Surgical facelift treatments are back and even better. Despite the wide popularity of non-invasive treatments like Botox and fillers, many people are turning towards the permanent benefits of a facelift surgery to beat the clock.

Aging of the facial skin is something that everyone experiences with the passing of time. But a greater consciousness about the possibilities of having fresh and youthful skin has developed in a big way in our fitness-oriented society. Facelift is a veteran anti-ager cosmetic treatment that tackles loose, sagging and puffy skin of the face and neck.

It comes as no surprise that this surgical procedure has fans even amongst the younger people. Many in their 30s inquire about facelift treatments. But facelifts are complicated cosmetic procedures and require a great deal of experience and expertise on the part of a plastic surgeon.

To help you understand the smallest of details about this procedure, Dr. Joel Kopelman spoke to Dr. Laxmeesh Mike Nayak on Beauty Doc podcast. Dr. Nayak is a nationally and internationally renowned plastic surgeon and is also an active member of American Academy of Cosmetic Surgery and the American Academy of Facial Plastic and Reconstructive Surgery.

Here’s everything you need to know before getting a facelift.

Who is a good candidate for a facelift surgery?

Lots of people think facelifts are only to fill up the fine lines and wrinkles in the face. But when we say facelift, Dr. Nayak says, 

“A facelift’s main goal is to correct the sagging in the lower face and neck. It does not erase every little fine line or flaw. It’s a surgical procedure to remedy sagging in the jawline and neck. For other skin related signs of aging like winkles, there are different options for treatment.”

So who is a candidate for a facelift procedure?

Dr. Nayak says that, ““The window for a good facelift opens when there is enough facial improvement or correction to be made. The need for a facelift does not always stem from aging issues. A person at 30 may need a facelift, but one at 70 might not. It has a lot to do with the state of mind a person is in, and which affects one’s appearance in a big way.”

A person who is thinking of getting a facelift done has to be healthy enough physically to undergo this surgery. Add to it the process of going through the recovery. Dr. Nayak also says that “patients should be  mentally ready for the downtime that such a surgery requires. A good facelift can take you back a couple of weeks. But when you recover, it will turn you back twenty years so it’s worth the trouble.”

Factors Directly Affecting Facelift Results

There are some medications, lifestyles or health conditions that can directly affect the recovery from a facelift surgery. A smooth recovery and great results depend on many factors like BMI levels, underlying health conditions, medications and lifestyle choices. 

Although it is true that the absence of these conditions does not guarantee that there will be smooth recovery. Nonetheless, it is important to eliminate some obvious risks. Smoking is one such risk. Because it changes and reduces blood circulation to the skin, it is a double whammy when it comes to facelift surgery.

Dr. Nayak says, “During a facelift, I am dissembling parts of the face and not just tightening the upper layer of the skin. And then I have to put it back together meticulously. For great facelift results, it’s important to have a good blood circulation. For example in the case of patients who smoke, the blood circulation is lower than normal. This can affect the recovery process badly. During anesthesia also, they may have bleeding complications. ”

Plastic surgeons also know exactly how much skin should be lifted in order to have great results with minimum bruising. In a facelift surgery, the degree to which the skin is lifted off the foundation of the face affects the results.

The more you lift it off the facial foundations, the more the skin depends on the supply of blood from very tiny, little pipe-like capillaries. If you only lift it off ½ an inch, the capillaries have to carry blood for ½ inch. If lifted off more from the foundation, the capillaries will have to do greater work to circulate the blood in the skin. Because blood circulation is lower in the bodies of those who smoke, it can cause a lot of wounds and scars during recovery from the facelift surgery.

Complex facelifts: the neck as the site of aging

Facelift involves tightening and enhancing the loose skin around the jaw line and the neck. This is because loose folds of skin on the neck are some of the most obvious signs of aging. Someone may have a great skin tone without too many lines, but still have a heavy neck. For plastic surgeons, such cases are actually the tough ones! 

Dr. Nayak who is an authority on facelifts explains this in simpler terms. He says, doing facelifts involves three main steps;

1. Sculpting unfavorable fullness
2. Replacing it with favorable fullness
3. Skin tightening.

“The analogy can be made with belly fat. If there is a big belly, no amount of good skin can hide that. So just treating the skin will not reduce the fat or size of the big belly. In such cases, I prefer to do what is called a deep neck lift.”

A deep neck lift is a surgical procedure which gives a stunning reduction of loose skin under the neck and lower face. Dr. Nayak says, “what sets this technique apart is that it allows plastic surgeons to truly sculpt the foundations of the neck. And not just the upper layer of loose skin. That part of the process is just fine tuning done at the end of a neck lift. Deep neck lift gives a visibly sculpted look to the jawline and tightens up the skin according to this newly shaped neck.”

Facelifts have got better with time. 

Traditionally facelifts involved liposuction. There was much extracting of fat from the skin which was thought to release the tight muscular structure underneath the loose layer of fat.

Next the facelift procedures evolved to focus on tightening both the muscle and the skin. The facelift procedure remained like this for a long time until such complex procedures as deep neck lifts have come which have got some amazing reviews from patients wanting to get more definition to their skin and neckline. The facelift surgery has undergone a major makeover and it is this too which has cause the re-entry of this veteran procedure back into the beauty world.

The secret behind a Great Neck Lift

According to Dr. Nayak, “the key to doing a good neck lift surgery is to surgically resculpt the foundation of the neck.”

Describing his own approach to this complex yet rewarding process, he says-

“I generally have a target shape in mind for my patient’s jawline and the neck area. For this very reason, I don’t do liposuction (extracting the upper layer of subcutaneous fat under the skin) at all. I want to leave that cushion of fat intact, because it is this upper layer of fat that keeps things looking natural.”

What to Expect During The Actual Procedure

During the procedure, the plastic surgeon carefully lifts the skin and muscles of the neck and removes extra skin and fat for sculpting from different layers under the platysma which is the midline muscle in the neck. Sculpting the underlying muscles does not affect the functionality of your jawline or neck.

But Dr. Nayak also says that there are some risks involved in this complex procedure. He says, “the risk lies more in sculpting the layer under the salivary glands.” These are the glands which help release saliva in our mouth. The salivary glands are extremely vascular. This means that they have a large flow of blood through them. 

He says that “sculpting the salivary glands during a neck lift is very challenging and comes with great responsibility.” After this long and complex process of working on the different layers of the skin, Dr. Nayak ties up everything back to how it was and in a large number of cases tries to preserve the uppermost layer of subcutaneous fat as a natural cushion to the skin.

Potential Risks Of Deep Neck Lift

But like all surgical procedures, deep neck lifts also come with potential risks. Part of being a good patient is to learn about the risks involved with any particular beauty procedure you want to get done.

There are many good surgeons who have written cautionary papers on doing bad neck lifts. Some of the risks could be nerve injury in the neck or the patient may develop fluid in that area. Since it touches upon many complex vascular organs, bleeding in a confined space in the neck is also a potential risk. 

But one big risk with deep neck surgeries can be the problem with drains.

In order to drain out any fluids or some fat that comes out after a surgery, plastic surgeons often put drains in the neck which is usually removed in 5 days. But leaving the drains in can develop excessive fluid in the area where the surgery took place. This may not be so good for the patient.

Talking about using drains, Dr. Nayak however says that “the bruising in any part of the neck in his experience of doing neck lifts was much less than when drains were not put. The recovery process is certainly way better when drains are put for 5 days.”

After Your FaceLift

After the surgery your neck may feel tight. There may also be some bruising. It normally takes two weeks for the bruising to disappear. Your stitches can come out in 5 to 10 days.

Downtime required for face or neck lift surgery is longer because recovery can take several weeks. In the meantime, it is very important to follow your surgeon’s post-surgery instructions to reduce swelling and discomfort.

Despite the universal disapproval of the downtime needed for facelift surgeries, there is a huge spike in the popularity of this procedure because of the promise of permanent results. Many people would rather spend money on one facelift or mini facelift for long lasting results than spend thousands on fillers and botox every six months.