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A Smooth, Fresh, Younger-Looking You

Facialplasty, Facelift Stamford, Connecticut – Plastic Surgery

A facelift (facialplasty) is a procedure designed to counteract the effects of aging on the face. This includes the gradual sagging of facial skin with deepening "smile lines" from the nose to the corners of the mouth, as well as folds from the corners of the mouth to the jaw and the gradual appearance of jowls. Also visible is the progressive sagging of the skin under the chin and along the anterior neck, accompanied by the appearance of parallel "bands" or webs at the angle between the neck and the jaw. While improved by a facelift, secondary fine skin wrinkling over the upper and lower cheeks from the cumulative effects of a lifetime of sun exposure are not completely eradicated.

The operation involves an incision that begins just above the ear, along the hairline, and extends downward in front of the ear and terminates behind the ear in the scalp above the hairline. An additional small incision is made under the chin.  Through these incisions, the superficial muscles of the neck and the tissues over the cheeks with which they blend are suspended and tightened. The overlying skin of the face and neck are then repositioned, thereby resulting in a "two-layer" facelift. This provides a superior and long-lasting result.

I feel that a facelift is one of the more powerful procedures offered by Plastic Surgeons.  Years of facial aging can be wiped away in a single operation.  My taste is to resuspend the tissues in layers that make the overall result more natural and youthful without giving you a surprised or tight appearance.  The best facelift, in my opinion, is one that is accompanied by comments like "you look great...what did you do?" or "what are you using on your skin?"  A carefully planned facelift pays attention to how the aging process has affected the deeper soft tissues of the face and asymmetries that have developed over the years as a result of facial expression. 

This procedure is done on a day surgery basis, meaning that you can enter the ambulatory surgical facility in the morning, and leave for your home later in the day.  A gauze wrap dressing and small drain tube are often used and removed the morning after surgery.  The recovery involves bruising and swelling lasting 10 - 14 days.  Small stitches are removed by twelve days after surgery. 

Fat grafting or fat transfer can be added to a facelift to help "volumize" the aged, hollowing face.  We have learned over the years that lifting the deeper layers of the face, which include fat and muscles, improves the results of facelift surgery by filling certain areas with these tissues.  A good example lies in the appearance of our children and babies.  Look at the beautiful, round, full character of their "pinchable" cheeks.  The aging process takes this away and leaves a more flattened topography to our cheeks.  During a facelift, sutures are used to resuspend sagging fat/muscle up to their original location making the face look less rectangular and more heart-shaped.  If we need even more volume to treat an aged face, I use fat transfer.  In this procedure, fat is harvested from the abdomen or sides, treated, and reinjected through very small incisions into hollow areas of the face.  Typical sites I treat with fat grafting include the cheeks, nasolabial folds, and lower eyelids.  Another option when a patient needs more volume in their face is to use fillers like Juvederm, Radiesse, etc. 

Fat transfer is an exciting area of research these days.  We are attempting to understand the way in which the fat survives.  One theory is that adult stem cells are carried along in the transferred fat and then divide to form new cells in their new home.  If that is the case, then the stem cells may also be capable of forming other tissues such as skin, which would be a way to further improve aged skin.  In other words, we would not just be volumizing the deeper layers of the face, but also improving the quality of the overlying skin.  Another application of fat stem cell technology is in reconstruction of injured or lost tissues such as in a mastectomy.  As of now, fat transfer is an excellent way to add volume to the face.