A facelift, or rhytidectomy, is cosmetic surgery to reduce the signs of facial aging, such as wrinkles or sagging skin. On this page, Dr. Azar answers some frequently asked questions about facelift surgery for Thousand Oaks and Westlake Village residents who are considering the procedure.
If you would like to find out if a facelift is right for you, request a consultation with Dr. Azar to discuss the possibilities. Or you can call our office at (805) 373-7073 and one of our knowledgeable, friendly staff members will schedule your appointment.
This patient, age 75, wanted to address her wrinkles and sagging jowls. Dr. Azar performed a combination facelift, neck lift, and upper eyelid surgery. For more photos of Dr. Azar's facelift results, visit his photo gallery.
Keep in mind that each patient is unique and your results may vary.
How is a facelift performed?
During a facelift, Dr. Azar carefully tightens the face's underlying muscles and fascia, also known as connective tissue. He makes discreet incisions along the hairline, by the ear, or on the chin, and removes excess skin. Then he skillfully re-drapes the remaining skin for the most natural-looking results.
What happens to the mid-face as we age?
The cheeks tend to flatten with age. Take a look at your high school yearbook picture and notice your cheeks. Chances are you will see you had very prominent, round cheeks - they were rounded like a golf ball and pinchable. By age 45, many women's cheeks look more like a flattened egg. A teenager's cheeks have a reflection of light that reveals youthful beauty.
Can flattened cheeks be corrected?
Yes, Dr. Azar can rejuvenate flattened cheeks with an endoscopic mid-face lift. This procedure, which focuses on the middle of the face, involves using an instrument called an endoscope to separate the tissues around the eye and cheek through tiny forehead incisions made along the hairline. Dr. Azar then suspends the tissues of the cheek from the temple using a new absorbable plate called a mid-face Endotine™. This facelift technique gives the cheeks a very youthful, lifted appearance without artificial implants.
A board-certified plastic surgeon, Dr. Azar develops innovative surgical techniques and is dedicated to providing exceptional outcomes.
Which age group is best suited for a facelift?
"The ideal time to have a facelift is between ages 47 and 57. Patients younger than 47 should have a very good, solid reason to have a facelift - as in the case of actors or individuals with facial features that make them look older than their age. Patients older than 57 are still candidates for a facelift, but they may need to undergo a more conservative procedure to maintain a natural look."
How does your facelift technique produce natural-looking results?
"I perform what's called a SMAS advancement. The SMAS, or superficial musculoaponeurotic system, is the covering below the skin, but above the muscle layer of the face. When I do a facelift, I go below the SMAS and tighten the face's muscle layer. Then I simply re-drape the facial skin and remove the excess skin. I'm not pulling on the skin to lift the face. I'm restructuring the muscle and then gently re-draping the skin for a very natural look - not the 'windswept' look of old-fashioned facelifts. People tell my facelift patients that they look rested, like they've just been on a Caribbean cruise. Nobody can really tell they've had surgery."
Does going below the SMAS pose any risk?
"Of course, there is a certain degree of risk with any surgery. However, I am a specialist in facial nerve and muscle surgery, so my advanced specialty training makes me very well-suited at avoiding any facial injuries."
Aren't the scars at the back of the neck a telltale sign of a facelift?
"Facelift incisions are a lot shorter than they used to be. I limit the incisions behind the ear, and I don't go along the hairline in the back so that if you want to wear your hair up, no one will see the scar in the back."
Do you ever combine a facelift with other procedures?
"Yes. Because a facelift affects only the lower 2/3 of the face, I often combine a facelift with an eyelid lift and/or a brow lift. I commonly use a minimally invasive Endotine™ technique that involves inserting a dissolvable implant through a tiny incision in the upper eyelid or the scalp. Performing an eyelid lift and brow lift complements the results of a facelift, opening up the eyes and making the upper third of the face look younger."
This 52-year-old woman came to Dr. Azar for facial rejuvenation. He performed a facelift, endoscopic brow lift, and an upper and lower blepharoplasty. For more photos of Dr. Azar's facelift results, visit his photo gallery.
Keep in mind that each patient is unique and your results may vary.
Can a facelift help improve a sagging neck?
"Yes. A neck lift is part and parcel of a facelift. There is also a separate neck lift procedure called a platysmaplasty for patients with extreme excess skin and sagging in the neck. This procedure can be done by itself or in conjunction with a facelift. During your personal consultation, I will recommend the procedure best for you."
How does the Endotine™ technique work?
"The Endotine device, developed by Coapt Systems reduces the need for stitches and improves the accuracy and simplicity of brow lift and eyelid lift procedures."
Do you offer mini-facelifts?
"No - and for good reason. Mini-facelifts, which are marketed under several different names, including the S-lift (for the shape of the incision) and the thread lift, among others, are very market-driven. I think patients should be cautious about these minimally invasive techniques. A very small number of women - perhaps 5% - can get a lasting benefit from a mini-facelift. But most women who have a mini-facelift are likely to be back where they started in 2 or 3 years. A full facelift provides a much longer-lasting result."
Do you ever combine a facelift with injectable fillers?
"Yes, I do use injectable dermal fillers with the facelift. When I do a facelift, I almost always inject the nasolabial folds - the creases that run from the nose to the corners of the mouth. Sometimes I inject what's called the "tear trough" - the area underneath the eyelids. A lot of people end up with grooves underneath the lower eyelids, so that can easily be injected at the same time as the facelift. The cheekbones can be accentuated with filler as well."
What else can a facelift do to smooth out the nasolabial folds?
"If you have very deep nasolabial folds, during the facelift I can actually lift the skin a little bit farther than I normally would and smooth out the nasolabial folds completely. That's considered the definitive treatment for deep nasolabial folds."
How can you correct the nasolabial folds during a facelift?
"I borrow a little bit of fascia, which is like a big connective tissue layer on the temporal area, and graft it into the nasolabial folds under the skin. We always try to use your own tissues when we can."
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