Facelift surgery in the last ten years has borrowed a lot from our reconstructive history and the most modern techniques truly focus on rebuilding the facial soft tissue layers in a more youthful position in a more permanent way. These newer procedures are not just old fashioned skin-tightening procedures, but truly reposition and resuspend the muscles that carry the skin. The use of chemical peels and CO2 laser skin resurfacing procedures have added a new dimension in facial rejuvenation surgery, so that the surgery repositions the deep layers and the skin is made more youthful in appearance by peel and by laser resurfacing techniques.

Facial aging starts in your thirties and some men and women can be a candidate for a central neck tightening (platysmaplasty), mini-facelift or facelift by their late thirties or early forties. The effects of gravity, exposure to sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck. Since facial aging does not occur all at once, it is commonplace to perform brow lifting and eyelid surgery at an earlier age in stages. Usually by the late forties or mid fifties, most of the facial tissues show some sign of aging and are more appropriately all corrected together. The best candidate for a facelift is a man or a woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well defined.

Facelifts range from "mini" to "standard" to "extended SMAS" depending on location and extent of both skin and muscle laxity. The operation is done on an outpatient basis under local anesthesia with sedation, or under general anesthesia. Incisions are made within the hairline (or along the hair margin) above the ear, extending down around the lobe, and ending in the hairline behind the ear. The deep muscle layers of the face and neck are tightened, the facial skin is redraped and lifted, and the excess skin is removed. This will create a more youthful jawline and a better contour due to the removal of loose skin and excess fat but without an operated look.

Usually one or two nights in the outpatient recovery are required. The patient goes home with head and neck wrapped in dressings or elastic garment, which can be worn for the first few days to prevent swelling. Minimal initial discomfort is easily controlled with oral medication. Sutures are removed within 5-7 days. Bruising and swelling decrease to "socially acceptable" levels in 10-20 days. The final result is evident in 4-6 weeks or sooner with continued improvement for several months.

Additional procedures that would enhance the result are: Eyelid Lift, Brow Lift, Chemical Peel, Chin Enlargement, Nose Reshaping (Rhinoplasty), Fat Suction, Laser Skin Resurfacing, Cheekbone Enhancement, Augmentation/Enhancement of Lips, Reduction of Earlobes.