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 Have you been considering rhytidectomy in Atlanta? Rhytidectomy is the technical term for a face lift. When most people think of surgery on the face, they think of a face lift. I have heard it described by patients as the tool to correct any aging abnormality of the face. In this section I will describe four different approaches to face lift surgery and use terminology that I believe accurately describes the procedures. This is a very confusing area for most of us because different physicians advertise different procedures, which all sound great, but unfortunately, often they fail to deliver the result. In general, if a true short cut to achieving the ultimate face lift result with limited down-time existed, we would all be doing it.
The Truth about a Face Lift Atlanta
True face lift surgery should be called a cheek, jowl and neck lift as all three areas are addressed with this procedure. It can dramatically enhance facial contour, tighten the neckline, ease the deep (melo-labial) folds adjacent to the mouth and remove sagging skin. The rejuvenation starts just below the lower eyelid and encompasses the entire lower two-thirds of the face. Face lift Atlanta surgery can be performed in different layers or planes. The three most common planes are the superficial (over the SMAS fascia), the deep (under the SMAS fascia) and the subperiostial, which is at the level of the facial bones. The superficial plane is the traditional plane for face lift surgery and produces a very natural lift. The deep plane provides one central advantage - active repositioning of the cheek (malar) fat pad. As we age, the fat pad sags and creates worsening of our aging characteristics. Repositioning the fat pad to its native location improves the appearance and prominence of the cheek bones while reducing the aging appearance of the tissue below. In general the deep plane lift is more aggressive, but the results are equally natural in their appearance. The subperiostial lift allows active repositioning of the entire face, and most be respected as over pulling can result in severe facial contour abnormalities. At the Atlanta Center for Facial Plastic Surgery, we use a combination of these techniques individualized to the patient's needs. In general the midface is approached either in the deep or subperiostial plane; while the jowl and neck are addressed in the superficial plane. Although most people will go back to work in two to three weeks, it takes a full six weeks to truly heal from this procedure
A very popular face lift which has been called many different names is the "mini," "quick," "S," and/or "band-aid" face lift. We call our version of this type of facelift the SPA LIFT because we incorporate improved skin care to protect the longevity of the result and laser treatments of the wounds to improve their healing. This face lift predominantly addresses the neck, jawline and jowl; little change is appreciated in the upper cheek and melo-labial folds. The dissection plane is superficial, and the incision and dissection are shorter than in the traditional face lift discussed above. The true key to this procedure is that sutures are placed under the skin to tighten the tissues. Without these sutures the results of the face lift will not last. The advantage of this lift is that it can be done under local anesthesia with mild sedation and has a significantly shorter recovery period. Most individuals undergoing this lift will be able to return to work in days and truly look excellent in a couple of weeks.
The Midface lift by itself is a relatively new concept in facial plastic surgery. It can be accomplished by two different approaches. The first approach is to do the top half of a deep plane face lift. This involves an incision, which starts in the hairline and comes down to the bottom of the earlobe but does not go behind the ear. A deep plane lift then addresses the elevation of the cheek fat pad and gives improvement to the melolabial folds (the deep lines that frame the mouth) and the jowl. The most change is in the midface with less change in the melolabial folds and jowl. The second approach is from above with the endoscope. Through an incision in the hair over the temple, dissection is performed down onto the face, and in the subperiosteal plane the tissue and the fat pad are released so that they can be pulled upwards toward the incision. This pull not only lifts the fat pad but also drags the melolabial fold and jowl superiorly. The major negative with the endoscopic Midface lift is the pull adjacent to the outside of the eye. Patients will often note that their eye appears more Asian - this effect disappears as the tension relaxes over the first six to eight weeks. The huge advantage to the endoscopic approach is no visible incision but yet a very powerful change and result.
The last variation of face lifts that we do at the Atlanta Center for Facial Plastic Surgery is a neck lift. This is accomplished with an incision, which starts at the tip of the ear, then wraps behind the ear and into then goes into the hair. The surgery is done in the superficial plane and recreates a tight neck line. Sometimes a third incision under the chin is needed to remove fat in that area.
When face lifts are overdone, the face looks pulled or "tight," but when done correctly, the patient is rewarded with a rejuvenated, natural look. This surgery is perhaps the most powerful that facial plastic surgeons have to reduce the signs of aging. This procedure can be performed alone or can be combined with other aesthetic surgeries such as brow lifting, eyelid surgery and/or nasal reshaping.
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