Facelift in San Francisco, California

There are two popular facelift procedures, a “SMAS” lift and a “deep plane facelift,” and both offer excellent, natural looking results. Your plastic surgeon recommends the technique that is best for you based on your personal aesthetic goals, anatomy, and degree of correction, as well as the surgeon’s expertise in both techniques.

The SMAS and deep plane lifts deal with the SMAS layer in distinct, different ways but studies have shown that there are no major differences between the two procedures in patients under the age of 70 (even when compared over 10 years).

SMAS Facelift

A superficial musculoaponeurotic system (SMAS) facelift targets the lower two thirds of the face, including the cheeks and jowls, to address sagging skin, excess fat, and volume loss. This technique is less invasive than other options, and the recovery time is shorter. 

The technique involves lifting the skin from the superficial musculoaponeurotic system and the muscle layer. The SMAS is then tightened (SMAS plication) or reduced (SMASectomy).

Deep Plane Facelift

For a deep plane facelift, the skin and SMAS are lifted together (not separated) and tightened. Deep plan proponents say that this procedure offers a more natural look, and the results tend to last longer.

A facelift addresses laxity in the lower face, but the surgery does have some limitations. Aging and menopause cause the skin to loosen and sag. Additionally, the supporting structure of fat and muscle starts to collapse, resulting in droopy cheeks, sagging jowls, and other signs of aging.

A facelift supports and reshapes flattened cheeks, but it can’t fix the skin’s tone or texture, hollow areas, nasolabial folds, fine lines, or age spots. A facelift also doesn’t help with any areas of concern in the upper third of the face, such as crow’s feet, dropping eyelids, or frown lines.

The age range for a facelift is typically from your mid-40s into your 80s. Candidates should have visible signs of aging, such as jowls, laxity in the face and neck, banding in the neck, and dropping in the cheek area. The person should be in good health and not have any underlying medical conditions.

Depending on the type of facelift, your surgeon’s credentials, and the surgeon’s facility, your facelift will be done in a hospital or accredited outpatient facility either under general or local anesthesia. 

If you have elected for a SMAS lift, the surgeon begins by making an incision in front of and behind the ears. The surgeon then separates the skin from the SMAS, repositions it, and secures it in place with sutures. Excess skin is then trimmed, and the incisions are closed with sutures. 

With a deep plane lift, the surgeon creates a flap on each side of the face that includes the skin and SMAS. The flap is lifted and repositioned. Sutures are used to hold the SMAS layer in the new position, and the external incisions are closed with sutures.

Depending on the technique, a facelift takes one and a half to four hours. Someone needs to drive you home after you recovery in the surgical facility for a short period of time.

After the procedure, your face is covered with bandages that need to stay in place for at least the first 24 hours. The surgeon or a nurse will remove the bandages. You will then need to care for the incisions. You won’t be able to shower until the drains are removed. It’s important to limit exercise for four weeks after the surgery.

The swelling will be most noticeable 48 to 72 hours after the procedure, and it will subside after a week to ten days. Sutures are removed after seven to 10 days. You can return to work after the swelling subsides, which is typically two weeks after the procedure.

In many cases, plastic surgeons recommend neck lifts with facelifts. The neck area is the first to show signs of aging. Combining the two procedures ensures that you have a balanced and more youthful appearance. For the neck lift, the surgeon lifts the skin from the platysma muscle of the neck. The muscle is repositioned, and secured in the new location with sutures. Typically, the platysma muscle can be accessed through the same incisions that are made for the facelift. If your skin is severely lax or the platysma muscle banding is very noticeable, the surgeon may make an additional incision under your chin.

Because each person has unique needs for facelift surgery, the cost in CA varies widely. The surgeon’s level of training and experience also affects the cost. When you go in for an initial consultation, ask for a breakdown of all the costs, including those that you can expect to incur over and above your plastic surgeon’s fee. These costs include hospital costs, anesthesia, follow-up appointments, and medications. 

Note that facelift surgery is considered to be an elective cosmetic procedure, and it is not covered by insurance.

Many advancements have been made in facelift techniques, primarily driven by consumer demand for improved outcomes.

• Treatment depth: When facelifts were first introduced as a mainstream cosmetic procedure, the techniques only involved pulling the skin taut, and trimming the excess. Modern facelift techniques now involve lifting and repositioning the muscles under the skin for longer-lasting, more natural looking results.
• Sutures: Surgeons use sutures to tighten the connective tissue and muscles to re-drape the skin without stretching it.
• Lift direction: Surgical facelift techniques used to only involve pulling the skin up towards the scalp. Modern techniques involve pulling the tissues back and up for a more natural appearance.
• Less invasive: A better understanding of facial anatomy allows surgeons to know exactly how much skin should be lifted, as well as the specific tether points to snip to minimize swelling and bruising.
• Better technologies: Many surgeons use devices to firm and lift the skin, as well as to remove unwanted fat during the surgery. This limits the size and number of incisions, and it also reduces tissue trauma that causes swelling and bruising.

The optimal age for a facelift depends on the person. Most individuals who benefit from facelift surgery are between the ages of 40 and 70, although people in their mid-40’s tend to see the best results. The goal of a facelift is to preserve the natural features of the face while correcting signs of aging.

The results of a facelift procedure fade over time as your face continues to age. Most people find that a facelift lasts between five and 10 years, but this depends on a number of factors, such as:

• Facelift technique: Typically, the more invasive the procedure, the longer the results will last. Mini-facelifts or S-lifts that are less invasive, and the results may last two to six years. The results of a full facelift may last as long as 15 years.
• Genetics and skin condition: Men and women who have darker, healthier skin with less sun damage, as well as patients who opt for a facelift before the age of 60, tend to have longer-lasting results from facelift surgery.
• Additional procedures: A facelift may be performed in conjunction with other procedures, such as eyelid surgery, brow surgery, or a neck lift. These procedures enhance other areas of the face, and the combination of anti-aging procedures tends to produce more noticeable results that last longer than standalone procedures.
• Lifestyle: Exercise, diet, sun protection, and skin care routines may prolong and maintain the results of facelift surgery.

There are six things that you can do to extend the results of a face lift for as long as possible.

1. Select a surgeon with a strong reputation. The surgeon should be board-certified with years of experience in different facelift techniques. Ask for before and after photos of past patients that are close to your age. Every provider that is listed on Anzolo Med has been carefully checked to ensure that they meet the medical requirements as set by [STATE].
2. Carefully follow all post-operative instructions. Your surgeon will give you a post-procedure schedule of instructions and appointments. Follow the instructions carefully, and attend all scheduled follow-up appointments. If you experience any unexpected symptoms during recovery, contact your surgeon right away.
3. Use a high-quality sunscreen at all times. The rate of aging directly correlates to the amount of sun exposure. Wear a hat, stay out of the sun, and use a high SPF broad-spectrum sunscreen every day.
4. Stay hydrated. Drink water regularly throughout the day, and use a high-quality moisturizer to lock in your skin’s moisture.
5. Maintain a healthy lifestyle. Take steps to prevent significant weight fluctuations (both up and down). Eat a well-balanced, healthy diet, and exercise regularly. Avoid alcohol because it dehydrates your skin. Smoking accelerates the aging process, so try to quit or cut down on your tobacco use.
6. Schedule non-invasive and minimally-invasive treatments. There are a wide variety of non-invasive and minimally-invasive cosmetic treatments that may help to slow the process of aging and prolong the effects of the facelift. Examples of effective in-office treatments include laser, chemical peels, Botox®, facial, and dermal fillers.

As with any type of surgery, there are some risks associated with a facelift. Your surgeon explains the risks in detail during the consultation.

• Hematoma – a collection of blood under the skin that needs to be drained with a small surgical procedure
• Facial nerve injury – Risk of facial nerve injury is extremely low, and nerve damage is typically not permanent