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What areas are treated during Face Lift surgery?

My patients often ask me what areas are approached during facelift surgery. I find that this is easier to explain if we divide the face into the three known aesthetic areas. The UPPER THIRD area is encompassed by the forehead, the MIDDLE THIRD extends from below the eyebrows to below the nose and encompasses the nose, eyelids and cheeks. The LOWER THIRD extends from below the nose to below the chin and includes the mouth lines and jowls.

Facelift surgery in most surgeons’ consideration encompasses the lower third area. Again, this is the area below the nose, including the mouth lines and jowls. Most surgeons will approach the jowls and the neck to various extents. Few will raise the midface (middle face or cheeks). Doing so improves the mouth lines and jowls more effectively. It raises the cheeks rejuvenating this area of the face which is an area which sags with aging.

The midface area or the cheeks has been neglected in the past. This area is lifted during our Active Facelit. To do so requires that the cheek mound be lifted as an independent unit during the facelift procedure. If you were to pull up and to the side on your cheeks, you can notice that doing so exerts a greater pull on the mouth lines than solely pulling on the lower face alone. To do so however requires a surgeon well versed in facial plastic surgery, most particularly one who is Board Certified in Facial Plastic Surgery. Most facelift surgeries performed in the past and even today do not include the midface since it requires expertise in facial surgery as posessed by Board Certified Facial Plastic Surgeons.


The duration of a facelift is dependent on many factors five of the most important are:

1. How old is the person seeking the procedure.
As we age the skin tends to lose collagen, elastic fibers and fat, another words it atrophies, becoming thinner and loosing elasticity or snapback. Therefore it will stretch and sag soon thereafter. I recently saw a close picture of Camilla, Prince Charles’ wife. She had a facelift performed prior to their wedding. I could tell that her neck and jowl sagging had returned five years later.

2. What is their lifestyle.
Certainly a person who smokes, drinks excesively as well as leads a stressful lifestyle cannot expect a long lasting result. I would certainly inform that person he or she is not a candidate.

3.What type of facelift is performed.
A person in their early to mid forties will need a much lesser facelift than someone in their sixties to seventies. These are the candidates for one of the various types of minilfts. Today minilifts have been popularized and many surgeons have given a name to their variation but it is still basically a mini lift, this was the first type of lift performed back in 1940.

Today’s minilifts have been substantially improved by approaching the underlying facial musculature which lies inside a sheet of tissue called the “SMAS”. By pulling up and back on this sheet the face is “lifted”. The skin is then softly draped over this tightened and lifted musculature sheet, thus providing for a soft natural look. And in this way avoiding that tight “windswept” look.The incision for this lift is limited to and in our practice hidden virtually invisibly within the ear lobe. Someone in her sixties to seventies will need a more extensive lift so as to include a neck lift as well as a cheek lift. Some fat liposculpturing will likely be needed in the neck and the jowl area.

I see many people in my practice who are in this age and have read about the minilifts. They come in asking for a lift but with the incision not extending behind their ears. Doing so would limit the improvement possible to their neck. No one wants to look pulled, different or have a surprised look. Of course, in our practice we want all of our patients to look natural, like themselves but with a soft more youthful look.

4. What care is excercised after recovery Just as you need to care for and maintain your car, you must provide care for and protection of your skin. Again, good habits, avoid liquor, sun and smoking as well as stress. Also good cleansing and moisturizers (here the least expensive are better, olae vera etc).

5. Qualifications of the surgeon performing the surgery Last and most important, the surgeon should be Board Certfied in Facial Plastic Surgery. This is indicative of the surgeon having been verified to have extensive facial surgery experience and passed rigorous testing in this area.

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