April 9, 2013

6 Don'ts for a Natural-Looking Facelift Result

6 Don'ts for a Natural-Looking Facelift Result

Getting natural-looking results from a facelift is largely in the hands of your surgeon. As such, choosing a facial expert with extensive experience performing facial plastic surgery and facelift surgery is vital, as is understanding some of the outcomes that your surgeon is aiming for. Here are the important don'ts that an experienced surgeon will know to avoid during your procedure - don't hesitate to do your research and discuss these with your surgeon during the consultation process leading up to your facelift.

1. Don't Overdo the Filler.

While filler or Botox can be administered during a facelift to improve the result, these should be used conservatively in order to avoid a ''bloated'' look. Botox and filler used in moderation simultaneously to facial-rejuvenation surgery is a great way to add volume to an aging face.

2. Don't Stretch the Skin.

Support and elevation of the face should be achieved by elevating the muscle/fascia layer rather than placing tension on the skin - but, how is this done? Incisions (these can vary in shape and size/can be short or long depending on your needs) made on either side of the face create skin flaps that allow your surgeon to access and dissect the deep-down superficial muscular aponeurotic system (SMAS) - the thin layer of muscles below the skin. In the early days, facelift surgeons would simply pull the facial skin tight, trimming away any excess. Unfortunately, this caused that dreaded ''windswept'' look that patients wish to avoid today. Your facelift expert will design an incision size/length that's appropriate for your hairline and facial features and use the access it provides to actually reposition your facial features to where they used to be. While some trimming of extra skin is also performed with an appropriate amount of tension, it looks completely natural when done in combination with SMAS tightening.

3. Don't Pull Straight Back.

Elevation of the face should be in an upward direction and never pulled straight back (the latter would result in an unnatural "windswept'' look). If your surgeon has specialized training in facelift surgery (e.g., through the completion of a fellowship in facial plastic and reconstructive surgery), he or she will have trained with highly experienced facelift surgeons, learning where, how and in what direction to lift and tighten so that the result looks natural. In other words, your surgeon will be aiming to do the opposite of what gravity has done to your face over the years: repositioning the deep layers upward, not backward, to yield a natural-looking result.

4. Don't Overdo the Neck.

Avoid excessive liposuction in the neck - too much can actually remove the smooth appearance of the skin as it lies on the underlying neck muscles. In fact, one of the telltale signs of a poorly done facelift is a lumpy appearance along the neck and jaw line. If liposuction is indicated, it should be done sparingly and very carefully in order to avoid irregularities. Again, you will have to trust your facelift expert to make good decisions here based on his/her experience with facelift surgery.

5. Don't Change the Natural Hairline.

A specialist in facelift surgery will pay meticulous attention to maintaining a normal hairline position by carefully designing incisions that will not disturb the natural hairline substantially (doing so can look very unnatural; an odd-looking hairline is another telltale sign of a bad facelift). Many patients ask why their surgeon can't simply hide incisions in the hairline, rather than placing it in front. This technique is done precisely to avoid changing the hairline in any odd way. Consider this: if an incision is made in the hairline near the ear, the hairline must be pulled back in order to meet the incision, moving the hairline away from the face by about an inch. This looks unnatural. As a patient, you have nothing to fear when it comes to well-designed incisions; they heal extremely well, to the point that even you will have to look carefully to see them!

6. Don't Forget the Ears.

There are two ways to design the incision that goes in front of the ear: 1) hide it inside the ear, behind the tragus (the part of the ear that projects immediately in front of the ear canal) or 2) make the incision directly in front of the tragus. It is not uncommon for surgeons to place the incision behind the tragus in an attempt to hide it; unfortunately, this usually changes the way the ear looks in an odd and unnatural way. Incisions placed in front of the tragus are only visible until they fade, at which point they become extremely difficult to see, and the ear retains its natural shape.

Dr. Buonassisi is a highly trained and experienced facial cosmetic surgeon who focuses his entire practice on plastic surgery of the nose, eyes, face and neck. Book a facelift consultation with Dr. Buonassisi today!

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