Spotting the Signs of Aging: Choosing the Best Facelift Option for You

Our faces age in different ways. Lines develop on the forehead. Crow’s feet appear beside the eyes, vertical lines develop between the brows, tear troughs and nasolabial folds deepen, facial skin begins to sag, and jowls develop along the jawline. Fortunately, we live in an era when we have multiple options for restoring youthful facial appearance.

Minimally invasive treatments such as BOTOX® and dermal fillers can be effective in dealing with early signs of aging. Some patients continue nonsurgical treatments for years.  Others decide to re-examine their rejuvenation regimen when they notice that injections are no longer giving them the results they had come to expect.

If you decide you would like to proceed with a facelift there are a few things you need to take into consideration.  Is your entire face in need of rejuvenation or are there certain areas of the face that appear to be aging at a more rapid pace?   A traditional full facelift is not always necessary.  Below is a brief description of the types of facelifts that are available.

Full facelift:

A full facelift lifts skin and muscle throughout the entire face.  A brow lift and eye lift are separate procedures that can be included with a full facelift. A full facelift generally involves a longer incision that is hidden by the hairline and wraps behind and below the ear.

Short scar facelift:

In a full face lift, the incision extends around and behind the ear.  A short scar procedure eliminates all scarring behind the ear. It is suitable for younger patients with less advanced aging, and allows them to continue to wear their hair up after surgery.

Patients are often concerned about their recovery following a facelift.   They can expect varying amounts of swelling and bruising.  It is best to rest and avoid strenuous activities during the first week. Most patients are presentable within 3 weeks, and can return to normal activities within 4 weeks or so after surgery. It is important to keep sun or tanning rays off the face for at least 3 to 4 months.

Remember that these are general guidelines and that everyone heals differently.  Your surgeon will take steps to ensure that you are comfortable throughout the process and heal as quickly as possible.

Finally, you may find the following definitions helpful as you explore your facelift options.

Subcutaneous facelift:  This procedure deals only with the facial skin and does not involve the deeper layers of the face. Subcutaneous facelifts address the laxity of the skin.

SMAS Superficial muscular aponeurotic system:  The SMAS is the layer of tissue that lies beneath the skin and fat. Your surgeon may tighten this layer to address more advanced signs of aging and to give the facelift a good foundation for longer lasting results.

A composite facelift: This is for extensive rejuvenation of the face. A composite facelift includes a lower eyelift and cheek lift to correct severe ptosis of the midface.  This procedure has fallen out of favor in recent years.

The facelift technique that is most appropriate for you depends on the degree of aging, and the problems to be addressed.  The success and safety of your surgery depend on selecting a board certified plastic surgeon who understands the anatomy and structure of the face.

Dr. Eric Pugash is a member of the Canadian Society for Aesthetic Plastic Surgery, the Canadian Society of Plastic Surgeons, and the American Society of Plastic Surgeons. Let Dr. Pugash guide you in making the best choices for your surgery.