Facelift (Rhytidectomy)

The facelift is a common and well-known plastic surgical procedure. However, not all facelifts are the same; there are many different ways to do a facelift, and not all patients need the same operation.

The goal of the facelift is to create a more youthful facial appearance by removing excess skin, tightening and lifting the skin and deeper tissues, and creating a well-defined lower jaw and neck. Depending on the age of the patient and each patient's unique process of facial aging, one of several types of facelift procedures may be chosen. For example, older patients with a lot of excess skin and significant sagging of the tissues will likely require a more extensive procedure than a younger patient with early signs of facial aging.

Dr. Muzaffar asks each patient what he or she desires from a facelift procedure. Then, after a thorough history and physical examination, he chooses the appropriate procedure for the patient in an effort to individualize the treatment plan as much as possible. Dr. Muzaffar offers various types of facelift procdures, including the endoscopic brow and midface lift. This procedure is ideal for early aging of the brow and upper face; it is done through small scalp incisions and can correct sagging brows and deepening nasolabial folds (the creases between the cheeks and upper lip) with minimal swelling, bruising, and downtime. Dr. Muzaffar has published scholarly articles on this subject.

Procedures:

The "standard" facelift is performed through incisions in front of and behind the ear, extending slightly into the hairline behind the ear. The incisions are placed so that they are hidden in natural creases. Through these incisions, a variety of different facelift procedures can be done, depending on the characteristics of the particular patient. In addition, the facelift is typically combined with a neck-lift, or cervicoplasty; this is usually done using an incision under the chin to tighten the neck and improve the jawline.
In some cases, simple tightening of the skin alone is adequate. This can be performed through the standard facelift incisions or through smaller incisions if the amount of skin tightening required is less significant. These smaller incision procedures are the so-called "mini-facelifts" or "minimally invasive" facelifts.

However, more often, some lifting and tightening of the deeper tissue of the face are required. This deeper tissue layer is known as the SMAS (superficial musculo-aponeurotic system). The SMAS may be modified in various ways: through plication, or gathering it up with sutures, to both tighten the SMAS as well as to add volume in desired locations such as the "cheekbone" area; through excising or removing some of the SMAS and suturing it together to lift and tighten it; and through lifting the SMAS layer as a continuous sheet of tissue and redraping and re-suspending it. All of these maneuvers serve to lift the tissues of the face, soften the nasolabial folds, and add volume to the cheekbone area. In addition, modification of the SMAS can be done in such a way as to enhance the definition of the jawline and improve the contour of the neck.

In some patients, only part of the face requires treatment. For example, in younger patients with early signs of facial aging, such as deepening nasolabial folds and formation of a groove between the lower eyelid and the cheek, without sagging of the skin of the lower face, a cheek or midface lift may be appropriate. This procedure can be done in various ways: through the lower eyelid; from the scalp (see the browlift section for more information) as part of a browlift; and from incisions inside the upper lip in combination with the lower eyelid incision. The tissues of the cheek can be redraped to smooth the transition between the lower eyelid and cheek, to add volume to the cheekbone area, and to soften the nasolabial folds.

Finally, the use of soft tissue fillers has become commonplace in facial aesthetic surgery, both in isolation and in combination with surgical procedures such as those we have described above. In the appropriate setting, the use of fillers can help to enhance and refine the results achieved through surgical treatment of facial aging.

Whichever procedure is most appropriate for you, Dr. Muzaffar will ensure that he understands your goals and that all your questions and concerns have been addressed before proceeding with surgery. Detailed information about the surgery, risks and benefits, and the postoperative care plan are provided at the initial consultation.