Facelift

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The aging face is a composite challenge often requiring attention to various aspects of the face, using different techniques. Rhytidectomy (facelifting) is a surgical procedure mostly addressing the lower face and neck. Dr. Sparano does not believe the same facelift technique should be applied to every aging face. A customized approach should be pursued surgically, in order for results to be the most natural-appearing and long-lasting.

Specifically, a facelift can accomplish a significant improvement in appearance by correcting the sagging tissues of the cheeks, jawline, and neck. The techniques of facelifting have evolved extensively over the prior decade. Previously, the facelift surgeon would attempt to accomplish facial rejuvenation by pulling facial skin higher and tighter. This often resulted in an unnatural appearance consisting of a “wind-blown” or “stretched” look. More refined techniques allow for the deeper tissues and skin to be manipulated independently from one another, along differing vectors.

Dr. Sparano of NJ employs a deep-plane facelift technique with a partial SMAS resection and imbrication. Described simply, Dr. Sparano perform his dissection beneath the deeper tissue under the skin to maximize results at the jowl and lower mid-face. His direct manipulation of the SMAS tissue allows for a longer-lasting result definitively countering the passive effects of aging. It is important the SMAS plane of tissue be addressed along the course of its mobile region. That is, there are fixed areas of the SMAS, which if simply pulled, yield short-term results. Conversely, when the mobile portion of the SMAS is surgically manipulated, the surgical results are more substantial in gain and duration. Separately, the skin can be carefully redraped with natural contouring. This leads to a more natural appearance with hidden incisions closed without tension.

The ultimate effect of a facelift is to create natural-appearing youthfulness. A pleasing facelift result should demonstrate a rested appearance, with absolutely NO distortion of the tissue around the eyes or mouth. This is important! The jawline and lower half of the face should appear youthful, as should the neck (see necklift). Dr. Sparano usually performs a necklift at the same time as a deep-plane facelift. A beautiful necklift is an impressive and gratifying procedure for patients and surgeons alike.

Dr. Sparano does not shave any hair for any facelift procedure. Incisions are hidden in the hair above and behind the ear, behind the ear cartilage, and in natural skin creases. Dr. Sparano performs a careful, multi-layered closure to minimize tension on the healing incisions, thereby minimizing their visibility. Dr. Sparano believes the extra time mandated for careful wound closure is worth it to maximize the insignificance of visible incision lines around the face. His weekly (if not daily) facial reconstrcution following Mohs surgical ablation of skin cancer, have helped him perfect his soft tissue techniques over the years.

Dr. Sparano performs his deep-plane facelift and necklift surgeries using general anesthesia at the outpatient surgical center of Jersey Shore University Medical Center in Neptune Township, NJ. After a facelift, a patient will usually return home or spend the night in a nearby hotel if traveling from a distance. Dr. Sparano has patients travel for facelift surgery from various parts of New Jersey. As his careful work has become popularized, he has performed facelift and necklift surgery on an increasing number of patients from New York and other regional secotors. About 2 weeks after surgery, a patient can expect to return to ordinary social and professional activities, but with a more youthful and rested appearance. For appropriate candidates, Dr. Sparano also performs miniature facelift operations (see miniature facelift).

 

FREQUENTLY ASKED QUESTIONS

What specifically does a facelift fix?
Generally, the facelift operation treats the lower portion of the face (cheeks and jowls) and neck. The procedure does not address the brows or eyelids, which can be helped by other surgical procedures. Similarly, it will not help the wrinkles around the lips, which can be helped with other procedures. Dr. Sparano performs his consultations very carefully. He studies the nuances of any given face pre-procedure, and adjusts the necessary components of surgery for each againg face individually. Just as in rhinoplasty, the capacity to make these adaptations is important for maximally successful outcomes. Dr. Sparano has participated at some of the regional meetings in New Jersey and New York, where consensus data is discussed and examined. In addition to demonstrating to a patient the anticipated results of surgery, Dr. Sparano takes pride in his observations and discussion of concomitant limitations of surgery. Some of these often include: (1) the tiny "outpouching" of tissue right beside the corner of the mouth (in an otherwise youthful jawline and lower cheek); (2) the fullness of tissue directly above the upper-most extent of the nasolabial fold.

When is the best time for a patient to consider a facelift?
Most patients who choose to experience the benefits of the facelift operation do so between their 50's to 70's. That said, a facelift can be performed at any age. Often, patients in their earlier years are better fits for smaller procedures.

How painful is the procedure?
Most patients experience mild pain or discomfort following the procedure. This discomfort is easily controlled with an appropriate pain relief medication. Patients often transition to Tylenol/acetaminophen based pain relief by 1-2 days following surgery.

What is recovery like after a facelift?
The face can be bruised, swollen, and numb in the days following the surgery. For a deep-plane facelift and necklift, bruising will typically last for 1 week or less, but can last up to 3 weeks at times. The majority of the swelling diminishes over the first 7-10 days, but some swelling can endure over the subsequent 2 weeks. Patients are advised to relax and avoid strain or exercise during the first 2 weeks following surgery.

Are there dressings or bandages that will need to be worn after surgery?
A specially designed wrap is applied to the face and neck for the first 2 days following surgery. Dr. Sparano likes to see his post-operative patients on each of the first 2 post-operative days for cleanings and dressing application. A lighter, removable wrap is applied during the days that follow. By seeing his patients 3 times over the first 7 days, Dr. Sparano and his staff maximize potential for successful outcomes.

How much time off from work should I plan for after my facelift?
Patients will need to schedule time off from work, and are usually advised to take at least 2 weeks off after a deep-plane facelift and necklift, and at least 1 week off following a miniature facelift.

How soon can I return to exercise after a facelift?
Exercise and strenuous work or activity should be avoided for 2 weeks.

When will my stitches be removed after a facelift?
Stitches are generally removed on the 7th post-operative day.