Facelift and Neck Lift Overview
Dr. Niamtu has been performing face and neck lift surgery for over 20 years and this website represents transitions through these decades of experience. He is passionate about Deep Plane Face Lift and performs around 100 facelifts per year.
Don’t miss our Facelift Video Page for the most information.
Facelift surgery is my clinical passion and signature procedure. I do not perform body surgery my concentration is totally on the face. I have performed almost 1,800 facelift procedures. I do not perform “quickie” or short-cut procedures. There are no shortcuts for safe procedures with natural and lasting outcomes. Shortcut procedures produce shortcut results. There are so many “miracle” procedures on social media. Beware of procedures that sound to good to be true. Beware of surgeons that have names for their facelifts and beware of any procedure that claims to deliver facelift results. There is no replacement for contemporary Deep Plane procedures. Choosing a facelift can be very confusing, so always look for someone that has first and foremost, experience. Any experienced surgeon should be able to show you hundreds of before and after pictures of their work.
I perform all surgeries so there is never a doubt about whom is doing your surgery. I am a surgeon, teacher and author and I have written 5 editions of some of the most popular textbooks in the field of cosmetic surgery.
My facelift contributions are well recognized on an international basis, and I have lectured on face and neck lift surgery on six continents. I love facelift surgery and it remains the focus of my practice. I also perform the other common procedures done at the same time as facelift such as eyelid surgery, brow lifts, facial implants and more. It is possible to hide mediocre body surgery with clothes, but the face is right there out in the open for the world to see. If you don’t look good, I don’t look good. It is your face and my reputation, so safe surgery and natural results have always been my goal.
Call Today! 804-934-FACE (3223) Schedule a Consultation
What factors influence the decision to undergo facelift surgery?
- The patient’s desires and expectations and most importantly “what bothers them”
- The general health of the patient.
- The ability to take time off of work or play.
- The budget of the patient.
Patients should never be “talked into” a procedure. Remember, this is elective surgery and you should only do what bothers you. Good surgeons may suggest various procedures but should never be pushy. I provide each patient a “menu” of procedures that I think would benefit them and let them they don’t need to get everything on the menu. In the end it is up to the patient. Patients should be skeptical with surgeons that insist a procedure.
If a patient is healthy, then multiple procedures are usually not a problem and routine facelift surgery can be performed. Since we are a fully accredited surgery center, we have most of the same requirements as local hospitals and all patients receiving facelift surgery must see their physician for history, physical and appropriate lab tests (if applicable). Patient safety is our primary concern.
Deep Plane Facelifts have about a two week initial recovery. I tell patients they will be on their phone the next day and their computer in 2-3 days. Patients that have the ability to work at home can usually do this after the first week. Some of our patients occasionally return to work less than two weeks and once in a while a patient many take longer than two weeks. This is not two weeks before your class reunion! If a patient is having surgery in advance of an important event such as a family wedding or reunion, I recommend that they have their surgery 6 weeks before the big event. It is interesting that most patients want to keep their surgery a secret, while others will go back to work after a week and show off their healing surgery.
Build your life around your facelift
Time is our most valuable asset, but you can’t rush a procedure or recovery. You have to build your life around your lift. Facelift and related recovery are a big deal and patients that try to rush the process can end up with problems. You have to have adequate time to heal. A facelift is not something you “squeeze in” between other projects. “I want a facelift to look good for my daughter’s wedding next month” or “I am going on a vacation in 4 weeks and have to loo great” are not phrases of success. Many people get in front of their aging and have lifts at an earlier age. Remember, the younger you are, the better your health and the easier your recovery.
When will I look like with a facelift?
Basically, a patient is a candidate for a facelift when the jowls (excess skin under the cheeks) and neck skin begins to sag. Put simply, if you think that you need a facelift, you, perhaps you do.
To get an idea of how you may look with a facelift, lie on the floor on your back, lift your chin and hold a mirror over your face. This counteracts the effects of gravity and can simulate the basic improvements of the face and neck that can be achieved with cosmetic facial surgery.
Today’s patients frequently have face and neck lift surgery at a younger age as they don’t want to wait till they look old, to look young. In other words, they want to reverse aging changes before they come severe. In reality there is no specific age for a facelift. We do them on 39 year old patients with premature aging and 85 year old patients who are still conscious about their appearance. When patients ask me when is the optimum time for a lift I smile and say “when you can’t stand it”!
How Long Will My Facelift Last?
This is a very common question. In some respects the surgery will last forever. If I had a 55 year old patient with a twin and I performed a facelift on the patient but not the twin, the patient will pretty much always look younger because we turned back their clock.
Although we can turn back the clock, we can’t stop it, so all patients will continue to age. Most minimally invasive procedures will not last as long as more comprehensive ones. Dr. Niamtu performs deep plane facelift. This approach produces more natural results and the results last about a decade. This does not mean that on the tenth year everything falls, but simply that as we age, the tightened tissues will slowly begin to sag with time. In rare cases some patients with elastic skin or weight gain may need a touch up procedure sooner after a lift. Other patients with healthy skin and those that take care of themselves may have cosmetic results that last 20 years or longer. No one can provide a guarantee on how long any cosmetic procedure will last and many variables are involved including the patients genetics, healing and after care as well as what type of surgical procedure was performed. One thing that can be safely said is that facelift surgery in experienced hands is an excellent long term investment.
Does any of my hair need to be cut during the facelift procedure?
Absolutely not! Contemporary facelift surgeons pay extremely close attention to preserving the patients natural hairline. Dr. Niamtu does not shave any hair during facelift surgery. I encourage men to “miss a haircut” and let their hair grow a little longer before their lift. This helps masquerade the incisions in the early healing phase.
Patients need to wait 30 days after the deep plane facelift before coloring their hair, so doing it right before surgery is a good approach.
The Facelift Procedure
Most patients that present to discuss facelift surgery are apprehensive because the word “facelift” is scary. A generation ago, a facelift was much harder, took much longer to recover, anesthesia was more difficult. Patients are also nervous about the incisions and the final result. These concerns are understandable and it is easy to put their minds at ease regarding the common misconceptions regarding facelift surgery. Advances in outpatient anesthetic techniques have produced treatments with faster recovery and less complications such as nausea. Finally, the incisions are truly hidden and rarely problematic. Dr. Niamtu goes to great lengths to use the smallest incision techniques available and to make incisions that will be hidden and look natural. As for the “result”, today’s facelifts are much more natural when performed by surgeons that truly understand the face. For almost 30 years, Dr. Niamtu has limited his practice to surgery of the head and neck and has always been a “student” of the face. He understands that contemporary facelift surgery involves not only tightening, but also restoring youthful volume. It is easy to make a patient look tighter, but with modern techniques such as facial implants, fat transfer and filler injection, they can look younger and not just tighter.
The above image shows the typical Deep Plane Facelift incisions. The surgeon may choose to use the white or yellow dotted lines in front of the ear, depending on the patients individual anatomy.
Facelift incisions heal extremely well and are rarely a problem in terms of scars. If an ungraceful scar does form, it can be improved with laser resurfacing. The images below are typical of healed facelift incisions and many other examples of Dr. Niamtu’s incisions can be seen in our incision gallery .
This patient is shown 90 days after comprehensive facelift and her healed incisions are barely visible. Dr. Niamtu takes great care to perform hidden and natural incisions. This patient is shown 8 weeks after facelift with the hidden incisions described above.
Chin Implants can Enhance Facelift Results
Many patients have recessive chins which can affect the normal and youthful profile. Performing a face and neck lift on a patient with a recessive chin can lessen the positive results of the operation. A chin implant is a simple procedure that is performed through the same “under the chin incision” used in the facelift. Enhancing the chin with an implant is a very small procedure that can make a big difference on the final result. The patient shown below is a great example of how a chin implant can enhance a facelift result. Although a facelift without a chin implant would have tightened this patient’s skin, the implant allows a more normal and youthful profile.
To see many more pictures of facelift with chin implant click here
Dr. Niamtu has an extensive facelift video collection
click the above link to view Dr. Niamtu’s facelift videos.
So nice of our patient to for this review!
Some Kind Words from facelift patients
Great Review from Australia
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Since Dr. Niamtu has performed over 1,600 facelifts and performs deep plane face and neck lift his contemporary videos are here.
The videos below may be older but still full of useful information for patients considering face and necklift surgery
More information about Facelifts from Dr. Niamtu's library of articles
These are common complaints that will improve or resolve over the first days or weeks of recovery.
Dr. Niamtu discusses the art of making natural and invisible facelift incisions.
Dr. Niamtu discusses the importance of platysmaplaty in face and neck lift.
Having great facelift results with invisible scars and telltale signs has everything to do with choosing the right surgeon.
For more information about these procedures or cosmetic facial surgery in general visit www.lovethatface.com
Joe Niamtu, III DMD
Cosmetic Facial Surgery
Richmond, Virginia
www.lovethatface.com
One of our favorite patients discusses her cosmetic facial surgery experience with Dr. Niamtu. This patient underwent facelift, eyelid surgery and chin implant. It is our honor to have such wonderful patients.
For more information about facelift surgery or Dr. Joe Niamtu, III visit www.lovethatface.com
Cosmetic surgery can improve aesthetics and self-confidence and can be very rewarding to the patient and surgeon. I am so lucky to have so many great patients like the one in this video.
Joe Niamtu, III DMD
Cosmetic Facial surgery
Richmond, Virginia
www.lovethatface.com
TV commercial where Dr. Niamtu talks about removing decades of aging with Facelifts / Necklifts
This is a letter from a pleased facelift patient.
Dr. Joe Niamtu, III cosmetic facial surgeon in Richmond, Virginia discusses face and neck lift surgery options with ABC TV Channel 8 Richmond’s Matt DiNardo.
Facelift surgery is the ultimate cosmetic procedure for improving aging of the lower face and neck. Dr. Niamtu frequently recommends chin implants for facelift patients as this small procedure can make a big difference in the result of the facelift. A simultaneous chin implant can enhance the facelift by extending the chin and thus improving the profile. In addition, some patients develop a droopy chin (sometimes called a “witch’s chin”) and a chin implant can lift and support the sagging chin which greatly enhances the facelift. Browsing the pictures in the facelift pages on this site will show numerous cases of facelift with simultaneous chin implant augmentation and illustrate the beneficial effects of combining these two procedures.
The patients below had simultaneous facelift and chin implant surgery.
This is a frequently asked question and the answer is frequently no! Dr. Niamtu routinely sees plus sized patients that were told by other surgeons that they needed to lose 50-80 lbs. before having a facelift.
As long as patients are in good health, many patients who are overweight can successfully have facelift surgery without losing weight. Dr. Niamtu employs a progressive sculpting technique along with his comprehensive facelift and submentoplasty and has produced very dramatic results in plus sized patients. The fact is that many patients have much more skin than fat in their face and neck. In many plus sized patients, the face and neck fat can be liposuctioned and sculpted to slim and tighten the face and neck.
The patient above is shown before and after facelift surgery by Dr. Niamtu employing facelift with submentoplasty and progressive sculpting.
Dr. Niamtu’s procedure for facelift surgery on full figured patients has been featured in Cosmetic Surgery Times Magazine who termed it the “Diva Lift”.
Cosmetic Surgery Times 10-09Article: Dr. Niamtu on facelift for plus sized patients
Read Dr. Niamtu‘s Blog on Facelift Surgery after Massive Weight Loss
After performing almost 1,000 facelift procedures, Dr. Niamtu has been able to eliminate bandages and drains from all facelift operations. The only bandage Dr. Niamtu uses with facelift surgery is a light “collar” that fits loosely around the neck which is only required for the first night after surgery. In addition, Dr. Niamtu does not use traditional bulky drains with facelift surgery. Eliminating drains and bandages has greatly streamlined the post operative recovery for patients.
The decision to have cosmetic surgery is a big one and involves much planning on the part of the surgeon’s office and patient life. It is not a decision to rush into and experience has shown that patients that rush into surgery without the proper planning and details have more problems than patients that think out and prepare for the process.
It is somewhat different for the experienced surgeon as we do numerous surgeries every day. Although Dr. Dr. Niamtu has performed over 20,000 facial surgery procedures, each patient presents a unique recovery process due to multiple variables.
A younger patient, with numerous local family members and a supportive spouse may have a great recovery experience. She has plenty of help for transportation, post op care, errands, food preparation and spousal support. All she has to do is heal.
A different patient may be older, not have a group of friends to assist, no one to help her at home with chores while she is recovering. She may also have a family member who is not supportive as they may have been against her decision to have surgery and now have to care of her. “I told you that you should not have done this” are not words any patient wants to hear when they are recovering.
So, what is a Caregiver?
The word caregiver should not be used loosely when referring to the recovering cosmetic surgery patient. A caregiver can be a spouse, a family member, a friend, or a professional caregiver or nurse. A caregiver “gives care”. As simple as that sounds, it is a problem for many patients.
Cosmetic surgery patients can be impetuous and impulsive. They make their mind up to have surgery and jump into it without much planning forethought. When asked about a caregiver, these patients may say “oh, I am fine my daughter will take care of me or my husband will take care of me.” The problem is that her son is 18 and not very dependable; he knows very little about taking care of a surgical patient and won’t be able to take her to the bathroom or perform other personal recovery functions. The husband may be an older man or have arthritis and may have physical difficulty getting the post anesthesia patient into the car at the office and then get the patient out of the car and up two flights of stairs at home. The bottom line here is that “all caregivers are not created equal”.
Why Do We Need a Caregiver?
The level of the caregiver depends upon the cosmetic procedure performed. For instance, a patient that came to the office only for upper eyelid surgery may not require any assistance. On the other hand, a patient that just had a facelift, upper and lower eyelid surgery, full face laser and cheek implants will have a lot more discomfort, swelling; require more wound care and ambulatory assistance. A young healthy person may do well without help where an older patient can’t do it.
When a patient is healing, depending upon the procedure, some are very swollen, some have blurry vision, some may have nausea or vomiting, some may require various level of wound care and some may simply need an understanding and compassionate person for emotional support.
The best way to think of it is “who would you leave with your children or grandchildren to baby sit?” It certainly would not be just anybody; you want an honest, competent, engaging and physically able person to guard your precious family. The same goes for a caregiver. You have to have someone smart enough make decisions and dispense medications on the proper schedule. You have to have someone strong enough to assist with lifting, walking, and trips to the bathroom. You need someone mature
enough to understand the physical and emotional needs of a recovering patient and the ability to fully support them. m
How Long Do I need a Caregiver?
That is a variable question and depends upon your age, health and how much surgery you had. The short answer is usually 24-28 hours. Some patients only need a caregiver for the first several hours and then do fine, others need longer support. If the patient has eye surgery or is on pain medicine, they cannot drive to the office. You need a caregiver until you can perform normal daily functions unassisted.
Who is the Best Caregiver?
Again, most responsible adults can provide basic post-surgical support. Our office can provide nurses or non-nurse professional caregivers to assist patients from a matter of hours or days. Recovering patients should not be in direct contact with sick family members or any infections. Also direct contact with pets can provide a source of infection. You definitely don’t want to sleep with your dog while recovering from your surgery.
Who is an Inappropriate Caregiver?
Back to the baby sitter analogy, don’t trust your care to someone you would not trust to care for your children or grandchildren.NEVER lie to your doctor and say that you have a caregiver when in reality you do not. This has happened and seriously complicates the entire process.
What do We Suggest?
For smaller procedures, your spouse can probably suffice. If you are having a facelift with other simultaneous procedures, we recommend a private duty nurse or non-nurse professional caregiver for the first night.
Joe Dr. Niamtu, III DMD
Niamtu Cosmetic Facial Surgery
Like any surgical procedure all patients heal differently. Most patients require at least 2 weeks of recovery after a bigger lift. Some patients heal faster and some take a few more days.
The patient below is shown throughout her healing process after facelift and laser to lower eyelids and facial scars and is featured in the video below.
The following video follows a facelift patient through 8 weeks of recovery
The video below shows a patient 1 day, 1 week and 3 months after facelift and full face CO2 laser. Well all patients recover at a different rate, this patient is typical for facelift and laser.
The following video is a patient of Dr. Niamtu’s seen at her 24 hour follow up. She underwent comprehensive facelift with platysmaplasty, upper laser assisted blepharoplasty and full face comprehensive CO2 laser resurfacing. This is a good example of a patient with an easier recovery. Recovery is variable and some patients breeze through and others find it more challenging. Attitude, family support, preparation and understanding of what to expect can make a big difference.
The same patient is shown at 6 days after her procedure.
The patient below underwent facelift chin implant and lower eyelid laser. She is shown at 2 weeks after surgery.
The same patient is shown below at 90 days after surgery
Facelift recovery must be discussed in relative terms because smaller facelifts have smaller recovery times and larger lifts have bigger recovery periods. Also there is individual variation between patients. A patient with a small (“Weekend Facelift”) facelift may only need 4-5 days to recover while a patient with a very large facelift may need 2 weeks or more. Our average facelift is the minilift and most of these patients are able to return to work or play in about 2 weeks.
The patient shown on the left had a larger (Comprehensive Facelift) facelift and eyelid surgery and is shown 7 days after her lift. Her before and after picture is shown below at approximately one month after surgery. Not all patients have this small degree of swelling and bruising. Some are similar and some have more.
The patient below is shown 2 weeks after comprehensive face and neck lift.
To find out more about cosmetic facial surgery by Dr. Joe Niamtu, III in Richmond, Virginia, visit www.lovethatface.com
Joe Niamtu, III DMD
Cosmetic Facial Surgery
Virtually all but the smallest facelifts require a procedure called platysmaplasty or submentoplasty. This step is omitted by many surgeons as it is more technically difficult and takes more time.
If you are considering having a facelift make sure to ask you surgeon if he or she will be addressing the midline platysma muscles and submental regions. A tighter, longer lasting and more natural result will result from these important procedures. Unfortunately, some surgeons are simply lazy and do not perform them. A facelift without addressing the midline deep tissues may look fine for a year or two, but when the neck bands and sagging return, patients will wish they had this performed.
The image above shows a left sided platysma muscle. Dr. Niamtu comprehensively addresses this muscle by tightening the platysma muscle in the center of the neck (this improves neck bands and “turkey neck”) and the lateral platysma which also creates a natural appearing, long lasting lift. Submentoplasty involves tightening the deep tissues of the floor of the mouth, which is also very important to improve chin/neck aesthetics. Liposculpture involves sculpting the excess fat in the chin, floor of the mouth, neck and at the border of the jaw. Some of this fat is “bad fat” and needs removed with liposuction, while much of the fat under the skin is “good fat” and is needed for a natural result. This fat is not suctioned away, but rather is sculpted to blend in and provide youthful contours of the unique area of the chin, jaw border and neck. Over treating the fat in this region will make a patient look gaunt or cause irregularities.
The above image shows how Dr. Niamtu tightens the aging platysma muscle in the midline of the neck
We all have different sizes and shapes and some patients are better candidates than others based upon their anatomy. The position of the structures of the voice box (larynx), hyoid bone and muscles of the floor of the mouth may determine the relative appearance of a facelift result. Patients that have these anatomic structures located higher and further back in the neck (top images) are better candidates for the “90 degree neck” as there is room to move the excess skin back into an acute angle.
Patients that have these anatomic structures located low and forward in the neck (bottom images) do not have the space to pull the skin back into and even with face and neck lift, may still exhibit a more obtuse (curved) neck. The bottom line here is that some patients will get a more angled neck from facelift surgery than others and must realize this before surgery.
Patients with the more rounded necks can enhance their results by having a procedure called submentoplasty which can in some cases reduce the roundness. A chin implant can also extend the front of the lower jaw so that result is more angular.
The picture above shows the difference between neck anatomy and possible facelift outcome. The top images show a normal neck with the structures lying high and rearward. This allows the skin to be pulled back at almost a 90 degree angle. The bottom images show neck anatomy that is lower and more forward. Even when pulled tight, the neck will be less angled than the normal neck. Submentoplasty and or chin implant surgery can help this type of anatomy to have a more angular result.
The video below shows Dr. Niamtu making actual facelift incisions with Radiowave Surgery and also using a scalpel. Some patients desire to see actual surgical procedures, while it makes other patients uneasy, so only view the video below if actual surgical footage does not bother you.
Although there are many types of facelifts, Dr. Niamtu performs a multiple layer lift. This means that not just the skin is tightened, but the deeper layers as well. This type of lift is more technically difficult but the lift is superior, its results last much longer than skin only techniques.
The patient is sedated with IV anesthesia, and local anesthesia is used as well to decrease the amount of anesthetic drugs necessary. The local anesthesia also reduces blood loss and controls pain when the surgery is finished.
Like most things in life, there is no clear cut answer for this question, but doing some homework can pay off in the long run. There are several misleading myths that confuse patients. Myth number one is “only have a board certified plastic surgeon do your surgery”. Obviously, your surgeon should be board certified, but his or her specialty has very little to do with their competence and outcomes. This myth is propagated as a marketing tool for plastic surgeons. It is like saying “a Lexus is the only safe car”; we can all see through statements like this. In reality there are numerous types of competent specialists including plastic surgery, ENT, oral and maxillofacial surgery, dermatology and ophthalmology that excel at facelift surgery. The actual specialty is much less important than the experience of a surgeon. Most patients would choose a surgeon from, say a dermatologist that performs several facelifts a week instead of a plastic surgeon that performs one a month. Although there are many talented plastic surgeons that excel at breast and body cosmetic surgery, they may have very little cosmetic facial surgery experience and only “dabble” in facelift surgery. A oral and maxillofacial surgeon or ENT trained cosmetic facial surgeon are likely to specialize in head and neck surgery only.
The second myth is that “new facelifts” can be done with the same results but much less anesthesia, recovery, downtime, incisions, etc. As you browse the facelift pages on this site, you will understand why this remains a myth.
The following are some important indicators to consider when choosing a surgeon.
- Is your surgeon board certified in a specialty that deals with the face?
- Do they operate only in an accredited surgery center?
- How many facelifts does your surgeon perform a week?
- Can your surgeon show you hundreds of before and after pictures of their own work?
- Is your surgeon involved with teaching and scientific publishing on the topic of facelifts?
- Can your surgeon provide you with patients that have had facelift surgery to discuss their experience?
- Can you get in touch with your surgeon if you have a problem? Cell phone?
- Does your surgeon “dabble” in facelift surgery or is it one of the major parts of his or her practice?
Dr. Niamtu is very involved with teaching facelift to other surgeons in the USA and abroad. He teaches specialties including Facial Plastic Surgeons, Plastic Surgeons, Ocuolplastic Surgeons, Oral & Maxillofacial Surgeons, Dermatologists and other surgical specialties. Dr. Niamtu has written a comprehensive textbook about cosmetic facial surgery and facelift surgery, authored a comprehensive DVD live surgery series and has numerous publications on facelift surgery. In addition he is considered an opinion leader on facelift surgery and is frequently interviewed by cosmetic publications and TV and radio media .
My favorite surgical procedure is facelift and I am one of the busiest facelift surgeons in the state, as I will do about 90 face and neck lifts a year. The average plastic surgeon performs less than 10 facelifts per year (1). The reason I enjoy performing facelifts is that it is truly the ultimate rejuvenation procedure.
No other procedure carries the physical and emotional impact as a well done facelift. You can hide mediocre breast or abdominal surgery, but with a facelift, there is no hiding. Good facelift surgeons are busy as you can’t do poor face and neck lifting and have repeat business. My biggest source for new facelift patients is referrals from previous patients on whom I performed face and neck lifts. The mere word facelift is very confusing. You hear upper facelift, lower face lift, full facelift, half facelift and facelifts named after people or franchises. A true facelift is called a rhytidectomy which literally means to “remove wrinkles”. This procedure has been around for a century and is still the basis of a “real” facelift.
Over the past century, surgeons have attempted to manipulate the real facelift procedure by omitting steps in the hopes of making it easier or shorten recovery. The problem is that every single step of the classic facelift procedure is integral to have natural and long lasting results. If one step is omitted, then the result is affected. Like so many other things in life, there is a right way to do something and a short cut way to do something and rarely is the short cut as good as the correct way. The same thing goes with facelifts. It is very fashionable for certain surgeons or corporate franchises that advertise on TV to promote “short cut” facelifts. The TV commercials often imply that the procedure is “revolutionary” or a “medical breakthrough”. Frequently, the procedure sounds too good to be true; “no anesthesia, minimal recovery, affordable”. Remember, most things that sound too good to be true usually are. Almost all of these procedures are smaller lifts that omit two extremely important parts of face lifting. Number one is the incision in the back of the ear (figure 1). Many surgeons want to omit this part of the procedure because it is harder to do this technique and takes much more training and experience. It is
this incision that allows the excess neck skin to be tightened in a natural direction. Doing a facelift without an incision behind the ear is OK for very young patients, but even patients in their early 40’s need a bigger lift or they will have excess skin come back in a matter of a year or two.
Figure 1. This image shows the preferred incision for a true comprehensive facelift. Most of the incision is hidden in the hairline. The dotted lines and dashes indicate areas where the incision is hidden behind the ear. It is the yellow incision that is so very important in facelift surgery. Small or short cut facelifts only use the blue incision and therefor are only 50% as effective in tightening the neck and jowls.
The other frequently omitted step is the Platysmaplasty (figure 2). This important step is done by making a one inch incision under the chin and freeing up the skin and platysma muscle from the deep tissues. Then the platysma muscle is reduced and tightened with sutures similar to a shoe string. This is an extremely important procedure to eliminate the neck bands that appear with aging. Omitting the Platysmaplasty does not address the banding in the neck and the patient will still have banding or it will return in a year or two. Doing a small lift will produce small results and short longevity when compared to a more comprehensive lift. I always perform facelift surgery with all the comprehensive steps and techniques that enable a safe, natural and long lasting result.
Figure 2. The above image shows the Platysmaplasty procedure which is an integral part of all facelifts.
Figure A show the sagging and pulled apart muscles and figure B shows how they are trimmed and sutured for a tight and long lasting sculpted chin and neckline.
So, back to the Apples and Oranges. A short cut facelift cannot and will not be as effective as the classic procedure. It can’t! You cannot omit important steps and get the same natural and long lasting result. Before patients make a significant investment in money, time and recovery they should carefully research the procedure. It is imperative to know exactly you are getting done (or not getting done) and the experience of the surgeon who is doing it. If you are considering a facelift that does not utilize an incision behind the ear or does not include a platysmaplasty, beware. You are not getting the comprehensive procedure that has proven safe, natural and long lasting for almost a century.
You get what you pay for! This is not just in surgical fee, but also in recovery. A facelift that heals in several days cannot compete with a larger lift that takes two weeks to heal. That extra week may seem like a long time, but to reverse 50 years of aging, a two week recovery is not unreasonable. I have no problem with surgeons that perform short cut facelifts. Some of them are beginners and we all do that when we start out. Some of them work for corporate franchises and they have no choice on what lift to offer. I may perform one or two “short cut” facelift each year. These are always on younger patients (rarely over 42) with minimal aging.
Most patients may only have one facelift in their lifetime so it is important to know what you are getting and what you are not getting. All facelifts are not created equal. A comprehensive facelift will have a more dramatic result and last longer than smaller lifts. The recovery will be longer, the surgical fee may be slightly higher but again, you get what you pay for. Also important is who is doing the actual surgery while you are asleep? Dr. Niamtu does 100% of all the surgery from the first incision to the last stitch.
There are many examples in everyday life where you get a bargain on something, but end up with an inferior product or job that is substandard or needs redone. Our facelift fee may be higher than some offices, but rest assured that you are getting a comprehensive procedure without short cuts. You also get the experience of one of Virginia’s most experienced facelift surgeons in Dr. Niamtu as well as access to our fully accredited in office surgery center and caring staff.
They say there are no bargains when shopping for parachutes or fire extinguishers. I think your face belongs on that list.
Reference
1. American Society of Plastic Surgeons, 2011 Plastic Surgery Statistics Report.
Joe Dr. Niamtu, III DMD
Cosmetic Facial Surgery
