Facelift

The facelift Arizona experience.

We believe that plastic surgery should be one of the most pleasant experiences of your life. We especially want to do everything possible to treat you with great attention and provide the best care possible for your face lift experience. It is noteworthy that we, as a population, are staying healthier as we age. Because of this, many individuals are in much better shape on the inside compared to how they may appear on the outside. Premature aging signs could be the reason you are seeking facial plastic surgery. However, it may not be the only reason. Many more patients seek facial plastic surgery to reverse the natural effects of facial aging.

We are living longer and there is a strong desire in society to look and feel younger. For many, much of how your face appears can determine how you may feel on the inside. People turn to plastic surgery to bring back a more youthful appearance to the face, neck, brows and eyes. This effect can restore or improve self confidence. In consultation, it is important to examine your face carefully. Treating one portion of the face by itself is not always the best approach. In most cases, a comprehensive rejuvenating procedure, which treats all the important facial regions, is the best advice. You can be sure that at the AB Guerra Plastic Surgery Center, we will listen to your requests and apply a logical and reasonable plan for your situation. The goal in mind is to achieve a natural-looking face lift result.

Individualized care for individuals.

We all age differently. Some people age faster around the eyes, but the lower face and neck are not too far behind for the rest of us. In order to provide the best results achievable, we approach every case based on individual issues, listening carefully to the requests and paying attention to the anatomic findings.

We have classified facial aging into three basic types. We may recommend a certain treatment based on how you have experienced facial aging. In the first scenario, primary aging occurs in the lower face. Early jowls may appear and loose skin may develop at the jaw line. Treatment for these patients likely will include a mini facelift, that can address early laxity of the jowls and jawline. A second scenario shows us that jowls and jawline laxity may be accompanied by significant looseness in the neck as well. When the neck is seen to be involved, a neck lift may be combined with the facial surgery, for optimal results. In the third group of patients, the lower face holds up nicely and most of the aging signs are found in the upper face and eye region.

Treatment of upper facial aging can be carried out separately, or may be combined with a face and neck lift as desired by the patient. There are other options that are offered to all our patients in order to individualize their care and optimize the results. For instance, we know that with aging, the fat in the face gradually thins and the bones get smaller and weaker, loosing volume. For that reason, we offer procedures that can restore the lost volume with the use of implants and fat transfer techniques. Cheek and chin silicone implants may be recommended when necessary. Fat transferred into laugh lines, and creases may appeal to some, as a more natural option.

Basic steps in the standard SMAS facelift.

It is important for anyone considering facial plastic surgery, to know the basic steps of facelift surgery. Anesthesia is required for the procedure and all patients are made comfortable before surgery begins. Facelift surgery involves incisions placed so these are hidden under your hair in the temple and scalp. Incisions in the face are hidden in the natural creases in front of the ear and behind the ear. A second incision under the chin may be necessary to further improve aging of the neck or to perform neck lipo. After the incisions are made, the skin of the face and neck is elevated utilizing surgical techniques to expose the deeper tissues.

The underlying tissue is then repositioned with the deeper layers of the face and the muscles lifted into a youthful position. The deeper tissue layer is extremely strong and much less elastic than the skin. This deeper tissue layer is sculpted or redistributed from the face, jowls and neck at this time. The facial and neck skin is re-draped over the newly uplifted facial contour. The excess skin is evaluated at this time and the excess is trimmed away. A suction drain is optional. The incisions are carefully closed using a multilayer technique of deep and superficial sutures. Dressings are then applied before the patient goes to the recovery room.

Age related changes in the face and neck.

As an individual ages, the tone of the facial muscles gradually decreases. The facial skin elasticity also gradually diminishes. The skin and fat volume of the face gradually thins, allowing wrinkles and lines to become more prominent. These age-related events combine to cause a flabby or droopy appearance in the face and neck. Loose skin, jowls, lines, bands and wrinkles develop as a natural result of the physical aging of the face. The cheeks may become flabby resulting in the development of deep laugh lines. The jowls continue to sag, leading to a double chin. The turning down of the corners of the mouth, the formation of deep folds and wrinkles around the mouth coalesce, resulting in an aged appearance.

The face is not the only part of the anatomy that ages. Puffy fatty deposits in the upper and lower eyelids develop and the crow's feet increase in prominence as we age. In fact, for many the eyes can be the first area to show signs of aging. The brows may also become droopy and loose their naturally beautiful arch. The facial bones change with aging and are reduced in volume and strength. The chin and cheek may recede as part of facial aging. The entire facial region including bones, muscle, fat and skin appear smaller and more delicate in older individuals.

Personal goals of face lift surgery.

The goals of surgery should be clear to anyone undergoing face lift surgery. In our practice, the highest priority is given to restoration of the sagging facial tissue into the normal anatomic position, where the face tissue was previously located, before it became saggy. This means the surgeon has to manipulate the tissue and pull in a superior direction, and not backwards. The face sags due to gravity. It falls down. The face does not come forward. It does not make sense to pull backwards. Once the tissue is relocated into the most natural position, the next priority is to remove the excess skin that allows your face to sag. A measure twice, cut once approach ensures accurate placement of incisions and removal of the excess skin.

Science has demonstrated the human face is a multi-layered structure. The skin is a soft and pliable layer that easily stretches under pressure. Underneath the top layer, the face is made of material that is tougher and resists the forces that can lead to sagging. This layer is called the Superficial Muscular Aponeurotic System (SMAS). This important tissue layer is rich in collagen, and very strong, compared to the skin. The standard modern facelift incorporates surgery in this collagen-rich layer.

The priority for surgery is to use this SMAS tissue to hold the face in the new more youthful position. A variety of techniques have been described on how best to accomplish this goal. Studies demonstrate that these techniques are basically equal. Importantly, it is the surgeon experience that can make the difference. At the AB Guerra Plastic Surgery Center, we employ a technique that has changed little over the past eight years and have many satisfied patients.