Facelift (Rhytidectomy)

Facelift and necklift procedures have undergone significant surgical refinement in the past ten years. Older techniques focused on lifting only the skin, which created an unnatural appearance, and the results had limited longevity. The focus today in plastic surgery facial procedures is to produce results that create a natural look and last much longer. The facelift operation is designed to address aging in the midface, laxity in the skin of the cheek and jowl areas and aging changes of the neckline and chin area. Dr. Applebaum performs the deep plane facelift, which focuses on vertical lifting of the connective tissue, SMAS (superficial musculo-aponeurotic system-platysma muscle) cheek fat and muscle attachments in a natural lift that repositions all of the above structures to a prior, more youthful position. Dr. Applebaum believes that surgically it is important to address the deeper structures in the cheek and jowl area to fully rejuvenate these areas and have a long-standing result.

In the aging process the cheek fat pad and surrounding tissue move down and create deeper laugh line folds and a more tired appearance. In some individuals the cheek fat has become hallowed and placement of a midfacial implant will correct the loss of volume and give a natural youthful appearance to the face. The fullness created in the cheek at the time of surgery will help to rejuvenate your smile and lift the tiredness away from your face.

Necklifting is almost uniformly addressed with the facelift procedure. The structures that age in the neck include the skin and thin platysma muscle that drapes across the entire neck. In some cases localized pockets of fat and prominent glands can add an aged look to the neck. Dr. Applebaum believes that several areas of the neck need to be addressed and tightened for a successful result. The platysmal muscle, especially, plays a major role in aging the neck and jaw line area. This muscle must be tightened and reshaped in order to produce a more youthful jaw line and neck angle.

The Isolated Neck Tuck procedure is one that is performed by making a small incision under the chin area and addressing the muscle and skin laxity from this small incision. Depending on the condition of the neck skin elasticity this procedure is used in patients with minor changes or those patients that do not desire any aesthetic correction above the jaw line. It is important for Dr. Applebaum to assist you in determining which procedure will provide the best results.

The Mini-Facelift is directed at improving the neck and jowl areas in those patients with early aging changes that are motivated to undergo facial aesthetic surgery. The recovery from a mini facelift is about 10 days due to the fact the Dr. Applebaum still addresses the deeper layers of the neck and jowl to obtain the optimal results.

The Lunchtime Facelift is a great marketing tool used by many doctors to attract patients into their offices by offering minimally invasive facial office procedures that can be performed in an hour’s time. Today one of the more popular minilift procedures is the use of barbed sutures to lift the midface and brow. The sutures are placed under local anesthesia with the patient completely awake. Most plastic surgeons have abandoned the suture lifts because the results are temporary and can create unusual puckering in the tissue over time.

Facial Liposuction as a single procedure has very limited indications in the aging face. In the younger patients with good neck elasticity fat can be removed with remarkable results without lifting the skin. Dr. Applebaum believes that in other areas of the face fat should be left alone to add fullness and an element of youthfulness to the face. There are very selective areas of the jowl and neck that liposuction can produce remarkable results. The areas under the chin and jaw are selective areas that may benefit from liposuction alone, although in most cases a better result is achieved in using liposuction in combination with face lifting. Removing fat with liposuction in the neck must be done conservatively in order to ensure that the skin does not sag or show more aging after the procedure has healed.

Facial rejuvenation procedures are often combined with eyelid procedures, brow procedures and laser resurfacing of regional areas to give an optimal result.

Recovery time for facial rejuvenation procedures varies depending on the surgery performed, but in general, 10 days to two weeks are needed for recovery time. Cover-up make-up can usually be worn in 12 to 14 days if needed.

Frequently Asked Questions about Facial Rejuvenation Procedures

Q: At what point does one consider facial rejuvenation surgery?

A: The timing of facial cosmetic surgery is a very personal decision that is based on several factors which include the desire to look more youthful, correction of specific areas of aging and in today’s world the need to maintain a youthful appearance as part of their career. Many woman today subscribe to the concept that starting early with mini procedures keeps a youthful appearance with a natural look. Face-lifting is a common procedure that women in their late forties start thinking about.

Q: How often does facelift surgery have to be repeated?

A: Facelift procedures that address the deeper structures and not just the skin will have longevity of 10 -15 years. The eyes, brow and midfacial lifting generally have good longevity. In certain cases small ancillary procedures, such as structural fat grafting, placement of fillers are done in order to build continuous support for the skin and to add to the longevity of the result.

Q: Can laser resurfacing or chemical peeling replace a facelift procedure?

A: Resurfacing of facial skin with a laser or a chemical peel will improve the appearance of skin and have an element of tightening with reduction in sun damage and fine lines. The skin is not tightened to a degree that would approach the results of face lifting. In some cases full face resurfacing is performed after the face lift has healed to add an element of improvement in the overall results. Facelifting directly addresses the excess skin and aging of deeper cheek structures. In most instances facial resurfacing cannot replace facelifting, but both of these procedures can be done in combination in specific areas.

Q: How can I be sure that my facelift will look natural and not pulled too tightly?

A: The plastic surgeon performing the procedure must lift the deeper underlying SMAS (superficial musculo-aponeurotic system-platysma muscle) in combination with the skin to prevent a pulled tight appearance. Dr Applebaum’s results have a natural appearance with well hidden scars and facial structures that appear normal and youthful. Dr. Applebaum encourages patients to carefully examine pre and post operative photographs of his patients that have undergone facelift surgery as well as speaking to some of his patients to hear first hand about their results.

What our patients say

"I loved the fact that after my facelift and eyelid procedure people felt I looked better, but they couldn’t put their finger on what I had done because the results were so natural."
– S. H., a 53-year-old housewife and golfer who had mild sun damaged skin as well as early sagging in the jowl and neck, and wanted the most natural look possible.

"I was amazed at what the combination of laser and facelifting could do for my aging skin, considering all the years of playing tennis without sun protection."
– P.M., an active housewife and business owner in her mid-fifties who had significant sun damage and skin laxity, and was a great candidate for the combined use of laser and facelifting.

"My mother always told me to start early with little procedures, and nobody would ever know my beauty secret. She was right! Thanks to Dr. Applebaum and my mini-lift, I look and feel great. And because of the short recovery time, I could tell my friends I was just rested after a vacation, and everybody believed me."
– T.H. a 46-year-old attorney who underwent a mini facelift to treat early aging in her neck and jowl areas.