5 Facial Rejuvenation Procedures: Is a Facelift Right for You?

The facelift... For over one hundred years, it's been the most popular form of cosmetic surgery to rejuvenate an aging face.

A classic facelift removes sagging skin and extra fat deposits in the lower face, revealing the contour of your jaw and smoothing wrinkles in the lower face. The results are often a dramatically younger look.

What most people don't know is that a “facelift,” technically speaking, only affects the lower face. For total facial rejuvenation, additional procedures can be performed simultaneously, such as a forehead or brow lift, eyelid surgery, nose reshaping, skin resurfacing, fat injections, around-the-mouth surgery and a midface lift.

At Austin-Weston, our surgeons can address only the parts of your face that bother you, or they can recommend other areas of simultaneous rejuvenation. Sometimes leaving a portion of the face untouched while surgery on another area can be the perfect decision, but sometimes this can also upset normal facial proportion and harmony. Your surgeon will give you recommendations based on over 70 years of combined surgical experience as expert facial surgeons in Washington DC.

You and your doctor will work together at your consultation appointment to choose which combination of procedures is best fitted for you and create a customized treatment plan. At Austin-Weston, The Center for Cosmetic Surgery, we consider every aspect of your facial anatomy, desired look and lifestyle, guiding you through the decision-making process every step of the way.

Quiz: Is a Facelift Right for You?

If you answer yes to any of the following questions, you are a potential candidate for a facelift.

• My skin just doesn't feel tight anymore. Starting in the mid-40s, skin's elasticity lessons, resulting in sagging skin on the face and neck. At first, the tissues may just feel more lax, followed by skin that is actually hanging or wrinkled. Early in the process, a good skin care regimen along with Botox and fillers can prolong the need for surgery. As the skin becomes excess, only a facelift can tighten the facial skin.
• I have extra tissue in the jowl area and/or a sagging neck. Sagging skin in these areas is especially frustrating because there are not good minimally invasive options for treatment. Fillers, Botox, and lasers are underpowered for aging changes in the lower face. There are certainly companies that tout non-invasive solutions, but we have not found one that works up to our standards.
• My forehead has deep lines, and my eyes are getting bags. With age and gravity, the brow descends from its natural placement, making you look tired or sad. The body's natural response to this is to use the forehead muscle to lift the heavy brow, resulting in deep forehead lines. This is typically accompanied by aging changes below the eyes including bags, wrinkles, and hollowness.
• I have loose skin under my eyes and deep lines around my mouth. The middle of the face is also prone to aging, and as the 'midface' area loses volume, the overlying skin can sag, resulting in a loss of the more youthful 'triangular' face shape. The extra skin accumulates around the mouth as deep 'nasolabial folds' or 'parenthesis lines' that are initially helped by volume like fillers, but eventually, require surgery like a midface lift.
• My extra neck skin is folding over my collar and necktie. One in ten facelifts is performed on men. While the ideal aesthetic in men is for lower brows and a broader jawline, often this is best obtained through surgery. Even if you fit into one of these categories but are not ready for a surgical procedure, there are minimally invasive options or smaller procedures that can be performed under local anesthesia. Some of these include:
  • Botox for upper facial lines that are present with movement
  • Fillers like Juvederm for deeper lines or hollow areas
  • Isolated upper eyelid surgery under local anesthesia Eyelid surgery
  • Superficial laser resurfacing like Fraxel or a chemical peel to get rid of fine lines

Facelift surgery can improve the most visible signs of aging by removing excess fat, tightening muscles and re-draping the skin of your face and neck. Facelift surgery cannot stop the aging process, but it can set back the clock.

Five Facelift Options

1. Lower Facelift

The classic 'facelift,' this procedure most strongly affects the lower part of the face and neck. Incisions are typically in front of the ear and then around the back of the ear in a natural crease. Sometimes this incision is extended under the sideburn and sometimes there is an accessory incision under the chin. This is the only procedure to remove heavy and sagging jowls in the lower face. It is also the only procedure to trim away extra cheek and neck skin.

2. Neck Lift

Saggy and hanging skin under the neck can be genetic, a component of normal facial aging, or an unwelcome side effect of weight loss. A neck lift operation can be performed alone or as part of a facial rejuvenation procedure. Through incisions behind the ears and sometimes under the chin, extra skin can be removed, extra fat liposuctioned out, and loose muscles tightened to refine the neck/jaw contour. The results of a neck lift are often most impressive in profile view.

3. Brow Lift

Brow lift surgery is used to reverse the aged look that accompanies a drooping brow. Depending on how low the brow has become, your surgeon will recommend one of a variety of different brow lifts. For patients with minimal droop, Botox alone can raise the brow and delay needing a surgical procedure.

4. Mid Facelift

A mid facelift is designed to correct the area around the eyes and sagging along cheekbones, restoring fullness to these areas. For most patients, this procedure is usually combined with some form of facial rejuvenation. The midface lift is performed through a single incision beneath the lower eyelid lash margin. Mini or MACS-lift

5. Mini Facelift & MACS

Minimal Access Cranial Suspension (MACS) and mini facelifts are terms for shorter scar facelifts. When the incision is shorter, the result is less, and this can be ideal for a patient with early signs of aging, or someone who is willing to accept less result for less scar. This scar is typically limited to just in front of the ear, with minimal extension forward toward the sideburn or backward toward the nape of the neck.

Additional Facial Procedures

• Eyelid surgery: Eyelid surgery, or Blepharoplasty, addresses hooding skin in the upper eyelid and “eye bags” in the lower eyelids, improving the overall look of your eyes. It can be performed on healthy adults of any age. Incisions are typically made in the creases of your upper eyelids and just below the lashes in your lower eyelids. After the underlying fat is repositioned and excess skin is removed, the incisions are closed with fine sutures designed to leave nearly invisible scars.
• Fat grafting: Fat injections, or fat transfer from one area of the body to another, can significantly fill and even eliminate lines and wrinkles as well as hollow areas that come with age. This is sometimes called 'nature's filler' because it uses your own fat cells to fill in a hollow area.
• Liposuction: In patients with a full neck or excess cheek fat, liposuction can be used as an adjunct procedure to sculpt the face. This is occasionally performed alone, typically in the neck area, or it may require a component of a full facial rejuvenation.
• Chin implant: In patients with a retrusive chin from a weak jaw, a silicone implant can be inserted to give more projection and a refined frontal facial contour. This is sometimes combined with targeted liposuction of the neck or a neck lift.
• Around-the-Mouth Surgery: No facelift technique rejuvenates the mouth, but the mouth does age along with the face. As we age, we begin to see our lips lose volume and lines and creases begin to appear around the mouth, especially at the corners. The most common procedures used to rejuvenate the peri-oral area include lip lift, corner mouth lip, lower lip advancement and direct excision. Sometimes these procedures are done alone but are often part of a full facial rejuvenation.
• Skin Resurfacing: The latest laser resurfacing technology can eliminate layers of sun-damaged skin and vaporize damaged cells and fine wrinkles on the face. Chemical peels are another answer to resurface damaged skin. Finally, dermabrasion can mechanically treat the superficial layers of the skin to allow for new fresh skin to come in and leave behind collagen for a more youthful look.

What About a Liquid Facelift?

With aging, fat compartments diminish, and this loss of facial volume leaves the surrounding skin envelope looking excess and droopy. Restoring facial volume can lead to a more youthful look.

A liquid facelift is using fillers and Botox to camouflage the signs of aging without surgery. This is certainly not a surgical result, but in some patients who have great skin and tone, but are just missing volume, a liquid facelift can be very powerful.

At Austin-Weston, we pride ourselves on giving a more conservative and natural look after facial fillers. It is our belief that surgeons injecting fillers can often get a less 'done' result because a plastic surgeon knows when more filler is not the answer and when surgery can give a better result.

A combination of these procedures can be customized for your facial “problem” areas to achieve the look you desire. Always remember that a major medical procedure should be a thoughtful life choice, and that, if you are a smoker, you must stop before undergoing elective surgery.

If you live in the Northern Virginia or Washington DC area and are ready to reclaim your confidence, contact us to schedule a complimentary consultation at (703) 893-6168 or submit a form online to request an appointment.

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