jaw angles can help fill out a lower face, I question whether the effect would be significant enough to achieve your goals.
While I will have to see your pictures, it is possible that chin and jaw widening in combination with a limited or tuck-up facelift may create a more ideal result. Widening and lifting along the jaw line is a diametric movement of soft tissues that will usually result in a better outcome than either procedure done alone.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: chin implants, dr barry eppley, facelift, indianapolis, jawline enhancement, plastic surgery
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Wednesday, May 19th, 2010
Q: I am inquiring about the correction of a pixie ear deformity from a previous face lift done two years ago. I have read about so I know what it is. How did this happen and how can it be corrected. My ears really look funny and that is not a good look for someone 55 years old!
A: The pixie ear is a well known earlobe deformity that can occur after a facelift. It has been described for decades and, while once more common, modern facelifting techniques have largely eliminated this problem.
While folklore pixies are usually cute and even beautiful, they often have distorted facial features. One of those is the elongated earlobe, hence the name pixie ear deformity. If a facelift is pulled up too much (undue tension), there will be some secondary pullback of the tissues later due to gravity and wound relaxation. Since a facelift incision goes around the ear, the earlobe at the lower end of the facelift incision can show how much the tissues have pulled back down. Because the earlobe is the only portion of the ear that is not supported by cartilage, it can easily be pulled downward months later as tissues settle. Since this is a well recognized potential problem, plastic surgeons strive to keep the tensions point on the scalp areas above and behind the ear and not on the earlobe. It is also helpful to not try and pull a facelift so tight.
Correction of the pixie ear is relatively simple. The earlobe can be detached and restored to its normal shape. This will leave a small residual scar below the earlobe but it can be done in the office under local anesthesia. If it has been years and some jowl or neck relaxation has occurred, one can undergo a simple tuck-up facelift and restore the earlobe shape. By relifting some small amount of loose facial skin, there would be no visible scar below the earlobe as it is tucked back up underneath.
Dr. Barry Eppley
Indianapolis Indiana
Tags: dr barry eppley, facelift, indianapolis, pixie ear deformity, plastic surgery, secondary facelift
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