Introduction to Facelift
Unfortunately as we get older, both men and women develop lines and wrinkles, experience sag, and lose youthful fat from the midface. Facial aging takes a predictable but variable path depending on sun damage, history of smoking, genetics and other factors, but facelift surgery by Dr. Zuckerman, known medically as rhytidectomy, can effectively address many of these aesthetic issues. Despite an increase in the efficacy and popularity of non-surgical facial treatments, facelift surgery is a very common procedure and is often in the top five most performed cosmetic surgery procedures nationwide.
Dr. Zuckerman can help you achieve a rejuvenated appearance in many areas of the face including the cheeks, lower face, nasolabial folds (parentheses around the mouth), jawline, neck, and others. While there exist a disorienting array of facelift variants, most approaches can be divided into the full facelift and into the short scar or mini facelift.
Dr. Zuckerman can also perform minimally invasive fat grafting to several areas of the face to address a tired or hollowed appearance and restore a youthful contour. In addition, all of Dr. Zuckerman’s facelift techniques involve tightening the skin and underlying structures in a more vertical direction, instead of purely horizontal. With these modern approaches, you can avoid looking “stretched” or “wind-blown”. Instead, Dr. Zuckerman will help you achieve a natural-looking, beautiful, youthful result. He is an experienced board-certified plastic surgeon, has a long history performing facelift surgery, and trained at some of most respected medical institutions in the world including Brown University and New York University.
Am I A Candidate For Facelift?
Depending on the extent of your facial aging, you may be a good candidate for one of several facial procedures. A facelift commonly addresses many signs of facial aging including: midface (cheek) descent, deep lines and wrinkles, crows’ feet, jowling, nasolabial folds (parentheses around the mouth), excess skin in the neck, and others. Dr. Zuckerman will develop a customized treatment plan at your initial consultation based on surgical goals and existing anatomy. Available procedures may be performed in combination and include:
- Full facelift: This procedure lifts the midface, cheek, linearizes the jawline and addresses the neck laterally. However, a neck lift is required to fully address the neck.
- Short scar facelift: Addresses similar areas to the full facelift but involves a shorter incision. However, it cannot address the neck.
- Fat grafting to the face: An aged, tired, or hollowed appearance can result from the atrophy of youthful fat. Dr. Zuckerman can harvest fat and graft it to several areas of the face.
- Facial injectables: For milder concerns, Dr. Zuckerman may be able to address the signs of facial aging without surgery. Please visit the comprehensive non-surgical treatments list.
Typically facelift patients are older than forty, are in overall good health, and have good skin elasticity. Dr. Zuckerman can discuss your options if you do not meet one of these criteria.
Facelift in Detail
All of Dr. Zuckerman’s facelift techniques involve well-hidden surgical incisions. For healthy individuals without wound-healing problems or keloid formation, these incisions will heal to thin, almost imperceptible lines camouflaged by the hairline. Dr. Zuckerman’s techniques also feature a somewhat vertical vector when lifting or tightening skin and tissue to avoid a stretched or artificial-looking appearance. The procedures below are listed in order of decreasing surgical intervention.
Full Facelift
A full facelift involves an incision made along the hairline starting at the temples, travels around the front and back of the ear, and down along the hairline behind the ear. Dr. Zuckerman then separates the different layers of tissue from the facial muscles: skin and fat and connective tissue called the SMAS. He repositions and tightens both the skin and the underlying SMAS (see the image) and removes excess. Finally, Dr. Zuckerman closes the incisions. Most facelifts by Dr. Zuckerman are completed in three hours or less and is performed under general anesthesia with a board-certified anesthesiologist.
Short Scar Facelift (Short Incision Facelift, Mini Facelift) and MACS Facelift
As mentioned above, short scar facelift procedures typically involve a more minimal incision but address fewer areas of the face and neck and are most effective at lifting and rejuvenating the midface. While they are known informally by various names including the short incision facelift and the mini facelift, they involve a similar approach. Unlike the full facelift, a short scar facelift cannot address the aesthetic appearance of the neck. However in return, there is no need to place an incision above the ear near the temple. One type of short scar facelift that has gained popularity is the Minimal Access Cranial Suspension or MACS Facelift. This technique uses long-term dissolvable sutures to lift tissue of the midface from under the skin. One suture is typically placed at the angle of the jaw in a vertical vector. A second helps lift the cheeks, and a third for the upper cheek if necessary. These sutures are placed subcutaneously and therefore place little tension on the skin itself. This procedure creates a subtle, rejuvenated-looking surgical outcome. Short scar facelifts typically require less operative time than a full facelift, and most are completed in two hours under general anesthesia.
SMAS Techniques / Multiplanar Facelift
All of Dr. Zuckerman’s facelift techniques involve manipulating the submuscular aponeurotic sheath (SMAS) for most patients. The SMAS is tissue under the skin, overlying the facial muscles, composed of suspensary ligaments and connective tissues. The SMAS is connected to the platysma, the muscle covering the lower face and neck. Like skin, the SMAS can develop laxity with age and is therefore an important component to address in a facelift. Tightening it allows Dr. Zuckerman to lift the cheeks and to address nasolabial fold formation, jowling, and laxity of the neck. Generally speaking, eliminating laxity in the SMAS also helps extend the life of the facelift result. Dr. Zuckerman most often tightens the SMAS by pulling it upward obliquely, excising a portion of it that is excess, and then reconnecting the two remaining halves.
Fat Grafting to the Face
In combination with many facelift procedures, Dr. Zuckerman also performs small volume fat grafting to the face. This typically involves harvesting fat via liposuction from the abdomen or other locations and grafting it to areas of the face which are affected with age-related fat atrophy. He commonly grafts to the preriorbital area (see more information in the eyelid surgery (blepharoplasty) guide), temples, cheeks, nasolabial folds (parentheses around the mouth), corners of the mouth, marionette lines (vertical lines from the corners of the mouth down to the jaw). Patients’ results may continue to improve for several months after surgery. Depending on the extent of your procedure, Dr. Zuckerman will advise you as to the approximate operative time and whether general anesthesia or local anesthesia with sedation is the best option.
Non-Surgical Facial Treatments
For those with only mild volume loss, wrinkling, or ptosis (sag), Dr. Zuckerman may be able to recommend a variety of non-surgical treatments including cheek augmentation with the dermal filler Voluma, injectable Botox Cosmetic treatments to address lines and wrinkles in the forehead or to lift the brows, and Juvederm for nasolabial folds (parentheses around the mouth) rejuvenation. Laser Resurfacing or microneedling may also be able to restore a more lustrous appearance to the skin and ameliorate brown or age spots.
You may undergo facelift surgery on an out-patient basis at Dr. Zuckerman’s state-of-the-art, in-office, fully equipped operating room in midtown Manhattan. This operatory facility has been certified by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF), certifying it as a facility that offers an equally high standard of care as a hospital. The privacy, discretion, and convenience of Dr. Zuckerman’s private in-office operating room facility is an exclusive benefit of Zuckerman Plastic Surgery that many patients appreciate. Should you desire, you may also undergo surgery with Dr. Zuckerman at Manhattan Eye, Ear & Throat Hospital, a major hospital in Manhattan in the Northwell system where all types of breast, body, and face cosmetic surgery procedures are performed. Dr. Zuckerman is on staff in the department of plastic surgery for Northwell system hospitals in Manhattan among others.
Facelift Recovery
As part of the surgical process, Dr. Zuckerman’s staff are happy to help arrange a hotel stay and private nursing for the first 24 hours after surgery. Some bruising and swelling is to be expected, which will resolve within a few weeks. Dr. Zuckerman will place head bandages and will remove them after approximately one week. Elevation of the head is required for several days after surgery. Dr. Zuckerman will prescribe pain medication to manage any postoperative discomfort. Patients can typically return to normal activities within 1-2 weeks, but heavy lifting, stress on the incisions, or other intensive activity should be avoided for two to three weeks after surgery. The preliminary result should become apparent a few weeks after surgery, and scars will continue to fade for up to one year. Dr. Zuckerman includes a comprehensive postoperative scar care regimen to minimize the ultimate appearance of scars.
Facelift Before and After by Dr. Zuckerman
More Before & Afters
Dr. Zuckerman publishes many of his previous facelift results with patient consent. The before and after image gallery has pairs of high resolution images from three to four angles for each patient. Many prospective patients enjoy finding a similar case to their own that Dr. Zuckerman has performed in the past. Take a look through the gallery by clicking on the button below.
Risks of Facelift
The full facelift and its varianets are overwhelmingly safe when performed by a board-certified plastic surgeon. Dr. Zuckerman is highly experienced, and he and his staff will take the utmost care to provide a safe and comfortable surgery experience. Possible complications, albeit rare, involved with these procedures include:
- Collection of fluid, called a seroma
- Minor wound healing problems
- Asymmetry or contour irregularities
- Numbness, and issues with facial movement, which usually resolve
Common reasons patients request reoperation of a facelift include poor technique on the part of the original surgeon leading to a suboptimal aesthetic outcome: either failing to address signs of aging appropriately or creating an unnatural appearance.
Frequently Asked Questions About Facelift
Below are the answers to some questions Dr. Zuckerman most frequently receives from prospective patients. If you don’t see your question below, feel free to contact Dr. Zuckerman’s office, and a member of his staff will be glad to reach out to you.
A neck lift primarily addresses the neck while a facelift addresses the lateral areas of the neck and also the midface, cheeks, nasolabial folds, and more. These procedures are often performed together.
Yes, there are several options for this area of the face. As we age, gravity and other factors cause the midface to descend. If you experience mild forms of this descent, Dr. Zuckerman can offset it without surgery by performing cheek augmentation with the dermal filler Voluma. To soften nasolabial folds (parentheses around the mouth), Dr. Zuckerman can treat you with dermal fillers such as Juvederm or the long-lived Vollure. There are also options to address perioral lines, known informally as smokers’ lines though non-smokers may develop them as well, using Volbella or Restylane Silk.
Request Your Facelift Consultation
Are you ready for your facelift consultation with Dr. Zuckerman? He will perform a thorough evaluation of your desired outcome and needs based on your anatomy and medical history. Dr. Zuckerman will also address any questions or concerns you may have about the surgery and discuss with you the details of his approach: incision location(s), procedure length and techniques, likely operative outcome, etc. Contact his office by clicking the button below or by calling (212) 231-9897. Dr. Zuckerman also offers consultations via Skype and a process for out-of-town patients to visit New York City to have surgery with him.
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