January 25th, 2011 Miguel A. Delgado Jr, MD
Making the decision to proceed with a facelift is an exciting one. It is normal to have apprehensions, so it is a good idea to address all of them with Dr. Delgado, a facial cosmetic plastic surgeon, so that you can go into surgery without any anxieties.
One of the most common concerns of patients for a facelift in San Francisco Bay Area is the placement of the incisions and how visible they will be. This is one of the most important goals of the facelift procedures; besides having a great natural look it is equally important for the incision sites to be in the natural creases and as invisible as possible.
There are different incisions for the different procedures which can make up a facelift. They are:
1. “Short Scar Facelift” This has become popular in the last five years or so, and the incision is limited to the front of the ears ending at the earlobe. It is more limited in its ability to provide correction of loose skin and soft tissue in the neck in comparison to the Modern Facelift. It does however lift the deep structure which is called the SMAS, a firm and fibrous network that runs beneath the skin and over the facial muscles.
2. “Mini-Facelift”The incisions are similar to the “short scar facelift” the difference being that it involves the skin only. It is not a deep lift and does little if anything to improve the neck. Since it only involves the skin, it will only hold up for a few years.
3.“Modern Facelift” This facelift gives the best results for most patients and is the longest lasting, 8 to 10 years or more, however the incisions are longer. The incision line goes behind the ears and into the hairline. But a skilled surgeon with great technique is able to minimize the scar and for most patients it can fade and be almost invisible.
4. “Brow Lift” There are two different approaches to the brow lift, the first being the coronal lift, with this procedure the incision is hidden behind the hairline and goes from ear to ear over the crown of the head. There can be problems with this incision, such as hair loss, a wide scar and possible cutting of nerves on the top of the head. The other brow lift is called an Endoscopic Brow lift. In recent years surgeons now use an endoscope when possible, this is a specially designed instrument with a camera attached that passes through very small incisions allowing equal results as the “open coronal” approach.
5. “Eye Lift” For the upper eyelids, an incision is made in the natural crease of the lid. Once the incision has healed, it is almost invisible. For the lower eyelid, the incision is made just under the eyelash and again after healing almost impossible to detect. If only fat is to be removed, then the incision is made just inside the lower lid.
So as you can see a lot of planning and thought goes into all the procedures to give the patient the most natural facelift results with minimal evidence of any procedure having been performed.