Details: Deep Plane Facelift

What are the goals of facelift surgery?
Dr. To strives to provide his patients with a more youthful and refreshed, yet natural appearance without changing the underlying characteristics of the face. After surgery the patient should look like a younger, more rested version of herself or himself rather than looking like someone else. Most of our patients wish to avoid an "operated", pulled or windswept appearance after facelift surgery.

Will I continue to age after facelift surgery?
No treatment or surgery can totally stop the effects of aging. A facelift can restore a youthful appearance, however continued stretching and settling of the skin and soft tissues of the skin will occur. Thus after surgery, patients will continue to age, but retain the improvement gained from their procedure. Facelift surgery will not cause a patient to age more quickly. Occasionally a secondary, minor revision may be done down the road, typically five or more years after the initial surgery.

What is the "down time" for a facelift?
Patients typically "look" worse than they feel immediately after surgery. As the transient swelling and bruising resolves, normal activity is resumed. Most patients return to work about a week or two after surgery.

How painful is the procedure?
Many patients experience very little pain after surgery. Medication for pain is prescribed, however some patients require nothing more than Tylenol for the majority of the post-operative period.

How does the Deep Plane Facelift differ from a traditional facelift?
The traditional face lift relies on pulling the skin itself to lift the skin and underlying tissues. While this method has worked well in the past, excess tension on the skin closure can lead to stretching of the skin giving the face a pulled appearance and widened scars. The deep plane facelift is a newer technique in which short skin flaps are elevated after which the dissection is taken under the deep plane - a layer of fibrous tissue and muscle. This deep plane, which has excellent strength and blood supply, is repositioned and used to provide the strength of the lift. This reduces the tension on the skin closure and more effectively elevates the soft tissues of the midface, leading to a more natural appearance after surgery.

Where are the incisions placed for facelift surgery?
Almost all of the incision is hidden in the hair or behind the ear. The incision is started in the temple, in the sideburn hair, extending to just above and in front of the ear, continuing around the earlobe and behind the ear. A short incision may be made in a natural crease underneath the chin if access is required to this part of the neck.

What sort of anesthesia is used for the Deep Plane Facelift?
The Deep Plane Facelift is done with sedation or general anesthesia under the supervision of a Board Certified Anesthesiologist personally chosen by Dr. To. Patient safety and comfort is the primary consideration, so be sure to discuss this issue with Dr. To.

What sort of pre-operative evaluation is necessary?
Routine medical clearance from the patient’s primary care doctor and standard laboratory tests are required. It is also necessary for patients to avoid certain medications, aspirin, herbal remedies and alcohol for 10 days prior to surgery. Patients are also instructed to take certain vitamin and herbal supplements to decrease bruising and assist in the healing process.

What is the typical post-operative course for facelift surgery?
After surgery a fluffy head dressing is also placed to decrease swelling. Patients typically return home that afternoon. The fluffy head dressing is replaced with a smaller dressing the following day. Sutures are removed as early as three days after surgery and all sutures are removed within a week.

What are the limitations of facelift surgery?
Facelift surgery will not rejuvenate the eyes or brows, nor will it significantly improve the quality of the skin itself. Thus complimentary procedures such as a browlift, blepharoplasty (eyelid surgery), laser skin treatments or Thermage® may be necessary to achieve the maximum improvement.

What are the alternatives to the Deep Plane Facelift?
Patients with minimal to moderate signs of facial aging may be candidates for the LA lift or the Contour Threadlift. Chemical peels, laser or radiofrequency treatments may be used to reinforce or substitute for surgical lifting, however the degree of lifting achievable with these methods is significantly less. BOTOX® Cosmetic may be used to reduce the action of certain muscles to reduce the appearance of facial wrinkles and frown lines, however this is a temporary treatment that will have to be repeated every several months, and does not elevate the facial tissues. Injectable fillers, such as Restalyne® may be applied to "fill in" facial wrinkles, but these treatments are temporary and are unable elevate the facial tissues.

Before	After

Before	After

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