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Facelift

Board-certified plastic surgeon James F. Boynton, MD performs the full gamut of facial rejuvenation and restoration depending on a patient’s desires, changes that occur with aging, and goals. Included in this comprehensive assortment of procedures is facelift surgery, which continually ranks as one of the most popular aesthetic treatments performed each year due to its ability to resolve numerous signs of aging and high patient satisfaction.

What Is a Facelift?

Facelift surgery is a cosmetic procedure designed to rejuvenate one’s appearance through the lifting and tightening of skin and underlying facial/neck tissue. Depending on a patient’s needs and concerns, this treatment can help smooth lines and wrinkles, eliminate excess skin and jowling, combat skin sagging, restore lost facial volume, and tighten muscle band laxity in the neck (known as the platysma). By customizing each facelift to meet the specific goals of the individual, Dr. Boynton is able to help patients achieve the more youthful facial aesthetic they desire with results that appear entirely natural. A facelift and a necklift in many cases are “interlinked” as one procedure; however, most times colloquially it is referred to as a “facelift,” which can be confusing.

Who Is a Good Candidate for Facelift Surgery?

Generally speaking, candidates for facelift surgery are often bothered by one or more of the following cosmetic concerns:

  • Loose, sagging skin in the face and neck
  • Moderate to significant lines and wrinkles (including nasolabial folds) and downturning of the corners of the mouth (which can give a frowning-like appearance)
  • Loss of volume in the cheeks, as well as flattening of the cheeks, and midface
  • Excess and/or displaced fat throughout the face and neck
  • Notable jowling

In addition to wanting to correct the above issues, patients need to be in good overall health with no unmanaged health concerns that may inhibit proper healing to be considered a good candidate for facelift surgery. Ideally, patients should also be non-smokers (or have quit using all tobacco products, including E-cigarettes, at least two weeks before surgery) and have realistic expectations for what can be accomplished with treatment. Dr. Boynton will discuss all of this criteria in complete detail at the time of the consultation, helping to determine the most appropriate course of action based on your unique case.

How Is the Facelift Procedure Performed?

At our practice, Dr. Boynton offers a variety of facelifting procedures starting from the non-surgical, to minimally invasive, to more complex facelifting procedures. Dr. Boynton always looks to develop an individual plan with each patient that accomplishes their goals in the least invasive way but that still gives lasting results.

Facelift

This is a 57 year old female patient who was unhappy with the appearance of her jowls and neck after having undergone a previous “isolated neck lift” elsewhere, 12 years prior. She underwent a short-scar office-based facelift with a revision neck lift and platysmaplasty (re-tightening of neck muscles) under local anesthesia with valium. 4 month after photos are shown.

Liquid Facelift

Starting sometimes in their 30s, but definitely in their 40s, most individuals show changes of aging in their face that begin to bother them. Facial aging is affected by genetics, exposure to or history of smoking, and sun exposure. In many patients with “early” signs of aging, non-surgical injectables can restore and rejuvenate the face without a lengthy recovery. BOTOX® Cosmetic and XEOMIN® are both popular methods of restoring the appearance of the forehead, and they can also elevate the brow to some degree (i.e. a “BOTOX brow lift”), as well as improve crow’s feet lines on the sides of the eyes.

Patients also start to lose “fat” in the central aspects of their faces, in particular the perioral region around the mouth, and get heavier “smile lines” or nasolabial folds about this time. There are a variety of fillers (JUVÉDERM VOLUMA®, JUVÉDERM® Ultra Plus, JUVÉDERM VOLBELLA®, RADIESSE®, Sculptra® Aesthetic, Restylane®, Restylane® Lyft, Restylane® Defyne and Refyne, as well as BELOTERO BALANCE®) that can add volume back in this area, as well as into the corners of the mouth and jawline area. All of this done together is essentially a “liquid facelift,” which can restore a number of concerns in areas of the face without incisional surgery.

The Silhouette InstaLift™

The Silhouette InstaLift™ is a tiny step beyond filler that is a dissolvable suture with barbs or cones on it that can give some degree of “lift” to the cheek. This is done in a simple 20-minute procedure in the office without any incisions.

Micro and Nanofat Injections to the Face

Fat injections to the face have been around for some time, however it has only been in recent years that the technology and refinement in instrumentation and technique have allowed for “small particle” fat injections that don’t leave “lumpiness” and can truly add some stem cell effects and rejuvenation to the under-eye region, areas of the cheeks, and around the mouth.  Nano and microfat injections truly take the results of every facelift up another notch, and this is a nice added procedure for patients.

Neck Rejuvenation

The other concern often addressed with the “liquid facelift” is excess fullness in the neck/chin area. This can often be improved with either liposuction or lipo-contouring alone, or a suture-suspension neck lift technique like the ICLED percutaneous trampoline platysmaplasty. By utilizing a fiber-optically placed suture on top of the platysma muscle to support and bolster the neck, this neck lift can provide some “lift” for patients who have mild skin laxity without the need for open neck and facial incisions, as are typical in traditional face and neck lift procedures.

There is even a T-Z Plasty, also known as a direct neck lift, that older men sometimes opt for to address the “turkey gobbler.” This lift is done directly without a facelift and involves removing lax skin, thinning central neck fat, as well as tightening the neck muscle that serves as an internal “hammock,” also called the plastyma, and known as a platysmaplasty.

All of these procedures are offered in the comfortable setting of Dr. Boynton’s office without the need to go under full anesthesia or to a hospital unless requested.

Short-Scar Facelift (and Neck Lift)

Some patients—generally those who have too much excess skin, sagging jowls, etc.—may need more than a liquid facelift. These patients often benefit from a more comprehensive approach called the short-scar facelift and neck lift. Dr. Boynton has been trained in many different types of facelift techniques; however, for many of his patients, he has found the best overall solution has been his short-scar face and neck lift. This eliminates the vast majority of the “scar behind the ear” and along the lower hairline that is included in a “classic facelift” that often is more visible when women wear their hair up. This also leads to a faster recovery and is mostly done in a simple office setting under local anesthesia with valium alone.

This innovative technique is typically performed in the office without traditional hospital care, anesthesia, or overnight stay. Patients often enjoy not having to go to a hospital, and most are very comfortable with local anesthesia and valium medication for mild relaxation. Some benefits of this procedure may include a much faster recovery than a traditional facelift because of limited incisions, as well as not having to undergo anesthesia. It is also more economical for patients since there is generally no hospital stay.

The short-scar facelift and neck lift, which is similar to a mini-facelift, involves a well-concealed incision just in front of the ear and just inside the base of the sideburn area along the hairline. The incision goes behind the earlobe only, and it avoids the classical, longer incisions behind the ear that typically extend down the back of the hairline. This has always been the most objectionable part of a facelift incision to most patients since the behind-the-ear incision can be seen (especially in patients that like to wear their hair up in a ponytail). Dr. Boynton performs the short-scar face and neck lift incision to avoid this area completely. Additionally, there is a small incision under the chin that allows direct access to sculpting and thinning of any fatty tissue in this area, as well as the platysmaplasty—which is the neck tightening procedure that works like an internal “bolster” in the neck while really helping to sharpen and define the neck line.

In the cheek area, Dr. Boynton separately raises the skin and performs a cheek lift. He then tightens the SMAS, or deep tissue layer of the face, using a combination of SMASectomy and specialized plication sutures that tighten and suspend the jowl. The tightening of the deep layer of the face and the platysmaplasty really help to ensure a lasting result.

Ultimately, Dr. Boynton seeks to achieve very natural results that are not over-tight or over-pulled. Results from the short-scar facelift and neck lift are meant to highlight each patient’s natural beauty without changing the way the patient looks. Following the procedure, patients typically need approximately one week to recover.

What Is Recovery from Facelift Surgery Like?

Recovery following a facelift will depend on the specific technique employed, as well as one’s natural healing process. After a liquid facelift, there may be some degree of swelling and/or bruising in the targeted areas, though these symptoms are generally minimal and should fade relatively quickly. Whether performed alone or in combination with liposuction or the ICLED neck lift, most individuals are able to return to normal activities the following day.

When the short-scar facelift and neck lift are performed, patients can usually expect some bruising, swelling, and/or tenderness to occur initially throughout the treated region. Like the liquid facelift, these side effects are temporary and should resolve over time. Any discomfort experienced can typically be managed with medication, and the majority of women and men are able to resume office jobs, school, and other non-strenuous activities after approximately one week. Any heavy lifting, intense exercise, and other strenuous physical actions will need to be avoided for a bit longer to help ensure proper healing.

How Long Do Facelift Results Last?

The length of results from a facelift will depend on the technique that is performed. A liquid facelift utilizing only injectable treatments is designed to yield long-lasting, though temporary, results. When the effects of the injectables begin to fade, patients will need follow-up injectable treatments to maintain the outcome. A surgical facelift with the short-scar facelift technique is designed to produce results that can last 5-10 years with the proper care. The overall quality of an individual’s skin and genetic factors will play a part in terms of how long the outcome can last. With that in mind, there are other factors involved in maintaining results that are completely within your control. A healthy diet, adequate skin protection from the sun’s harmful rays, a good at-home skin care regimen, keeping a stable weight, and living a generally healthy lifestyle can go a long way toward maintaining the effects of facelift surgery years into the future.

How Noticeable are Facelift Scars?

One of the major benefits of both liquid facelift and short-scar facelift techniques is the inconspicuous nature of residual scars. For patients who undergo the liquid facelift technique without additional liposuction or neck lift treatment, there are no surgical incisions at all; therefore, there should be no residual scarring whatsoever. For individuals who have the short-scar facelift, incisions are extremely well-concealed as they are placed in very discreet areas. Indeed, the very design of this technique aims to minimize scarring; scars from this type of facelift surgery should be rather small and well-hidden. Plus, scarring typically fades to some degree over time.

How Much Does a Facelift Cost?

Here at Boynton Plastic Surgery, the price of facelift surgery often ranges between $10,000 and $11,000. With that in mind, it’s important to note that this treatment is customized, so the total cost of a facelift will depend on several different factors. These include the specific concerns being addressed, the particular technique utilized, whether or not additional treatments are being performed to provide an even greater enhancement, and other components. Due to this number of variables, an in-office consultation will be necessary to determine pricing. At this time, Dr. Boynton will listen to your aesthetic desires, perform a complete facial evaluation, and formulate a custom treatment plan that can help you achieve your goals. Based on the proposed approach, he can then provide a close approximation of the overall cost of your facelift surgery.

At Boynton Plastic Surgery, we never want “price” to keep patients from receiving the cosmetic care they desire, which is why we have partnered with CareCredit® to offer several plastic surgery financing options. With a variety of choices available, qualified applicants can find a monthly payment plan that enables them to comfortably cover the cost of facelift surgery with little to no interest.

Is it Possible to Have a Facelift without Surgery?

While no other procedure will have results that are as extensive or that last as long as a surgical facelift, it is possible for many patients to achieve significant facial rejuvenation without surgery. As noted in the section above, a Liquid Facelift utilizing cosmetic injectables and dermal fillers can smooth out fine lines, add volume to facial features, and give the face a more refreshed and youthful appearance. Dr. Boynton also offers an advanced procedure called the Silhouette InstaLift™, a minimally-invasive treatment that lifts underlying facial tissues and rejuvenates the midfacial area by using a system of dissolvable subcutaneous sutures. Non-surgical options like laser skin resurfacing and chemical peels can also be effective for reducing signs of age and skin damage. If your aesthetic concerns are fairly mild or minimal, or if you simply want to avoid surgery at this time, these less invasive treatments may be suitable options for your needs. During your initial consultation, Dr. Boynton can help you determine the best course of treatment for your goals.

Schedule a Facelift Consultation

If you would like to learn more about how facelift surgery can help you meet your goals, please contact Dr. Boynton to schedule a consultation. He can discuss all aspects of a facelift with you and answer any questions you may have.