Descent of the lower
portion of the face causes the youthful triangle formed by the chin and
jaw to revert to a square configuration formed by the jowls. The Face
Lift can elevate the jowls and reverse the early changes of aging of
the lower portion of the face and neck.
questions about Cosmetic Face Lift Surgery:
Who is a good candidate for face lift surgery?
People in generally good health who wish to remove signs of aging —
including sagging in the face and neck, facial wrinkles, and lines and
creases on the forehead — can benefit from face lift surgery. Ideally,
patients will have skin that is still somewhat flexible, though there
are no strict age requirements. Perhaps most important are realistic
expectations about what a face lift can accomplish. It is therefore
crucial that patients understand the limitations as well as the benefits
of the various face lift procedures.
2) Am I too
young (or old) for a face lift?
In determining whether a face lift is right for you, age is not
necessarily the most important factor. Most face lift candidates are
between 40 and 70 years old. However, the procedure can effectively
enhance the appearance of people over 70, and some opt for the
procedure in their 20s and 30s, often as a means of correcting
hereditary conditions. In general, the condition of your skin and the
features you would like to improve are more important considerations
than your age. A qualified cosmetic surgeon can best evaluate whether a
face lift is likely to accomplish your cosmetic goals.
3) How long
will face lift results last?
Since the aging process is ongoing, no face lift produces permanent
results. Nevertheless, many procedures leave the face looking refreshed
for 10 years or longer. The longevity of your face lift will depend on
many factors, including the condition of your skin, whether you smoke
or drink, and how old you are when you undergo surgery. However, if
signs of aging reappear, you will most likely continue to look much
younger than your actual age, and further surgery usually remains an
4) Will it be
obvious that I've had a face lift?
During a face lift, surgeons do everything possible to make the
procedure invisible. The placement of incisions is selected
strategically, so that any scars forming after surgery are likely to be
hidden by hair or obscured by natural creases in the face. To limit
scarring, incisions are made whenever possible in areas that tend to
heal well, and extremely small sutures are used when repositioning
skin. Nevertheless, some scarring is a possibility that should be taken
into account by anyone considering face lift surgery.
5) What types
of face lift surgery are available?
There are many different types of face lift procedures, each one
offering various benefits for people with different cosmetic goals and
needs. The range of options allows you to accomplish different
objectives, which may have to do with aesthetics, cost, convenience, or
a combination of all three issues. Common procedures include the lower
face lift, the mid face lift, the mini “weekend” face lift, and the
endoscopic face lift. A qualified cosmetic surgeon can best guide you
in deciding which procedure is appropriate for your situation.
6) Is face lift
Given how sensitive the face is, most face lift procedures involve
surprisingly little pain. Patients receive local or general anesthesia
during surgery, depending on how invasive the procedure will be or
their own preferences. However, most surgery involves some discomfort,
and patients may experience moderate pain, particularly during the face
lift recovery period. This often results from swelling and bruising
occurring after the procedure. These effects are usually controlled
with cold compresses, while additional pain can be minimized with
medication prescribed by a cosmetic surgeon.
7) Can I be
awake during face lift surgery?
Whether you sleep or remain awake during face lift surgery depends on
the type of anesthesia used during the procedure. If general anesthesia
is used, you will sleep throughout the operation, while local
anesthesia allows you to remain relatively alert. Often you will be
able to choose which type your surgeon uses. In other instances — for
example, if your face lift is particularly invasive — the nature of
your surgery and the area to be treated may make general anesthesia
8) Will face
lift surgery eliminate all of my facial wrinkles?
Most face lifts can dramatically refresh and invigorate the lower
two-thirds of the face. By removing excess fat and reshaping loose
muscles and facial tissue, cosmetic surgeons reduce sagging in the
cheeks and around the jaw. While this usually makes patients look
younger and less tired than before surgery, a face lift will not
eliminate all common signs of aging. For patients with wrinkles on the
forehead and around the eyes, BOTOX® injections, chemical peels, or
laser resurfacing may be able to help. Blepharoplasty, on the other
hand, can resolve drooping eyelids, and brow lifts often minimize a
sagging forehead area.
9) What does
SMAS stand for?
SMAS stands for the superficial muscular aponeurotic system. For the
purposes of a face lift, this area constitutes the most important area
of facial musculature. These are the muscles most commonly tightened to
enhance a patient’s facial appearance. By altering their shape and
consistency, cosmetic surgeons are able to reduce sagging in the cheeks
and along the jawline, producing a younger, invigorated appearance.
10) What is an
endoscopic face lift?
An endoscopic face lift is a less invasive alternative to a
conventional face lift. For the right patient, it minimizes facial
sagging and wrinkles while requiring fewer incisions and, often, less
anesthesia than the traditional approach. During an endoscopic face
lift, three or more small incisions are made in discreet areas of the
face. Through one, a device fixed with a miniature camera is inserted,
allowing surgeons to follow the procedure on a monitor. Through the
remaining incisions, surgical instruments are used to remove excess
accumulations of fat and remodel distorted muscles and tissue below the
surface of the skin. Because less skin is cut during the procedure, an
endoscopic face lift minimizes the possibility of visible scarring.
11) Why do
patients get mid face lift surgery?
The primary reason is to look younger and to have a happier expression
on the face. With facial aging there is descent or drooping of the
cheeks and mid face. The descent of the cheeks causes one to have a sad
expression on the face. Descent of the cheek also contributes to dark
circles under the eyes and to deepening of the fold between the cheek
and lips (nasolabial fold). Elevation of the cheeks can reduce the dark
circles and nasolabial fold as well as give one a more cheerful
expression on the face.
12) Why do
patients get mini face lift surgery?
The primary reason is to look younger. With facial aging there is
descent of the lower portion of the face. This causes soft tissue to
droop below the jaw line (jowls). When we are young the jaw line is
round with the soft tissue following the boney contour. Jowl formation
changes the jaw line from a round configuration with the skin tightly
associated with the bone to a squared configuration with loose tissue
hanging below the boney jaw line. A mini face lift surgery can elevates
the jowls, and return the lower face to a youthful round contour.
13) Why does
the mid face and lower face droop with the passage of time?
There are several reasons. One reason is that the structures that
attach the skin to the boney skull elongate allowing for sagging of the
skin. A second reason is loss of elasticity of the skin so that the
skin itself sags. A final important reason is loss of volume. Our face
looses volume with time and this facilitates wrinkle formation and
descent of the face. An analogy is a beach ball. If the ball is fully
inflated it will be perfectly round and without wrinkles on the
surface. If some of the air is let out of the ball it will no longer be
round and it develops wrinkles on the surface.
14) Aging causes both loss of volume and drooping of the cheeks and
lower face. Do I need volume added to the face with injections or
surgery to correct the drooping soft tissue?
Many patients benefit from addressing both. We often perform mid face
lift surgery, mini face lift surgery, and add volume with fillers
during the same procedure. Adding volume with fillers often reduces the
amount of surgery that is done and allows the patient to recover more
15) How long is
recovery for mid face lift surgery?
Mid face lift surgery is typically performed at the same time as eyelid
surgery. Eyelid surgery results in bruising and swelling that often
resolves in 3 weeks.
16) How long is
recovery for a mini face lift surgery?
It takes 2-3 weeks for bruising and swelling to resolve. Stitches are
removed about two week after the procedure.
17) Does mini
face lift surgery require general anesthesia in a hospital?
No. We often perform the procedure in the office using oral sedation
and local anesthesia. Patients are often less anxious in the office
than in the operating room and it substantially reduces the cost of the
18) When are
the stitches removed after face lift surgery?
About two weeks after the procedure.
19) Does mini face lift surgery effect my hairline?
The surgery technique used has little effect on the sideburns and
20) Is it
possible to get a face lift without having surgery?
In some patients the primary problem is loss of volume from the face
and there is not much sagging or drooping soft tissue. In these cases
simply adding volume to the face with fillers can substantially improve
the aging changes in the mid face and to a lesser degree the lower
face. We now have fillers available that give results for a year and
longer. We also have non-surgical alternatives for the face lift such
as the Thermage, practiced by Dr. Rinky Kapoor.
21) What causes
some people to get a bad result from a face lift?
In our opinion, most bad face lift results are caused by removal of too
much skin. Removal of too much skin results in an unnatural, pulled
back, wind swept appearance. The amount of skin that must be removed to
achieve an acceptable improvement in appearances is reduced if volume
is added at the same time that the skin is removed. It is particularly
important to avoid unnecessary removal of skin from the lower eyelids
as this can cause problems with eyelid closure and vision.
benefits from neck lift versus a mini face lift?
If jowl formation is the primary concern then the min face lift is our
procedure of choice. Some patients have excess skin in the neck as well
as jowls. As long as the neck is thin and the amount of skin in the
neck is mild to moderate our procedure of choice is still the mini face
lift. If someone has a thick heavy neck with much redundant skin in the
neck then a neck lift is more beneficial than a mini face lift. A neck
lift is sometimes called a full face lift. A neck lift differs from a
mini face lift as the incision extends much further behind the ear and
the amount of surgery is greater in the neck lift. Most patients have
neck lift performed in a surgery center or hospital under general
anesthesia. On average the neck lift also takes substantially longer to
recover from than a mini face lift.
23) Can face lift surgery be done at the same time as eyelid surgery or
forehead lift surgery?
Yes. Many patients prefer to get all procedures performed at the same
time. This allows the patient to go through a single recovery period.
24) Are their
risks associated with face lift surgery?
Yes. All medical procedures have risk associated with them. You should
discuss the risk of face lift surgery with your surgeon so that you can
make an informed decision.
25) Why should
I consider The Esthetic Clinic for my face lift surgery?
Dr. Shome is trained in the US and has practiced in the US, the UK and
in Singapore. He had an immensely successful practice in these
countries. He, along with Dr. Kapoor have set up The Esthetic Clinic at
the Apollo Hospitals, Hyderabad. The Apollo Hospital Group is the
largest corporate hospital group in Asia and the Hyderabad center is
the largest and the best equipped amongst all its hospitals and is
accredited by the Joint Commission International (JCI), the world’s
highest health care delivery accreditation institution. The Esthetic
Clinic at Apollo Health City, Hyderabad is amongst the best equipped in
the world. Moreover, the average cost of a face lift at the Esthetic
Clinic is about 1/4th the cost of a similar surgery in the US or the
For more information on Dr. Debraj Shome's work, click on: