Face Lift Plastic Surgery Information Resource for Southern California including Orange County, Newport Beach, Beverly Hills, Los Angeles, and San Diego.
Face Lift
Consultation for Face Lift
Outlined below is what you can expect from your face lift consultation. Read carefully, as there are many suggestions that will save you time, answer your questions, and help you to convey to your plastic surgeon what you want to accomplish.
Health History
All cosmetic surgery consultations begin with a thorough health history. This is especially true if general anesthesia is being used, but also applies to local anesthesia. Face lifts are usually done under general anesthesia. Prior to meeting with Dr. Cruise you will be given a health history questionnaire to fill out in the waiting area. There are five areas of your health that you will be asked about. Be sure to answer questions in detail so that your surgery and anesthesia can be optimized for you.
General Health
General health problems are important to discuss so that your surgery is as safe as possible. Be sure to mention any chronic illness. Of particular concern are high blood pressure, diabetes, heart problems, liver and kidney disease, stroke, cancer, bleeding problems, and wound healing problems.
If you have medical problems, Dr. Cruise will make sure your health is optimized as much as possible to ensure your safety during surgery. This may mean referring you to your private physician. If you know you have a health problem, you can often save time by bringing a letter from your private physician to your cosmetic consultation stating what the health problem is, how it is being treated, and whether or not you are able to tolerate general anesthesia safely.
If you are seeing any specialist (cardiologist, kidney doctor, psychiatrist, etc. ) be sure to bring a letter from them stating that you are able to tolerate surgery.
It is extremely important to let Dr. Cruise know if you have ever had a blood clot.
Past Surgical History
Your questionnaire will ask about any previous surgeries. Be sure to identify any problems you may have had with anesthesia. Of particular concern are previous cosmetic surgeries, especially if you do not like the result and are interested in revision.
Medications
Be sure to list all medications you take including aspirin and over-the-counter medications. These are important as they may increase bleeding and affect your surgery. It is extremely important to stop taking aspirin and aspirin- containing products at least two weeks before surgery. Tylenol is a good alternative. Here is a partial list of aspirin-containing products and other products to be avoided prior to surgery.
Allergies to Medications
Information about medications that cause allergic reactions is very important so that these medications can be avoided. Of particular importance is the type of reaction you had, especially if you had trouble breathing. Be sure to include this information! Nausea is not an allergic reaction, but it is important to mention as well.
Smoking, Drinking and Drug Use
These three will certainly affect your surgery and must be mentioned so that your surgery can be optimized. Smoking causes a profound decrease in wound healing and will lead to worse scarring and a less favorable result. With large procedures such as a face lift, neck lift, tummy tuck, and breast lift, smoking must be stopped at least 3 weeks before and after surgery. Otherwise, the results could be disastrous and lead to non-healing wounds, poor scarring, and/or infection. With smaller procedures such as eyelid surgery, nose surgery, breast augmentation, and liposuction, smoking will hurt the overall result but this may or may not be noticeable. In this case smoking cessation is strongly advised, but is not mandatory.
What Do You Want To Change?
It is important that you have a clear idea of what you want changed when you go for consultation. No plastic surgeon wants to hear, "What do you think I need done?"
Look in a mirror and identify what bothers you. Be specific. It is helpful to break up the face region into six parts: Eyebrow, Upper Eyes, Lower Eyes, Temple Area, Cheeks, Jawline. Evaluate each one of these areas individually as this is what the plastic surgeon does in his exam. A face lift does not address the first three problems. If you are concerned about these areas you may be best treated by having a brow lift, upper blepharoplasty, and/or lower blepharoplasty in conjunction with your face lift. Click on these areas if you want more information and discuss this during your consultation.
Common Complaints
- Temple: Crow's feet, droopy skin.
- Cheeks: Loose/hanging skin, loss of cheek fullness, large nasolabial folds.
- Jawline: Jowling, loss of jawline definition.
Common Complaints with the Aging Face.
Ideal Facial Shape
- Temple
- Smooth without a hollow.
- No wrinkles when not smiling.
- Cheek
- Full with the most prominent point just under the lateral eye.
- No nasolabial fold when not smiling.
- Smooth when not smiling.
- Jawline
- Border should be clearly visible without jowling.
- Triangular in shape.
Physical Exam And Treatment
The goal of the face physical exam is to determine exactly what is causing the problem. Below is a typical sequence that an experienced plastic surgeon uses to determine what can be done to correct problems.
Temple
With aging, facial fat either descends or goes away, or does both. In the temple region, this causes a sunken area characteristic of aging, droopy skin. Crow's feet with smiling are not uncommon and are acceptable as long as they are minimal. Permanent wrinkles and/or deep lines during smiling give an aged appearance. A face lift will elevate some of the descended temple fat as well as smooth out the wrinkles. Wrinkles with smiling will not be eliminated but should be improved. Concurrent brow lift and/or lower blepharoplasty may be necessary to treat significant crow's feet.
Cheek
Similarly, facial fat in the cheek descends or goes away. As it falls, it bunches up just above the nasolabial crease giving the typical fallen face appearance. During your consultation, your plastic surgeon will pinch this area and elevate the fat upward, thus, simulating a face lift. During a face lift, the surgeon will reposition this upward by 1 of 3 methods.
The Three Most Common Face Lift Methods
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Subcutaneous Face Lift. The skin is undermined to an appropriate level that is determined during the physical exam. The skin is then advanced laterally and slightly upward to put it back where it was during youth. This effectively tightens the skin and smoothes out the facial contour. Care is taken to put all the skin tension above and behind the ear so that there is minimal tension in front of the ear itself. This avoids an "operated-on" look.
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Subcutaneous Face Lift with Fat Suspension. This additionally elevates the descended fat into position with the use of sutures.
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SAMS Face Lift. SMAS is an acronym for Superficial Musculo-Aponeurotic System. It is a fibrous/muscular layer under the skin. Above it lies the cheek fat. Below it sit the facial muscles that animate the face. A SMAS face lift will elevate the SMAS and thus, concomitantly, elevate the facial fat and muscles.
It has been shown that all three types of face lifts can achieve excellent results. Which is best for you depends on what needs to be corrected and what your plastic surgeon is most comfortable with. Dr. Cruise always incorporates fat suspension into his face lifts.
Jawline
Like the cheek, your plastic surgeon will evaluate your jawline by pinching the soft tissue on top of it and elevating it to see what is the best treatment. Jowls are a combination of fat and SMAS that have descended with age. During a face lift, this tissue is re-suspended into the cheek area where it belongs.
Typical Face Lift Incisions
Typical face lift incision.
Variations above the ear
Hairline Incision. This incision does not cause hair parting complications plus it allows for more upward skin pull. The incision is well hidden at the hairline.
Variations in front of the ear
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| Retro-Tragal Incision. This incision goes into the ear canal and, therefore, part of it is not visible. Potential downside is tragal distortion. | Tragal Edge Incision. This incision stays on top of the tragus. It is well hidden but does not go into ear canal. |
Variations behind the ear
No Posterior Ear Incision. Dr. Cruise utilizes this so that hair can be worn up and no incision can be seen at all behind the ear.
Dr. Cruise's normal incision
Dr. Cruise utilizes the above incision. Above the ear, the incision is within the hairline, it then goes retro-tragal. Dr. Cruise is usually able to avoid a posterior ear incision so that hair can be worn up without any visible scar.
Face Lift Cosmetic Surgery Information Resource for Southern California including Orange County, Los Angeles, San Diego, Newport Beach, and Beverly Hills.