Facial Rejuvenation Procedures: Surgical And Non-surgical Options
Aug 23, 2022
As we age, our facial skin loses its elasticity and begins to thin, weaken, and descend down the face. The skin will start to show evidence of damage from the aging process and from cumulative sun exposure (as well as current or past smoking habits).
Equally important to address as the aging skin is facial volume. This occurs in multiple areas of the face but is often noticed in the cheeks. The contour of the face becomes flattened with aging as our volume descends with the skin.
Fat compartments provide volume to our face, and as we age, these compartments stretch and sag. The unwanted tear troughs (the deep crease between the lower eyelid and upper cheek), deep smile lines, and jowling result from the stretching and sagging of our skin and facial volume around fixed points.
There are many non-surgical and surgical treatments for aging facial skin and replenishing volume. When considering which treatment is right for you, think about the problem areas you are hoping to address. Is it a skin problem, a volume problem, or a combination of both? A consultation with your plastic surgeon can help clarify this for you.
Common non-surgical therapies we may be familiar with are:
Lasers, dermabrasion, and chemical peels all offer a spectrum of therapies that differ in the depth of skin penetration. Lasers are energy based while dermabrasion is a mechanical treatment and peels are chemically derived topical solutions.
There are many filler types on the market and most are familiar with the ones made of hyaluronic acid (HA). These are good volume-enhancing options that last a few months while some non-hyaluronic acid fillers can be long lasting or even permanent.
A great volume replenishing option that is all-natural is facial fat grafting. Typically performed by a plastic surgeon, fat is harvested from your preferred donor site and then transferred to small syringes for grafting to the face. Whereas fillers may last a few months, fat injections can last forever. The body will reabsorb a range of 20-40% of grafted fat, so your provider may slightly overfill an area in anticipation of this change.
There are a lot of newer technologies on the market that use different mechanisms to treat skin aging and volume loss. An example of such a device is one that uses microneedling to puncture the skin over a wide area to stimulate the underlying collagen and resulting in skin tightening.
Other devices have ablative capabilities that use energy or heat to treat areas of skin damage and tighten the skin. Some devices can combine both microneedling and ablative technologies among many others. These platforms can produce impressive results in the right patient but may require multiple treatments and ultimately become quite costly.
There is one common surgery that comes to everyone’s mind when discussing facial aging: the facelift.
As newer technologies or “minimally invasive” options come to market, the surgical facelift becomes more of a mystery. Of the treatments described above, none are as powerful as a surgical facelift for facial rejuvenation.
Facelifts have been around for quite some time and certainly should not be considered an outdated treatment option.
Techniques are always evolving to produce lasting and safe results, so there are many varieties of this surgery. But not everyone experiencing facial aging needs a facelift. A consultation with your plastic surgeon will help guide you to the most appropriate treatment plan.
A safe and effective facelift technique targets a fibrous, muscle layer of the face called the superficial musculoaponeurotic system (SMAS). This is a strong layer of the face deep to the skin but above the facial muscles.
At Oceana Aesthetics, our favorite technique tightens the SMAS to produce lasting results. Once the SMAS is tightened – thus producing a more youthful face – the skin is re-draped over top. Excess skin is trimmed, and the incision is closed in a tension-free manner.
The incisions can be lengthy but well hidden. They typically run from the tuft of the sideburn along the inside of the ear, behind the ear, and into the hairline. A tension-free closure allows the incision to heal into a nearly invisible scar.
If the neck is tightened as well, a small incision is commonly placed behind the natural crease under the chin.
This would involve a more limited incision to address the mid-face or lower face or a combination of the two without a neck lift.
A neck lift can be performed by itself or with a facelift.
The neck lift helps eliminate the banding we see on the front of the neck as superficial muscles of the neck separate with aging. In addition, a neck lift can treat jowling and improve the contour of both the front and sides of the neck. A drain is often placed during a neck lift and removed the following day.
Facelifts are outpatient procedures, meaning most patients go home after surgery.
At Oceana Aesthetics, we will schedule you for your first post-op appointment the following day to assess the skin and incisions and remove a drain if one was placed. At Oceana, we use dissolvable sutures for our skin closures. This means no sutures have to be removed at a follow-up appointment.
After surgery, a special, compressive dressing is applied to help limit discomfort and swelling. This is taken off the next day at your first appointment. A new and reusable compressive dressing is then applied.
Swelling peaks typically by days 2 to 3 and then begins to subside. By week 2, most swelling has resolved. However, there may be residual swelling that can take several weeks to fully disappear.
Facelifts are generally well tolerated from a postoperative discomfort standpoint. Most patients require a week out from work but may take longer for privacy reasons while the residual swelling continues to resolve.
Additional procedures, such as brow lifts or eyelid lifts, often accompany facelift surgery. A powerful combination for the right candidate includes:
Dr. Blumenauer is well trained to perform the above procedures to help you achieve your facial aesthetic goals. For more information, schedule a complimentary consultation with Dr. Blumenauer at Oceana Aesthetics.