American Society of Plastic Surgeons
For Medical Professionals

Lifting the veil on face and neck lifts: Rediscover youthful contours

lifting the veil on face and neck lifts

You've stood in front of the mirror countless times, your fingers gently tracing the contours of your face, feeling the changes that time has inevitably brought with age. Your skin doesn't lie. It tells tales of laughter and tears as well as experiences and memories.

While you value the wisdom and maturity the years have brought you, perhaps you yearn to recapture your youthful contours. If so, a facelift and/or neck lift may be suitable for you.

ASPS Member Surgeons Aviva Preminger, MD, and Sara Dickie, MD, shared their insights into the transformative power of facelifts and neck lifts to restore your youthful appearance.

The facelift: Turning back the clock

The term facelift, medically known as a rhytidectomy, might evoke images of tightly pulled skin that looks undesirable. Yet, the reality is far from this old stereotype.

"One of the biggest misconceptions is that you're going to look funny or overdone or pulled like you were in a wind tunnel," said Preminger.

That "pulled" look was the result patients got decades ago when only the top layer of skin was stretched. That outdated technique has been replaced by more sophisticated surgical procedures that work deep into the muscle layer for a more natural result.

"While lifting and tightening and removing extra skin, I can address the muscle layer and add additional support by pulling and supporting the muscles, which tend to loosen as we age," said Preminger.

A facelift offers subtle yet profound rejuvenation for patients in their 40s, 50s and beyond when done by a skilled plastic surgeon. Imagine softening those deeper lines that run from the nose to the corners of the mouth, known as nasolabial folds. Visualize lifting those sagging cheeks and restoring their natural contour and volume.

Facelifts focus on the mid to lower regions of the face, smoothing and tightening the skin, muscles and underlying tissues to give you a refreshed appearance.

The incisions are hidden

The type and location of incisions are determined by a patient's unique needs and the surgeon's chosen method. A traditional facelift incision, which is the most common, begins at the temples within the hairline, proceeds down in front of the ear, mirrors the earlobe's natural curve and extends behind the ear into the lower scalp. Some patients opt for a limited incision, which starts at the hairline above the ear, circles the ear's front but doesn't reach the lower scalp.

Placement of the incisions minimizes visible scarring by situating them in natural skin creases or concealed areas, like the hairline. This, combined with meticulous sewing up of the incision, provides the most camouflage possible.

"That takes me the longest time – sewing the skin back together to make the most perfectly hidden scar," said Dickie. "The skin needs to lay perfectly flat with no tension. I spend a lot of time making sure those scars are really well hidden and the stitch is very fine."

Adding a brow and eyelid lift

It's essential to note that a facelift doesn't address all aspects of aging. The upper face, especially the brow area and eyelids, may require separate procedures like a brow and eyelid lift. When you combine these with a facelift, the results are harmonious and can make you look and feel like your best self.

Some patients need a neck lift too

Patients who get a facelift also need a neck lift. This is because the skin tends to be thinner on the neck and is especially susceptible to the downward pull of gravity and the sun's aging effects. That's where creases, vertical bands and the dreaded "turkey neck" can develop and make you feel self-conscious.

The surgeons we spoke to said many patients can manage facial aging noninvasively with injectables and fillers, but treating the neck requires surgery.

"For a lot of women, the neck is the first thing that ages," said Dickie. "And we have so many tools in our arsenal these days for facial volumization. But you can't really do anything for the neck that's noninvasive or injectable. It doesn't take care of that hanging skin or the loss of the defined jawline."

For that, Dickie said she has to operate and that a neck lift is often best done in conjunction with a facelift for overall facial harmony.

You can think of the neck as a pedestal for the face, and when it's sleek and youthful, it complements your facial features, which is an excellent reason to get a neck lift along with a facelift.

A neck lift redefines and enhances the delicate angle between your jawline and neck. It removes excess skin, tightens the underlying muscles and even eliminates or reduces fatty deposits that can accumulate beneath the chin.

Safety is your foremost concern

There's no denying that any surgical procedure carries risks, and it's natural for you to feel apprehensive. Here's the comforting truth – when conducted by a board-certified plastic surgeon with a track record of excellence who understands your unique needs, these procedures are incredibly safe.

"You want to go to someone who's experienced, who's board certified and skilled in doing facelifts," said Preminger. "If you feel comfortable on all of those levels, then that's your best chance for a good result."

The initial consultation is a crucial aspect of ensuring safety and achieving natural-looking results. This is the moment for candid conversations about your desires, concerns and medical history. Your surgeon will guide you on the best approach, ensuring that the outcome aligns with your vision.

"I always tell patients that finding a plastic surgeon is a little bit like dating," said Preminger." There are a lot of people who can get the job done, but it has to feel right."

The beautiful transformation

Ultimately, the journey of facelifts and neck lifts is not merely skin-deep. It can be empowering knowing you've taken a step toward being the best version of yourself. It's about the newfound confidence that shines through every smile, every glance and every moment you cherish.

Age is just a number. You hold the power to define what that number means for you with the magic of cosmetic procedures. So, as you stand before the mirror again, remember that – with the help of modern plastic surgery – the reflection gazing back can be as timeless and radiant as you desire.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.


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