“Facelift” is a fairly generic term, and this can be confusing when one is looking to reverse the signs of aging. A facelift procedure lifts the cheek area and tightens the overlying skin, thereby improving the midface and jowls. It doesn’t address other areas of the face that may also be prematurely aged, and this can lead to disharmony if performed alone. Because of the confusion created this generic term, it’s not uncommon for a patient at my Boston practice considering a “facelift” to be surprised when it turns out to be a “facelift and …”. However, by combining the lift with other “accessory” procedures, a more natural look can be achieved.
While facial rejuvenation needs to be customized to each patient, and not every patient needs all additional components, in my experience the 3 most common ancillary procedures are:
- Eyelid surgery (blepharoplasty)
- Neck Lift
- Perioral Rejuvention
The need for eyelid surgery, particularly lower eyelid surgery, is often a good indicator that the facelift has been successful. As the sagging cheek is lifted and “driven up” towards the lower eyelids, excess skin can accumulate underneath the eyes. A lower blepharoplasty helps to eliminate any redundancy and smooth the transition from the lower lids onto the cheeks.
The same things that cause premature facial aging- sun exposure, connective tissue laxity, smoking, and genetics- also act on the neck. A facelift won’t correct neck bands or excessively loose neck skin. While some of these neck issues can be addressed through the same incisions used for the facelift, complete correction often requires an additional small incision underneath the chin in order to repair the platysma or neck muscle layer.
Finally, much like the neck, the effects of a facelift stop short of the nasolabial folds. Because of connections between the facial skin and the underlying connective tissues, lifting the cheeks doesn’t transmit to the area around the mouth. Subsequently, perioral concerns like “kissing lines” above and below the lips need to be separately addressed. Frequently, I’ll recommend a combination of skin resurfacing with either a chemical peel or dermabrasion and fat grafting of the lips.
Remember to seek out a facial plastic surgeon who is specifically trained and experienced in achieving the balanced look you seek. Taken together, it may sound a little intimidating when the patient started out interested in ‘just a facelift’. However, as I’ve learned from my little ones at home, sometimes the icing on the cake is the best part.