It is not unusual to have some apprehensions about facelift surgery. Facial Plastic Surgeon Dr. Anita Mandal, with expertise exclusively in the face and neck and over 20 years of experience in having performed thousands of facelifts, can put you at ease. As one of the top facelift surgeons in Florida, she focuses on delivering naturally beautiful and youthful results, without the pulled, “windblown” or stretched look that so many fear. In technically skilled hands, a facelift can restore a youthful appearance with improved definition of your cheeks as well as your neck and jawline.
With age, your face and neck start to sag due to loss of collagen and elastin as well as the effects of gravity. Although each person ages differently, the cheek and jowls migrate downwards and towards the center of your face, resulting in a more pear-shaped appearance. When young, our face has more of an upside down triangular shape with greater volume in the upper half of the face. An aging face begins to shift towards a triangular shape, appearing heavier in the lower half and more narrow in the upper part. When combined with the gradual loss of bone and fat in the cheeks and along the jawline, there is further loss of definition and youthful contours, resulting in the development of jowls and a turkey neck.
Many patients with busy lifestyles who are socially active, work or are in the public eye are keenly aware of the effects of aging and desire to look as good on the outside as they feel inside. While these days more people are pro-active about facial rejuvenation, starting the process earlier, with minimal-invasive procedures, can delay the need for more aggressive surgery. However, if you have more than mild to moderate sagging of your cheek, jowls and/or neck, you may be a candidate for a facelift. Palm Beach Plastic Surgeon Dr. Anita Mandal can perform facelift surgery to restore a vibrant, youthful look which also enhances your self-confidence.
Benefits Of A Facelift
- Lifts sagging jowls
- Defines the neck and jawline
- Tightens sagging neck
- Reduces fat under the chin
- Improves platysmal neck bands
What A Facelift Won’t Do
Many patients falsely believe that a facelift or even a full facelift will correct all of the aging in their face and neck. It is important to understand that a facelift is not a substitute for injectable filler, botox, laser, RF or other rejuvenation treatments. The primary goal of facelift surgery is to tighten and lift sagging in the lower face and neck as well as, to some degree, the cheek area. A facelift does not address the following concerns for which additional rejuvenation procedures are needed.
- Lip lines or other fine facial lines
- Frown lines between the brows, crows feet or laugh laugh lines and forehead wrinkles
- Wrinkles, grooves and creases of the lower face, such as the nasolabial smile lines and marionette or puppet lines
- Droopy or ptotic mouth corners
- Facial volume loss in cheeks, temples or under the eyes
- Heavy or sagging eyelids or eyebrows
- Poor skin elasticity
Weight Loss and Facelift Surgery
When patients, particularly those over those 40, lose significant amounts of weight, the skin of the face and neck can become loose, resulting in the need for a facelift. This skin laxity is due to loss of fat as well as to poorer “snap back” potential of aging skin. A young person’s weight can go up and down substantially with less chance of developing loose skin because of better intrinsic skin elasticity.
If you are actively losing weight, you may very well need a facelift after completing your weight loss. It is advisable, however, to hold off on having the surgery until you are at least within 7-8 pounds of your weight loss goal.
Genius™ RF / Infini™ RF is an effective way to minimize the degree of skin laxity that can result from weight loss. While a facelift gives the most productive outcome after completion of weight loss, Genius™ RF / Infini™ RF is most effective when initiated in the early stages of weight loss. Because Genius™ RF / Infini™ RF works by tightening skin, it can counter the effects of sagging that happens with weight loss. If Genius™ RF / Infini™ RF treatments are started early enough and continued during the weight loss period, it can prevent the need for a facelift due to weight loss.
Dr. Mandal typically performs facelift surgery with the patient under intravenous sedation (“twilight sleep”) or, sometimes, general anesthesia. This outpatient procedure, which takes several hours, typically allows patients to recover in the comfort of their home the same night after surgery.
Dr. Mandal camoflauges the incisions in front of and behind the ear as well as underneath the chin. Incisions are made slightly differently in men vs. women. She addresses the muscle by excising lax SMAS, then laterally repositions and sutures it to specific anchor points to give a natural contour lift to the cheek and jowl area. She removes excess fat and tightens platysmal neck bands through a submental chin incision to further define the neck angle. Overlying face and neck skin is then laterally re-draped, rather than stretched, over the newly created underlying contour with trimming of excess skin. Incisions are then closed after placing a tiny drain under the tissues and a head dressing is applied.
Sometimes a browlift and/or an eyelid lift is performed in conjunction with a facelift to rejuvenate the upper face and restore a balanced, more youthful look. When these procedures are combined, the operation is referred to as a full facelift.
After surgery, patients go home the same day with a pressure dressing around the head. For a few days, it is important to sleep at a 40 degree angle, preferably in a reclining chair or bed, to help reduce swelling. Dressings are typically removed, along with drains, on the next postoperative day. Prescription pain medications are taken until discomfort subsides. Antibiotics may be prescribed to prevent infection. Sutures are taken out in stages over the course of 7 to 10 days. At this point, bruising and swelling can be covered with makeup. You may gradually return to your routine activities over the course of 2-6 weeks following surgery. Activities such as golf, yoga, aerobics, weight lifting and pilates may require a longer waiting period. You may not color, perm or chemically treat your hair for at least 4-6 weeks until after surgery. You should avoid wearing earrings for at least 1-2 months. Once healed, the incisions are typically unnoticeable, enabling you to wear your hair short or pulled back with confidence.
A Natural Look
Dr. Mandal’s preferred facelift approach consists of repositioning the underlying SMAS layer tissues with excision of excess muscle only. She then artfully redrapes and trims excess skin. This method is key to having natural, youthful and defined facial contours and reducing the chances of an unnatural “pulled” or “windblown” appearance. The incisions are skillfully concealed within your natural wrinkles and creases in front of and behind the ears as well as under the chin. Some incisions are also hidden within the scalp to minimize hair loss and bald spots.
Complementary Rejuvenation Procedures
By the time most patients undergo facelift surgery, they typically experience aging in other aspects of the face. Addressing these concerns which are not corrected with a facelift can give a more balanced appearance. Additional procedures include:
- A browlift and /or eyelid performed at the same time for heavy eyelids or brows is referred to a full facelift. A non-surgical browlift with Infini™ RF / Genius™ RF can also give a lift to the upper face
- Botox® can improve crows feet, frown lines between the brows and forehead wrinkles to soften the upper face
- Restylane® Silk or Belotero® as well Genius™ RF / Infini™ RF can smooth out lip wrinkles
- Bellafill® – the 5 year filler, Restylane® Refyne or Juvéderm® Ultra Plus can fill deep nasolabial smile lines, marionette or puppet lines and lift droopy mouth corners
- Bellafill® – 5 year filler, Restylane® and Sculptra® can restore lost volume in the cheeks, temples or under the eyes
- Genius™ RF / Infini™ RF can help poor skin elasticity. In fact, having a facelift in the presence of poor skin elasticity increases the likelihood of an overpulled or windblown look. Pre-treatment with Genius™ RF / Infini™ RF, prior to a facelift, can help build tissue elastin and collagen to avoid an overstretched result from facelift surgery
As a Board Certified Facial Plastic Surgeon, Dr. Mandal focuses on satisfying results that are very natural looking. When it comes to the face, patients prefer quality and excellence over price. They seek her skills from throughout Palm Beach County, across Florida and a range of national and international locations. To discover your options, request a consultation online or call 561-238-0040 at our Palm Beach Gardens office.