Today’s skilled cosmetic plastic surgeon knows that getting the best results from any cosmetic operation requires a customized surgical plan for each patient. Facelift surgery is particularly challenging, since patients differ widely in their underlying facial structure as well as the extent of their visible aging. According to an article in the American Society for Aesthetic Plastic Surgery (ASAPS) publication, Aesthetic Surgery Journal, there are at least ten important considerations in designing a great facelift. If patients are aware of the process their plastic surgeon goes through to develop a surgical plan, they can be more active participants in some of these decisions.
A well-designed facelift will take into account factors including:
• Hairline Position. A small shift in the position of the hairline is considered acceptable and usually is not noticed, but patients starting out with an elevated hairline position may need special techniques to avoid raising it further.
• Incision Placement. Many patients and their friends judge the success of a facelift on the basis of minimally detectable scars. Where to place incisions depends on factors such as the amount of excess skin and whether the patient has pre-existing creases in front of the ears.
• Cheek Volume. If the cheek area appears flat because of inadequate bony projection, sometimes the use of fat injections or implants may provide better definition.
• Fat Pad. In rare instances, a herniated or prominent buccal fat pad, located in the cheek area, may need to be removed or sutured at a deep level.
• Cheek Folds. Cheek, or “nasolabial” folds are difficult to treat, but a facelift that pulls in a vertical direction will help to restore sagging soft tissue to its natural position in the cheek area. Injection with a soft tissue filler, such as fat, may also be necessary to achieve optimal results.
• Jaw Line. Jowls are caused by sagging soft tissue that must be elevated. If excess fat is present, it may be removed by suction (lipoplasty).
• “Trough.” There is a region defined by the angle of the jaw where it interfaces with the neck that is called the ‘trough’. A shallow trough gives the face a rounder look, whereas a deeper trough contributes to a more chiseled look generally associated with youth and attractiveness. When necessary, defatting this area may give it better definition.
• Chin. The profile of the chin plays an important role in an attractive appearance. An overly prominent chin, “weak” chin, “double chin” or “witch’s chin” all can be addressed with additional procedures performed at the same time as a facelift.
• Glands. Sometimes the glands located in the neck, underneath the chin, appear prominent and can detract from the neck’s appearance. While most patients find some fullness in this area acceptable, surgical removal or repositioning of the glands is an option, though not without risks.
• Neck Cords. If neck cords appear prominent from the frontal view, correction may require a small incision underneath the chin, nearly undetectable when healed.
“The very best results in our patients are achieved when we match what facial cosmetic surgery can give them with their realistic expectations.” Dr. Yarinsky listens very closely to what you want and suggests positive ways to reach the appearance that you desire. He specializes in giving you “not extreme” just “natural” results.