As we age, our tissues lose volume, elasticity, hydration, and structure; these changes affect all layers of tissue, from our skin to our bones. We all know the effects of facial aging when we see them; tissues are thin, droopy, and dry – they are old! As we have gained a deeper and more granular understanding of the aging process, we are able to address the aging process more comprehensively and precisely. We also know that facial “pre-juvenation” can be an important part of facial rejuvenation.
While we now have a spectrum of treatments, including non-invasive, minimally invasive, and surgical, facelift remains our most powerful procedure to slow down aging. While a comprehensive approach to slowing and reversing the effects of aging is foundational, a facelift is the cornerstone of preserving a natural and youthful appearance. Recapture your younger self — with our Boston facelift at our aesthetic surgery center, where we place the utmost importance on quality, safety, and service.
There has been a paradigm shift in our thinking about a facelift over the last several years; when and how to perform the procedure, how and what other treatments complement a facelift. Once upon a time, we used to wait until patients had significant signs of aging to offer them a facelift so that they would see a dramatic result. However, we have learned that many patients want to address the tell-tale signs of aging early with a more subtle result. Patients now demand a more longitudinal and subtle approach that keeps them always looking vibrant and confident. We now think of the role of a facelift earlier in the aging process, in conjunction with ancillary procedures and other surgeries, and with more refined and fine-tuned techniques. Patients from age forty - seventy can benefit from a facelift.
With facelift procedures that are tailored to each patient's exact needs, it is our pleasure to help our patients look many years younger, while still maintaining their natural beauty. A rhytidectomy is excellent for addressing changes to the midface. Patients with more advanced signs of facial aging in the mid-face, neck, jawline, or upper third of the face may benefit most from a combination of procedures.
Why choose Clareo?
At Clareo Aesthetics, we take great pride in offering our patients the full spectrum and best of the best facial rejuvenation services. We offer neurotoxins and fillers for temporary wrinkle reduction, hydration, and volume restoration. Our radiofrequency platforms allow us to permanently tighten the collagen in and beneath the skin. In-office fat transfer provides long-lasting and even permanent volume restoration. And, of course, our Clareo surgeons offer the best facelift techniques and results available. We will help you optimize your results of any treatment with a prescribed skin care regimen. At Clareo Aesthetics, you will not get a one size fits all treatment but rather a treatment plan customized to your needs.
Dr Tantillo’s message to those considering a facelift: A facelift should rejuvenate the face through restoration and harmonization. A facelift is not meant to pull tissue tight but rather to rebalance the tissues. A facelift brings out each patient’s beauty, youthfulness, and confidence. I love the moment when patients have that aahhh moment – “that is the face I want to see!”
Dr. Lee’s message to those considering a facelift: My goal for any facelift is to keep you looking like you, just 15 years younger! I want to highlight your natural youth and beauty and rewind the clock by restoring volume and resuspending your own tissues to where they once were at the same time, removing excess sagging skin to eliminate those deep lines and wrinkles. I want my patients to see themselves as they once were.
Our faces are somewhat heart-shaped in youth, with varying amounts of angularity and soft tissue, making us unique. Even with our individuality, there are some universal principles about facial aging. When young, our cheeks are full and strong. Our cheekbones give way to our midfaces which continue to taper into our chin. Our temples are full, our brows elevated, and our upper eyelids open and bright. Our lower eyelids blend into our cheeks, our jawline is well defined, our lips are full, and the corners of our mouth are upturned. Our neck is tight, with a well-defined and acute angle of the base of the jaw and neck.
As we age, our skin thins, dehydrates, and loses collagen support. The fat in our face atrophies, and the framework supporting the skin and fat of the face weakens, causing those tissues to droop. Our facial muscles can become thinner, and even our bones lose volume over time. All of this leads to our relatively heart-shaped face becoming squarer with jowls falling off our jaw. Our temples thin, our brows droop, our upper eyelids become heavy with excess skin, fat pooches out from our lower eyelids, and our lower eyelids become distinct from our cheeks. The red part of our lips thin, the corners of our mouth droop, our neck muscles separate and elongate. Our face and neck lose the angularity of youth.
A facelift addresses many signs of aging by repositioning soft tissues, tightening the supporting structure of those soft tissues, and removing excess skin. A facelift is not meant to announce that you have had work done but rather to give you the added confidence that comes with vibrancy, youthfulness, and athleticism.
There are several types of facelifts that can address many concerns and signs of aging, including:
Several variations of facelift surgery exist that address different anatomic areas and employ techniques best suited to the individual patient. A brow lift is occasionally referred to as an upper facelift. The cheek and jowl can be addressed alone; this is called a mid-facelift. The neck can also be treated in isolation with a procedure called a neck lift! The term facelift sometimes refers to a midface lift, and other times a mid-face and neck lift are performed together.
A mid facelift addresses the cheeks and jowls. The incisions are mostly in front of the ear, which allows the soft tissues of the midface to be repositioned from near the jaw toward the cheekbone. This repositioning eliminates jowls and defines the jawline. The nasolabial folds are softened, and the excess skin of the midface is removed.
A neck lift is performed with incisions mostly behind the ear and with or without an incision under the chin. A neck lift addresses the platysma muscle, neck fat, and neck skin. The platysma muscle loses muscle tone and separates in the middle of the neck. When seen in profile, the loss of muscle tone contributes to the loss of sharp angle between the bottom of the jaw and the neck; the tissues make more of a straight line from the chin to the bottom of the neck. When looking at the neck straight on, the muscle separation gives rise to the bands that go from the chin area to the bottom of the neck. A neck lift repairs the muscle separation and tightens the muscle in the front and back, which restores a youthful, angular neck.
Often there is excess fat in the neck, particularly in the middle of the neck. During a neck lift, this excess fat is removed by liposuction of direct excision. The excess skin of the aging neck is removed using the incisions behind the ears.
Facelift or Full Facelift
The term facelift is often used interchangeably with the term full facelift. A facelift is a mid-face lift and a neck lift done together and is more commonly done than in isolation. The cheeks and neck are rejuvenated by rebalancing soft tissue resulting in a youthful harmonization of the lower two-thirds of the face. Occasionally surgeons and patients will use the term full facelift to include a brow lift with the mid-face and neck lift. At Clareo, we use the terms mid-face lift, neck lift, facelift, and brow lift.
If you have been researching facelifts, you probably have come across the terms SMAS and deep plane face lifts. Each has its role in facial rejuvenation. To understand the difference, it is helpful to understand that the SMAS (superficial musculoaponeurotic system) is the same layer of soft tissue in the cheek and neck. In the cheek, we generally call it the SMAS, and in the neck, we refer to it as the platysma muscle.
SMAS facelifts either plicate the SMAS in the cheek by imbricating the parotid fascia or repositioning the part of the platysma below the ear further toward the back of the neck. The SMAS plication lifts the soft tissue of the cheek off the jaw, thus treating the jowls, while the platysma plication helps tighten the neck making it more angular. SMAS facelifts can also make an incision in the parotid fascia to elevate the soft cheek tissue off the jowls.
Deep plane facelifts dissect beneath the SMAS and platysma muscle to free, elevate, and reposition the soft tissues of the cheek and neck. Both SMAS and deep plane facelifts are often combined with the repair of the platysma muscle in the midline of the neck. This is done through an incision under the chin and treats the bands created by the platysma muscle as well as tightening the muscle to give a youthful and angular appearance of the neck.
At Clareo Aesthetics, we perform both SMAS and Deep Plane facelifts and will discuss the relative benefits of each with our patients. However, we often prefer the natural-looking results and longevity of the deep plane facelift.
Procedures are often combined to optimize results and minimize downtime and cost. Blepharoplasty is the most common procedure combined with facelift and neck lift surgery. However, Dr. Tantillo takes a conservative approach to cosmetic facial surgery and will never recommend additional procedures beyond the scope of what the patient requires to enhance their appearance. Everyone at Clareo Plastic Surgery places great importance on obtaining a natural-looking result that fits with the goals each patient hopes to accomplish with cosmetic surgery.
Blepharoplasty (Eyelid Lift)
Blepharoplasty is the second most common complementary procedure to facelift (second to fat grafting). Both the upper and lower eyelids can be addressed depending on the individual patient. An upper blepharoplasty removes the excess skin weighing down the upper lid, making people look tired, angry, or disinterested; the fat bulge often present in the upper eyelid near the nose is also treated. A lower eyelid blepharoplasty removes the fat bulging out from below the eye as well as the excess skin of the lower eyelid.
Patients whose brows are heavy or flat can have a brow lift at the time of their facelift. A brow lift is performed through an extension of the facelift incision to raise the brow and give the brow an arch.
With aging, the fat in our face not only droops due to loss of support but also loses volume. Therefore, to comprehensively address the aging process, your Clareo surgeon will often perform fat grafting at the time of a facelift. Fat is removed from another part of your body using gentle liposuction, prepared in the operating room, and injected into the face much the way fillers are. The location and amount of grafted fat are individualized, but common areas to treat are the cheeks, temples, nasolabial folds, and lips.
As a side note, many Clareo patients have facial fat grafting as a stand-alone procedure and an alternative to off-the-shelf filler. Fat is longer lasting than commercial filler, is often permanent, and for patients restoring volume in multiple areas of the face, it can be much more economical than commercial filler.
Most people think of the lips as being the red part of the lip; the part one puts lipstick on! However, anatomically the upper lip is defined as the tissue from the bottom of the nose to the mouth; the upper lip is the skin and mucosa (red part) that we see. As we age, the lip mucosa loses volume, and the upper lip skin elongates. Removing the excess skin of the upper lip is done by hiding the incisions in the base of the nose and known as a lip lift. A lip lift can be combined with a lip augmentation which involves placing fat or filler into the mucosa portion of the lip.
Anyone who is in good overall health and is bothered by the changes seen in their face over time may be a candidate for a facelift. Patients need not wait until the aging process is advanced.
Many patients prefer to address the aging process earlier with more subtle results. Patients in their forties can be good candidates for facial plastic surgery. Eligible patients should abstain from nicotine use for at least thirty days before and three weeks after the procedure. Studies consistently show that nicotine use impedes healing. If you are a smoker that is interested in a rhytidectomy or other cosmetic surgery, it is in your best interest to quit nicotine products well in advance of the procedure. Quitting smoking also helps patients age more gracefully, protecting the investment they have made by choosing to have cosmetic facial surgery. Talk to our Boston facelift team to find out more.
Facelift Recovery And Results
A facelift can be performed as a one day surgical procedure; however, many patients spend the night in the surgery center after the procedure. A facelift can be combined with other procedures, most commonly a blepharoplasty.
Downtime after facial cosmetic surgery is approximately two weeks. Patients should plan to minimize public appearances for at least ten days and avoid strenuous activities for four weeks after the surgery. Sedentary workers, patients that work from home, or those with careers that involve minimal physical exertion may resume work in as little as two weeks after surgery. Patients are generally comfortable with face to face interactions with coworkers and customers three weeks after surgery. More physically demanding careers may require additional time off work. Once recovered, patients will enjoy a more youthful appearance that takes approximately ten years off of perceived age.
You will see results immediately after surgery. Swelling is a normal response to surgery and will largely resolve in three to four weeks after surgery. Bruising can appear after surgery and if present will resolve within approximately ten days, although each patient heals at a different pace. As the swelling resolves and the incisions heal, the final facelift results become more visible. At Clareo Plastic Surgery, we strive to deliver the best facelift Boston has to offer. In just a few short weeks, patients can enjoy the full result of surgery with a rejuvenated appearance and the improved confidence that comes along with it!
After your facelift, you will no doubt want to keep your rejuvenated look and age gracefully and slowly! A skincare regimen that includes moisturizer, sunscreen, exfoliation, and a gentle acid is the daily foundation for the longest-lasting results. You will likely wish to keep up with neurotoxins on a regular basis, and you may occasionally wish to add filler injections. Radiofrequency microneedling stimulates collagen production and healthy skin. Broadband light (BBL) and intense pulse light (IPL) treatments can also keep your skin looking healthy.
Because Clareo offers the full spectrum of facial rejuvenation, your surgeon can discuss non-surgical techniques of facial rejuvenation. Neurotoxins will reduce facial lines due to muscle animation. Dermal fillers and autologous fat grafting can restore volume to the face. Radiofrequency can stimulate collagen and tighten skin and underlying tissues.
To be a candidate for a facelift, you need to be in good overall health. Any medical conditions such as high blood pressure and diabetes need to be well controlled. You should be at a healthy weight and maintain a healthy lifestyle. You should have a skin care regimen that you adhere to and includes moisturizer and sunscreen. You should not smoke; if you are a smoker, you need to be free of nicotine for thirty days prior to surgery. If you are prescribed blood thinners, you will need to be able to, at the direction of the physician prescribing the bold thinners, pause taking them around the time of surgery.
Good candidates have realistic expectations from surgery and want to achieve a more youthful and vibrant appearance rather than an overdone, tight appearance. You will need to dedicate time to recovery after surgery. Depending on what type of work you do and any other procedures you may have done at the time of your facelift, you should plan for two or more weeks out of work and six weeks of no strenuous activity.
You should maintain a healthy lifestyle and prepare for the recovery period after surgery. Your Clareo team will review your medical history and your prescription and over-the-counter medications. We will advise you which medications to pause before surgery and when to resume them afterward. Some patients will require an updated history and physical examination from their primary care provider as well as blood tests and an EKG.
You will receive detailed instructions on your post-operative care to review before surgery. Before surgery, your Clareo surgeon will prescribe any medications you need so that you can fill them and have them ready for you after surgery.
Your surgery will take place at a surgery center with a full staff of anesthesiologists, anesthetists, nurses, and scrub technicians to care for you. You will have received your pre- and post-operative instructions prior, which include fasting after midnight (unless you are instructed to take a medication with a sip of water). You will typically arrive at the surgery center early in the morning. Your surgery will take four to six hours, depending on what complementary procedures you are having. You will be ready for discharge to home approximately an hour to an hour and a half after the completion of the procedure.
Immediately after surgery, you will be cared for by our post-operative team at the surgery center. You will be discharged from the surgery center in the care of a family member or trusted friend. You should have someone stay with you for at least the evening of surgery. Your Clareo team will see you the day after surgery to check on you and change your bandages. Your sutures will be removed five to seven days after surgery. You will be swollen the first days after surgery, and some bruising is not uncommon. You should anticipate approximately ten days of social downtime; by the tenth day, much of the swelling and all of the bruising will have resolved.
You will continue to heal, and the subtle swelling present for two weeks will resolve within the first three months after surgery. Your scars will improve and fade the first year after surgery. The changes of a facelift are permanent, although the aging process marches on; therefore, maintaining a good skin care regimen and continuing with non and minimally invasive treatments will keep your results optimal.
The location of the scars depends on the technique your Clareo surgeon employs for you. Regardless of the technique, your Clareo surgeon will make every effort to locate the incisions and close the skin in ways to make the scars as inconspicuous as possible. Once fully healed, the scars are almost always difficult to see and unnoticeable at a conversational distance.
A well-done facelift restores youthfulness and confidence. Patients have a more vibrant, athletic, and healthy appearance. A facelift is a powerful tool for facial rejuvenation. While we now have many treatments to keep people looking youthful, facelift remains the cornerstone and gold standard of aesthetic facial treatment. A facelift offers the most natural and long-lasting facial rejuvenation because the surgeon can directly address the consequences of the aging process. Among other things, a facelift gives:
Schedule Your Boston, MA, Facelift Consultation at Clareo Plastic Surgery Today
At Clareo Aesthetics, our Boston plastic surgeons serve men and women in Newton, Needham, Brookline, as well as the Greater New England area who desire private, personalized care in a luxurious environment with help from our prestigious medical team. Call (617) 221-4865 or chat with us online to schedule your private facelift consultation at Clareo Plastic Surgery today.
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At Clareo Plastic Surgery, our cosmetic specialists are ready to help you achieve your goals with the most advanced treatments the cosmetic industry has to offer. Contact us today to take your first step toward a more beautiful you.