10941 Raven Ridge Rd, Suite #103, Raliegh, NC 27614
Plastic Surgery Credentials

Full Facial Rejuvenation Raleigh

What Form of Anesthesia is used in Face Lift Procedures?

In my practice, a full facial rejuvenation surgery takes many hours. It includes structural fat grafting, the face and necklift itself, and often associated procedures, such as a browlift, blepharoplasty, or chin augmentation. To perform these surgeries meticulously and artistically, it absolutely requires a fully relaxed nonmoving patient. My anesthesia preference for these surgeries is deep IV sedation. Now, that being said, I think that patients having facial rejuvenation surgery should be as concerned about the person performing their anesthesia as they are about the mode of anesthesia itself. In my practice, we use board-certified MD anesthesiologists who are highly experienced in elective cosmetic surgery. The most important consideration in the operating room by far is patient safety, and I think that the board-certified MD anesthesiologist is best equipped to select the mode of anesthesia and to conduct the anesthesia.

What is the Difference between a Facelift and a Necklift?

Well, the reality is that the face and neck are continuous structures. The skin of the face and the skin of the neck are obviously one continuous structure at the surface. And the deeper layers are continuous as well. The deep connective tissue layer of the face below the skin we refer to as the SMAS. It’s an acronym S-M-A-S and this layer is continuous with the platysma muscle in the neck. So, not only is the surface continuous but the deeper structures are continuous as well. So in general, when a patient has a facelift both the face and the neck are being rejuvenated together. On the other hand, with a necklift, the neck can be rejuvenated in isolation. Younger patients that don’t have significant skin excess can have a major neck rejuvenation performed through a submental or under the chin incision only, and don’t require incisions around the ears. However, if there are some more advanced aging changes the skin of the neck and the lower face can be re-draped together. So, a necklift is sometimes just a necklift, while a necklift can also be, essentially, a lower face and necklift without directly involving surgery of the upper face. Make sure that the surgeon that you see can discuss all of these options with you and provide you with reasonable expectations for the outcome of each version of the procedure. Whatever you decide to do it should be custom tailored for your particular needs.

Differences between Procedures Performed to Rejuvenate the Male Face versus the Female Face

Well, in some cases the intended goal is similar – for instance, in the neck. When you do a necklift surgery you are trying to create the maximum possible definition along the jawline and a sculpted appearance between the area under the jawline and the neck. A sculpted jawline and neck looks beautiful on a woman and looks handsome and rugged on a man. In other areas, however, the approach can be quite different. In female blepharoplasty surgery, you are trying to create a full and very smooth contour for both the upper and the lower lids. In male blepharoplasty surgery, you really want to maintain some sense of handsomeness and ruggedness in the male eye area. Therefore, male blepharoplasty should involve much more conservative skin excision and a willingness to leave some mild signs of aging behind. A few wrinkles, a few creases look fine on a man and I don’t attempt to eliminate all of them. Another area where the approach is quite different is the brow. The brow position for a female patient should be slightly above the orbital rim. If you achieve that with a conservative browlift surgery then you produce an elegant, rejuvenated, beautiful appearance. The male browlift surgery, however, should be approached with caution. The male brow looks just fine at the orbital rim or even below the rim. So, one has to be careful not to feminize the male face by over elevating the male brow. Another area that is quite different is the midface. With facelift surgery in female patients I always try to create more midface fullness to create fullness over the anterior lateral cheekbone. In a male patient, however, that significantly feminizes the face and it’s an outcome that should be avoided at all costs. So, female facial rejuvenation surgery often involves fat grafting and suspension of the midface, whereas, in male faces that typically should not be done.

Is A Short Scar Facelift a Reasonable Substitute for a Traditional Facelift?

In my opinion, in most cases, no. Ironically, many patients with short scar facelifts end up with surgical scars that are much more noticeable than those from a traditional facelift. In general, the overall rejuvenating effect seems to be much less dramatic. I see quite a number of patients who have had short scar facelifts performed in other practices and they tend to be frustrated with two issues. Number one, they have scars in front of their ears and the temple and sideburn area that are easily noticeable and difficult for them to conceal. Secondly, they tend to have very little improvement, and sometimes a complete lack of improvement in the contour of their jawline and neck. Philosophically, the short scar facelift attempts to transfer the primary area of skin mobilization and removal from the area behind the ear where scars are actually very easy to conceal to the area in front of the ear where scars are much more difficult to conceal. If one is attempting to produce a dramatic enhancement of the jawline and neck contour that absolutely requires a re-draping of skin into the area behind the ear. When the surgery is planned by and performed by a surgeon who is experienced and skilled this results in surgical scars that are essentially invisible once they have healed. They allow a patient to wear her hair up in a ponytail without feeling self-conscious. The proof really is in the pictures. Look at as many as you can. When you’re looking at results of short scar facelifts look at the sideburn area, look at the scars, look to see if the surgeon is attempting to conceal scars with the sideburn hair, and look at the jawline and the lateral neck for skin folds that are a telltale sign that has been inadequate skin re-draping in the area of the lateral neck.