Lower Facelift

(Lower Rhytidectomy)

facelift smoothes loose skin on your face and neck, tightens underlying tissues and removes excess fat thereby correcting the visible signs of aging. Deep cheek folds, jowls, lax skin on the front and sides of your neck as well as the cord-like structures in your neck may be successfully addressed in this fashion. Traditionally, facelifts were reserved for older patients and regarded as a way to “repair” an advanced aging deformity. But today, many patients are requesting procedures to rejuvenate the face at a younger age, all with the goal of maintaining – not regaining – a youthful appearance.

There are many variations to the facelift procedure and the placement of incisions associated with each. Dr. Sherwyn believes in performing quite a thorough procedure attending to the cheek, jowl and neck regions as the individual's needs require. All too often a limited approach to these areas is taken falling short of what is both desired and required. Hence, it is customary for Dr. Sherwyn to reposition the deeper tissues as well as the facial skin in order to restore a more youthful contour to the face.  Suspension of these deeper tissues, referred to as the submusculoaponeurotic system, or SMAS, provide a more natural appearing lift that lasts longer as it addresses the foundation along with the skin. Furthermore, in so doing, tension is diverted from the skin to this SMAS layer and inconspicuous, aesthetic lines of closure are more certain. In addition, a comprehensive evaluation and management of the neck is essential in order to achieve successful rejuvenation. Too often the neck is not addressed directly, centrally, but rather is addressed laterally or from the side, thereby failing to perform a midline platysmaplasty and eliminate the cord-like structures which typify the aging neck - as a result, the neck is not rendered as clean or crisp as possible. Though these procedures are quicker and easier to perform with faster recoveries, sacrificing several days of recovery for several years of result is not good math. In those instances where a platysmaplasty is not performed, it is not uncommon for patients to present with a recurrence of neck and muscle laxity. Hence, Dr. Sherwyn will often reposition the entire skin envelope of the neck in concert with removal of excess fat and muscle tightening, or platysmaplasty.

A recent trend in New York City (NYC) today is the minimally invasive, or “lesser”, facelift. One of the reasons for the increased popularity of these lifts is the significant media hype that is so pervasive in our society today. Many consumers equate new with better, which is simply not the case. These smaller lifts too often are performed on patients that should have had a more substantive procedure. Herein, the patient attains sufficient improvement but does not realize the benefit of the best facelift. So-called short-scar lifts, popular today as wellare appropriate on some patients, but at the same time, again, they do not comprehensively address the average facelift patient. Most proponents of mini-lifts and short scar procedures view the fact that they can be completed quickly as an advantage to both the patient and surgeon, but in reality, this rushing through the procedure is the typical source of little, if any, meaningful and sustained support from deep-layer tissues and low quality, poorly situated and poorly concealed scar in many cases. Patients are often disappointed because they were promised a maximum result with minimum surgery and their goals were not realized.

A number of adjunctive procedures may be performed simultaneously with a lower facelift and include brow lift (upper facelift), blepharoplasty, and a number of resurfacing techniques for periorbital and perioral rejuvenation. In addition, facial aging, particularly in the midface or central oval of the face, has been shown to involve a loss of volume. Autologous fat transfer has been successfully used as a means to address this loss of volume. Besides restoring volume, studies suggest that adding fat back to the face may also improve skin texture and tone.

It must be the goal of every facelift to conceal each and every incision. For what has this procedure truly accomplished if a patient becomes burdened, if not fettered, by unsightly, visible scars. Individuals who present in consultation for this procedure are told as a matter of record that they will be able to wear their hair in a ponytail or any style they so choose without any evidence that they had undergone facial rejuvenation surgery. Toward this end, incisions are placed along the margin of the ear as opposed to in front of the ear with attention given to recreating the normal architecture of the ear at the procedure's completion. Attention, too, is given to the location of the sideburn, the location of the incision behind the ear and the quality of the resultant line of closure.


For those individuals who have undergone prior facial rejuvenation surgery elsewhere and who are left with the stigmata of conspicuous scars and malpositioned hairlines much can be done to improve if not eradicate these unsightly sequelae. This office has been quite successful in this regard both with respect to enhancement of existing scars as well as sideburn and hairline reconstruction.

Whereas the results of a facelift do not last forever, in another sense the effects are permanent; years later, your face will continue to look better than if you had never had the procedure.

Ultimately, it is incumbent on surgeons performing facelift procedures to remember that it is someone’s face we have been entrusted with and that it deserves our best effort, not a compromised or half-hearted one.

To learn more about the Facelift procedure offered by New York City (NYC) plastic surgeon, Dr. Sherwyn, please contact us today.

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