As our face ages, underlying soft tissues descend from their youthful positions over the cheekbones, and in so doing, contribute to the jowls, lines and waddles of the lower face and neck. The purpose of a facelift is to lift and smooth the underlying soft tissue of the lower face and neck, followed by a careful trimming of any redundancy of the overlying skin envelope to produce a more youthful, natural and beautiful appearance. The orchestration of the key maneuvers of the facelift include: the actual making of the incisions, the lifting/re-positioning of the underlying soft tissue, re-draping and trimming the excess skin, and closing of the incisions. A well-performed facelift is truly one of the masterpieces of modern aesthetic surgery. No other treatment can so comprehensively accomplish the restoration of youth and beauty that the facelift can. However, there is much to consider when making the choice for a facelift: including recovery time (downtime), expense, and risk of visible scars. Therefore, if one is not prepared to undergo a facelift, aesthetic medicine today offers a full array of treatments that can accomplish some, but not all, of the same objectives of restoring youth and beauty. What follows is a sampling of some of the better substitute treatments:
• The so-called “liquid facelift” uses a combination of BOTOX® and fillers to smooth dynamic winkles and restore lost volume. The downtime is essentially negligible; the results last months to a few years.
• Laser resurfacing can very successfully improve the quality, thickness and tightness of facial skin. Depending on the type of laser, downtime may be negligible to more than a week for deeper treatments.
• Radio-Frequency (RF) Microneedling devices use tiny gold-tipped needles to penetrate the skin’s dermis. Once the microneedles are maximally engaged in the skin, a burst of radio-frequency energy is delivered to stimulate dermal collagen production, thus thickening, tightening and rejuvenating the skin of our face and neck.
• Precision SmartLipo is a terrific procedure for a “double chin” and minimal jowls. Local anesthesia, 3 tiny, well-hidden incisions, and a 45-minute procedure is all it takes to laser-melt and remove double chin fat and jowls, and laser-tighten the overlying skin. Downtime for this procedure is typically only a couple of days to a week.
Obviously, there are many factors to consider when selecting a procedure or treatment to address the aging face, including: level of invasiveness, downtime, risks, and the expected level of restoration of youth. I believe the key is to establish a trusted relationship with a board-certified facial plastic surgeon and clearly communicate your unique preferences and then have a detailed discussion of which options are best for you.