Face Lift

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.

Frequently asked questions about Cosmetic Face Lift Surgery:

1) 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 option.

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 surgery painful?
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 necessary.

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 rapidly.

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 procedure.

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 hairline.

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.

22) Who 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 European Union.