Answer:

Several months after a facelift, there may be some relaxing of the skin of the jawline and neck, requiring a "tuck up" procedure.  Nevertheless, most patients who seek out a repeat facelift will have had their initial surgery around 10-15 years prior.

Answer:

A midface lift addresses the cheek region and a lower facelift treats the jawline and neck.  However, a lower facelift can provide some cheek elevation, depending on the technique.  Most people require lower facelift procedures.  I personally rarely perform midface lifts.

Answer:

I perform fat injection to fill wrinkles of the face.  I usually harvest it from the abdomen.  In my experience, fat injected in the upper portions of the face generally works a little better than fat injected around the mouth and lips, although it can in many cases provide years of results.  Unfortunately, fat can be unpredictable, and touch up injections may be required.

Answer:

If there are just a few isolated marks, simple excision can be performed in the office.  If you have multiple pockmarks over a larger area of your face, dermabrasion or laser resurfacing may be required.

Answer: If you are a candidate for a facelift now, it does not pay to wait to have it done. Your skin and soft tissue will lose its elasticity with time. Having a facelift at your age now will provide a longer lasting result than if you waited several years from now.

Answer:

The gland you are referring to is called the submandibular salivary gland, which provides saliva that is secreted under your tongue.  There are some plastic surgeons who remove the protruding portion of the gland for cosmetic reasons.  In the hands of an experienced surgeon who routinely does this step, it is usually safe.  The majority of plastic surgeons, including myself, do not perform this for purely cosmetic reasons. 

Answer:

In counseling my patients, I stress the importance of a natural look after a facelift.  I feel that you best achieve this by avoiding too much pull on the skin.  During the procedure, deep sutures are placed to suspend the sagging tissue of the face.  These need to be placed firmly.  Next, when the excess skin is then draped back and removed, there does not need to be too much tension and pull of the skin but rather a gentle lifting.  I believe this avoids the "plastic" look.

Answer:

A standard facelift procedure involves making incisions around each ear, elevating the skin, suspending the underlying soft tissue, and removing the excess skin. A mini facelift follows the same basic principles of standard facelift, but the incisions are shorter and the amount of skin elevation and excision is less. In my practice, I have performed mini facelifts, but have abandoned this procedure in favor of the standard lower facelift.

Answer:

If you have a significant amount of sagging of the jaw line and neck, I do not believe there is a good non-surigical alternative to a face lift. Some patients who have volume depletion of the face without a lot of sagging of the skin may benefit from autologous fat grafting to re-volumize the facial soft tissue. Also, full face laser resurfacing can provide a generalized tightening of the facial skin. Both fat grafting and laser resurfacing, however, could be considered surgical interventions but not as invasive as a standard face lift.

Posted by William E. O'Mara Jr., M.D.