Beautiful, Natural-looking Results

“Aging gracefully” doesn’t have to rule out the possibility of facial rejuvenation surgery.  Dr. Pamela Henderson offers surgical experience with an artistic eye, so her patients can be confident that they will achieve a natural, refreshed look without the fear of looking “windswept,” “plastic,” or “unnatural.” In fact, face lift patients of Dr. Henderson’s Scottsdale, Arizona practice most commonly report receiving compliments that they look well-rested.

To learn more about restoring youth and vibrancy to your appearance with the natural-looking results of a face lift, contact Dr. Henderson, who proudly serves patients from throughout the greater Phoenix area, today. By dedicating her practice to the surgeries of the neck and face, Dr. Henderson has the passion and knowledge necessary to accomplish your facial rejuvenation goals.

What is a Face Lift?

During the aging process, a number of different changes are occurring simultaneously, including subcutaneous soft tissue descent, loss of skin elasticity, relaxation and shortening of the anterior neck muscles, and volume changes, such as loss of fat in the mid-face and deposition under the chin. Deepening of the folds between the nose and mouth, jowls, excess neck skin and muscle banding, facial hollowing, and a double chin are the result. A face lift, known clinically as a rhytidectomy, is a facial procedure that addresses these aging changes using techniques with varying degrees of invasiveness. The choice of approach depends upon the degree and location of the aging changes and the patient’s expectations. These include an increasing degree of aggressiveness: mini face lift, standard face lift and extended face lift.

“Mini face lift” can refer to either a procedure with limited incisions in front of the ears, or to one with limited depth and extent of dissection in the cheek region. A limited incision face lift (S-lift or short scar face lifts) involves incisions placed in front of the ear and addresses changes extending into the upper neck. As the laxity becomes more extensive onto the lower neck, the risk of skin bunching below and behind the ear when using a limited incision increases. Extending the incision behind the ear while still limiting the depth and extent of dissection in the cheek (for example, suture tightening without elevating the Superficial Muscular Aponeurotic System, or SMAS) can still be referred to as a mini-lift. For the patient with mild to moderate aging changes, who prefers a less invasive approach but still requires the full incision around the ear to avoid skin bunching , this technique can be appropriate.

A standard face lift involves elevating and tightening the SMAS layer in the lateral cheek and neck while removing excess skin. The dissection is beneath the SMAS layer unlike the mini-lift but does not extend as far into the mid-face region as the extended face lift and as a result the risks – especially of motor nerve paralysis – are reduced. This is the most common approach used for the patient with moderate to severe aging changes.

An extended face lift, as its name implies, is a more extensive procedure with dissection performed beneath the fascial layer (SMAS) with extension closer to the folds around the mouth and into the mid-face. This is beneficial if volume in the mid-face is adequate for lifting and may also be more appropriate for patients with heavier, thicker skin to achieve a satisfactory result.

Depending on the physical findings, liposuction under the chin, of the jowls, and to tighten the neck muscles are commonly performed in conjunction with all of the face lift approaches described above. To learn more about the face lift procedure, contact Dr. Henderson in Scottsdale, Arizona today.

The Face Lift Process

The Consultation
During a face lift consultation, the face and neck are examined for skin laxity, soft tissue volume, skin elasticity, neck banding, jowling, bone structure, facial symmetry, and overall skin health. The patient is counseled about the effects of loss of skin elasticity, skin thickness, and the risk of sun damage. Dr. Henderson will also consult with patients to ensure they have realistic expectations of the procedure. The position of the hairline is noted and the placements of the incisions are reviewed. Ancillary procedures including fillers/augmentation materials, fat transfer, and facial implants are discussed if indicated.

Preparing for Surgery

Approximately two weeks prior to surgery, patients will attend a preliminary appointment, during which Dr. Henderson will give preoperative instructions and review the patients’ consent forms. These instructions generally include avoiding medications that increase the risk of bleeding—herbs, vitamin E, aspirin, and NSAIDS such as ibuprofen—as well as taking supplements to reduce swelling and bruising. Patients who smoke are advised to discontinue smoking at least two weeks prior to surgery, and remain smoke-free for at least two weeks after their face lift.

Anesthesia

To allow for spontaneous breathing during the face lift procedure, and to avoid using an endotracheal tube, Dr. Henderson prefers using IV sedation, often referred to as “twilight anesthesia,” in the accredited in-office surgical suite as an outpatient procedure. Local anesthesia is also injected during the procedure to decrease bleeding and improve patient comfort.

The Procedure

Depending on the technique being used for the face lift, incisions are placed under the chin and/or around the natural contours of the ears, including along the edge of the cartilage in front of the ear in order to limit their visibility. Depending on the position of the hairline and the amount of skin laxity in the neck, the incision may be placed either into or around the hair tuft in front of the ear, and along or into the hairline behind the ear.

Generally, the neck is addressed first with liposuction of excess fat under the chin and in the jowls, after which the muscles’ bands are tightened by sutures. After elevation of the skin in the cheek regions and depending on the technique chosen, the fascial layer (SMAS) is either elevated and tightened, or tightened without elevation. The skin is re-draped, and the excess is trimmed without tension.  Application of tissue glue may be used in the neck and under the skin flaps and meticulous closure is then performed. If necessary, a drain may be placed to assist the healing process.

After Surgery

When the face lift surgery is complete, a light pressure dressing is applied, which will be removed in the office the next day. If drains have been placed, they will be removed as well. Depending on the degree of swelling, an elastic wrap may be used for the next 48 hours. Patients are instructed to apply cold packs for 24 to 48 hours following the procedure and to elevate their head while avoiding neck flexion for approximately two weeks. Sutures are removed at one week in front of the ears and under the chin and at two weeks behind the ears.

Some patients may experience postoperative discomfort, which is managed with medication. However, the incidence of postoperative discomfort is difficult to predict. Bruising and swelling diminish over approximately two weeks, at which time the average patient becomes “socially presentable” with hairstyling and makeup. At this point, patients may feel comfortable in public but to those people who are familiar with their normal facial appearance, there may still be noticeable evidence of the surgery. Generally at about four to six weeks, patients are ready to show off their “new, refreshed look” to family and friends. At this point, as healing continues, the patient may experience numbness, tissue firmness, and mild, typically unnoticeable swelling, particularly around the ears.

Final results of the face lift procedure are evident after approximately four to six months, although the appearance of scars may continue to improve for up to a year. Patients may find topical scar treatments helpful in minimizing the appearance of the scars. Some degree of skin “relaxation” may occur during this time which is actually the failure of the skin to contract as underlying swelling declines and is indirectly proportionate to the skin elasticity. In general, patients with greater skin elasticity experience less incidence of residual laxity. In occasional patients with poor skin elasticity, heavy skin and/or significant preoperative skin laxity, a tuck-up procedure may be required to achieve the desired result. This is generally delayed for approximately one year from the time of the original face lift. Although patients may resume most normal activities and light exercise in two weeks, strenuous activities and exercise are to be avoided for three weeks.

Risks

Although uncommon in association with a face lift, complications can occur with any surgery. These include but are not limited to bleeding, hematoma, infection, asymmetry, skin loss, numbness, nerve paralysis, hair loss, and abnormal scarring.

Learn More about Face Lift Procedures

When performed with skill and an artistic touch, cosmetic surgery can deliver results that dramatically enhance a patient’s appearance, while remaining incredibly natural-looking. Contact Dr. Henderson to learn more about how you can achieve your aesthetic goals with a face lift at her Scottsdale, Arizona practice.