Facelift
Deep wrinkles? Sagging neck and jowls? What can be done to turn back the clock? A facelift from Houston facial plastic surgeon Dr. Raghu Athré can retain the beauty, fullness, and youthful look of your face.
What is a facelift?
A facelift is also called a rhytidectomy. A facelift is a cosmetic surgical procedure designed to rejuvenate the face. The primary goal of facelift surgery is to tighten tissues that have started sagging due to age and gravity. A facelift will:
- Tighten muscles
- Remove excess fat
- Redrape excess skin
- Remove excess skin
- Elevate dropped/fallen tissues
A facelift will tighten the jowls, cheeks, and neck tissues, as well as soften the smile lines. Advances in surgical techniques and materials allow tailoring facelifts for individual patients. A facelift can be a saving grace for those who want to turn back the hands of time and restore youthfulness and buoyancy to the skin around their face.
The Basics of a Facelift
Houston facelift specialist and double board-certified facial plastic surgeon Dr. Athré offers several different facelift techniques to customize results for each individual patient.
Your skin loses its elasticity as you age. Your tissues are made of cells and held together with a matrix of proteins like collagen and elastin. As we age, the extracellular matrix of skin degrades, and collagen and elastin fibers reduce in quality and in total volume. The reduction of these proteins, collagens, and elastin causes thinner skin and fine lines — making your face appear older, tired, and less full.
The same type of process happens to the deeper layers that connect the skin to the underlying bony skull structure. These ligaments lengthen and fall because they cannot hold up against the forces of gravity.
The combination of all of these factors leads to the “aged face.” The aged face has:
- Fallen midface
- Jowls, fallen tissues along the jawline, and loss of jawline definition
- Sagging neck with loose neck skin
- Platysmal neck bands
- Excess fat of neck, double chin
- Skin Laxity of face with excess facial skin
- Deepened smile lines or melolabial/nasolabial folds
- Marionette lines along the jowls
- Cheeks that have fallen down causing a tear trough at the lower eyelid cheek junction
These characteristics can be caused by the natural aging process. Other factors that can speed up the aging process are:
- Sun exposure
- Tanning bed usage
- Environmental factors (Airplane pilots and flight attendants age faster because of increased UV light exposure)
- Smoking
- Rapid weight gain
- Rapid weight loss
- Frequent changes in large amounts of weight
- Poor nutrition
- Excessive alcohol consumption
- Chronic medical problems
- Poorly controlled diabetes
A surgical facelift is a cosmetic procedure that rejuvenates the cheek region, the jaw line and the neck. It does this by lifting and tightening fallen facial muscles, tightening the skin of the face and neck, removing excess fat, and redraping tissues of the face and neck.
See Dr. Athré Discuss The Basics of a Facelift on YouTube
See Dr. Athré Discuss Facelift vs Facial Rejuvenation on YouTube
Facial Anatomy
To understand facelift techniques, it’s important to have some understanding of facial anatomy. The face consists of soft tissue held on to the skull. From superficial to deep, the soft tissue structures of the face are:
- Skin
- Subcutaneous fat
- Muscle (SMAS layer)
- Sub SMAS layer muscle
- Superficial lobe Parotid gland
- Facial nerve
- Deep lobe parotid gland
- Buccal fat, additional deep facial musculature
Under all of the above, we get to the skull or bony layer. All of these layers may not be present depending on different locations on the face.
These soft tissue layers are tethered to the face with ligaments. Ligaments are thick bands of connective tissue. Your face has 4 ligaments tethering the soft tissues. In the cheek bone area, we have the zygomatic osteocutaneous ligament, in the marionette line area we have the mandibular osteocutaneous ligament, anterior to the angle of the mandible, we have the masseteric ligament, and finally the neck tissues are tethers to posterior compartments of the neck with cervical retaining ligament between the neck platysma muscle (same layer as SMAS) and sternocleidomastoid muscle.
1: Zygomatic ligament
2: Masseteric ligament
3. Mandibular osteocutaneous ligament
4: Cervical retaining ligament
Nonsurgical Facelift
A nonsurgical facelift rejuvenated the face without surgery. It can include dermal fillers such as Restylane™ and Juvederm. These fillers can increase volume and appear to “lift” tissues.
Another option is Dr. Athre’s Stem Cell Facelift. The Stem Cell Facelift adds volume using your own autologous fat derived stem cells to correct loss of volume, but also addresses skin laxity with fat derived stem cells. The combination of these two procedures can rejuvenate the face in patients with mild facial aging, and mild skin laxity.
RT Mini Facelift
Dr. Athré performs a mini facelift procedure called the RT Mini Facelift that is more affordable and requires less downtime than the traditional procedure.
The RT Mini Lift is still a type of a SMAS lift. It dissects between the muscle layer and the underlying tissue. However, the entire muscle layer is not dissected. A plane underneath the muscle layer is created and the muscle layer is tightened.
Patients that are good candidates for an RT Mini Lift are patients who have minimal aging in the midface, with mild to moderate aging along the jawline and neck.
Midface Lift
Patients with most of their aging in only the midface and cheek area may benefit from a midface or MACS lift. Another name for this type of lift is a cheek lift. This lift is very similar to a mini lift. It addresses a targeted region – the midface area, and is a type of SMAS lift. A frequent area of aging in many patients is the midface. As the cheek tissues fall, it makes the face look more round instead of heart-shaped. It also causes the lower eyelid and cheek junction to develop a tear trough. These types of patients could benefit from a midface lift to lift the fallen cheeks.
Lower Face Lift and Neck Lift
The lower face lift addresses aging in the neck. The neck is one of the first areas to show aging. Patients usually complain of a sagging neck, turkey neck, turkey gobbler, excess fat in their neck, or platysmal bands. All of these issues can be repaired with a neck lift. A neck lift tightens the tissues in the neck compartment to achieve a smooth, contoured neck.
The Deep Plane Facelift
The deep plane facelift creates a plane between the SMAS layer and above the deep facial nerves/muscles. By creating this plane from the preauricular (front of the ear) area forward, you can essentially create a layer to pull, and tighten the face. But, you have also divided the ALL attachments of the SMAS layer to the actual bony skull. The attachments between the skull and the superficial layers are called the osteocutaneous ligaments. Failure to actually release these ligaments will result in: (a) an inadequate lift, (b) rapid failure of the lift.
Most surgeons inadequately resect these ligaments because releasing these ligaments involves an intimate understanding of facial anatomy. You are very close to nerves of facial expression, and therefore utmost care and precision must be exercised.
This type of lift is useful for patients that have any type of aging of the midface (mild, moderate, and severe) along with aging of any extent of the jaw and neck. The advantages of a deep plane lift are:
- Natural result without over-pulled/windswept look
- Longevity
- Definition of the jaw
- The only lift that will rejuvenate the smile line(nasolabial fold)
- The only lift that will allow concurrent rejuvenation of the midface, jawline, and neck in 1 procedure
On a similar note, the disadvantages of a deep plane lift are:
- Involves more surgical skill
- Involves more surgical experience
Please note that the risk of a deep plane lift performed by someone who is well versed with the technique is EXACTLY the same as the other techniques. In sum, experience matters, and if done well, a deep plane lift is the best option for facial rejuvenation.
1: Green area – area addressed by deep plane facelift
2: Red area – area addressed by RT Mini Facelift
3D Facelift
The 3D Facelift is a combination of procedures that tackles the most common problems we see in aging. IT IS NOT ONE SIZE FITS ALL. It is a starting point to the discussion of facial rejuvenation. Facial rejuvenation is the art of looking at the face as a whole and addressing aging as a whole.
Aging involves loose tissues, loss of volume and loss of skin texture. Facial rejuvenation addresses all of those variables, and a 3D Facelift is Dr. Athre’s response to Full facial rejuvenation. The basic 3D Facelift includes a deep plane facelift, along with a chemical peel for skin resurfacing, and autologous fat transfer for volume replenishment.
The 3D Facelift can be customized for patients that have increased skin textural irregularities with laser instead of chemical peeling, etc. This level of customization once again exemplifies why it is impossible to estimate a patient’s quote with a singular cost estimate.
Anesthesia for a Facial Rejuvenation Procedure
See Dr. Athré Discuss the Definition of Anesthesia on YouTube
Facial rejuvenation procedures can be done using various types of anesthesia. Procedures such as an isolated lip lift or an upper blepharoplasty are usually performed under local anesthesia. In such procedures, medication is injected into the tissues where the surgery will be performed. These medications stop the receptors from sending signals of pain to the brain.
Dr. Athre is one of the few surgeons to perform facelifts in Houston under local anesthesia. Most facelifts in Dr. Athre’s practice are performed under local anesthesia with oral sedation. In this type of anesthesia, the patient takes a “cocktail” of oral medications. These medications give partial amnesia, reduce anxiety, reduce nervousness, and reduce pain.
Once the oral medications have been given time to work, the actual tissues are anesthetized with local anesthesia. The advantage to this type of anesthesia is that it has reduced bleeding, reduced bruising, maintains a high level of anesthesia, and is cost efficient.
Some patients may opt for general anesthesia. This type of anesthesia is performed in an outpatient surgical center. This type of anesthesia also has gradations ranging from mild to the type of anesthesia required for open heart surgery. This type of anesthesia is great for nervous individuals, anxious patients, and patients with a very low threshold of pain. The primary disadvantages of this type of anesthesia is cost, increased bruising/swelling, and increased bleeding. If you feel that you are a very anxious individual, consider using general anesthesia. The cost of general anesthesia for a facial rejuvenation procedure is $3,500-8,000 depending on the procedures being done.
See Dr. Athré Discuss Anesthesia Choices for a Facelift on YouTube
Before & After Photos
Facelift Surgery Process
Dr. Athré will make an incision in the hair around the temples and ear. A small (less than one inch) incision is made right under the chin to sculpt and tighten the next tissues. After Dr. Athré lifts the skin, the underlying muscle layer is tightened, and the excess skin is trimmed. Meticulous technique, attention to detail, and microscopic sutures all contribute to a natural, nonoperated look.
Dr. Athré will make small incisions in the hair around the temples and ear. A small (less than one inch) incision is made right under the chin to sculpt and tighten the next tissues. After Dr. Athré lifts the skin, the underlying facial muscles and neck muscles are tightened, and the excess skin is trimmed. Meticulous technique, attention to detail, and microscopic sutures all contribute to a natural, non-operated look.
The goal of a facelift procedure is to restore a very natural appearance, and to have the patient look like themselves, just refreshed and younger. No two patients are identical, so no two facelifts Dr. Athré performs are the same. Tailoring the surgery for each patient is the only way to prevent a “pulled” or unnatural windblown appearance.
Client Testimonial
“Couldn’t be any more pleased! I came in with a mindset of what I was expecting and they surpassed my expectations! His staff made me feel so comfortable along the way. Dr. Athre was so kind and makes sure you know what’s going on during the procedure. To anyone contemplating a procedure, go in for a consult and just do it!”
Facelift Recovery and Results
The surgery itself takes approximately 3 ½ hours. The time of surgery is based on what procedure and how many procedures are done. Many patients who opt for a facelift may also undergo a blepharoplasty, brow surgery or other cosmetic surgery procedures. More procedures increases the time of surgery. A full facial rejuvenation will take approximately 6 hours.
The recovery time for most facelift surgery patients is approximately 2 weeks. Patients are seen the day after their procedure, 5-6 days after their surgery, and 7-10 days after their surgery. Patients are generally back to work in one or two weeks, and complete healing can take up to one year.
Ancillary Procedures with a Facelift
There are many procedures that can be done together with a facelift. Most patients do not come in for consultation with aging in a specific area. Aging normally occurs in different areas of the face such as:
- Fallen or droopy brows
- Heavy upper eyelids with excess skin
- Fat bags of the lower eyelids
- Hollowing of the temples
- Sallow skin with fine lines and wrinkles
- Smokers lines around the mouth and thin lips
Complete facial rejuvenation deals with the rejuvenation of the entire face and neck rather than isolated parts of the face. Here’s a list of procedures that can be done along with a facelift.
Brow Lift
Eyelid Surgery
Fat Transfer
Lip Lift
Skin Resurfacing
See Dr. Athré Discuss Ancillary Procedures to a Facelift on YouTube
Schedule a Consultation
Facial rejuvenation
For this, people often go for cosmetic surgery which offers transformative solutions for enhancing facial appearance, utilizing advanced techniques like endoscopic procedures to achieve optimal results. From addressing skin imperfections to reshaping features through surgical interventions, cosmetic surgery provides comprehensive options for individuals seeking facial enhancement. Procedures such as ear surgery can correct protruding or asymmetrical ears, improving overall facial harmony. Through meticulous surgical techniques, cosmetic surgeons can refine facial contours and restore a youthful appearance, empowering patients to feel confident and comfortable in their own skin. Whether it's rejuvenating aging skin or refining facial features, cosmetic surgery offers personalized solutions tailored to each individual's aesthetic goals and desires.
- Comprehensive Consultations: Plastic surgeons specializing in Houston facelift procedures offer thorough consultations to understand patients' concerns and goals.
- Customized Treatment Plans: Plastic surgeons develop personalized treatment plans tailored to each patient's unique facial anatomy and desired outcomes.
- Surgical Expertise: They possess extensive surgical skills and experience in performing Houston facelift procedures with precision and attention to detail.
- Advanced Techniques: Plastic surgeons utilize state-of-the-art surgical techniques to achieve natural-looking and long-lasting results for patients.
- Patient Education: Plastic surgeons educate patients about the procedure, including potential risks, benefits, and recovery expectations.
- Preoperative Preparation: They ensure patients are well-prepared for surgery, providing guidance on pre-operative instructions and necessary preparations.
- Surgical Procedures: Plastic surgeons perform surgeries with a focus on safety, effectiveness, and achieving the desired aesthetic outcomes.
- Post-operative Care: Plastic surgeons provide comprehensive post-operative care and support to facilitate smooth recovery and optimal healing following the surgery.
- Follow-up Appointments: Plastic surgeons schedule follow-up appointments to monitor patients' progress, address any concerns, and ensure satisfactory results.
- Continued Support: They also offer ongoing support and guidance to patients throughout their Houston facelift journey, promoting overall satisfaction and well-being.
Facelift Houston offers individuals in the area a transformative solution to address signs of aging and rejuvenate their appearance. With Facelift Houston, patients can achieve smoother, firmer skin and a more youthful facial contour through advanced surgical techniques. The expertise of Facelift Houston surgeons ensures personalized treatment plans tailored to each patient's unique needs and aesthetic goals. From consultation to post-operative care, Facelift Houston provides comprehensive support and guidance throughout the surgical process. With Facelift Houston, individuals can regain confidence in their appearance and embrace a more refreshed and rejuvenated look.