In my San Francisco plastic surgery practice, I get the opportunity to talk to many patients every week who are interested in a facelift. Truth be told, it is one of my favorite procedures to perform. There are few other surgeries that can have such a positive impact on a person’s confidence, self esteem and general life outlook. But invariably, patients are concerned about looking “freaky” or “unnatural.”

Unfortunately, a few bad celebrity facelifts are to blame for this worry. In reality, the great facelift results far outnumber the bad ones. That’s why they are great – because we don’t notice them. If you’ve ever thought to yourself, “Wow. She looks amazing. What’s her secret?” then you might be looking at a great facelift result.

Unnatural facelift results do sometimes happen, but here are a few things you can do to avoid looking “weird”.

#1 Get a Facelift Earlier

Recent studies have shown that people who undergo a facelift in their late 40s and early 50s have better results and longer-lasting results. Most people wait to consider a facelift until they reach a certain age or until their face has already suffered years of damage from the sun, age and gravity.

By undergoing a facelift when you are a little younger, you will be able to make subtle improvements that don’t make a drastic change to your appearance. Plus, your facial skin, tissues and muscles will be more firm and more able support your surgical results for longer.

#2 Choose a Younger Plastic Surgeon

Can you teach an old doc new tricks? Well, maybe – but you’d have to offer a pretty big bone. After so many years of practice with a particular technique, sometimes even doctors can get into a rut or routine. It’s human nature to resist change, and it’s not necessarily a bad thing in most circumstances.

But when it comes to plastic surgery and especially facelift procedures, patients would do well  to search out a doctor who has experience, yes, but not too much experience if you catch my drift. Facelift techniques are continuously changing and improving every year. Your results can be improved by choosing a surgeon who keeps up with the techniques that can make facelifts better.

#3 Educate Yourself on SMAS Adjustments

Back in the day, plastic surgeons made incisions around the ear and simply pulled the skin upwards and as tight as possible before redraping it and reattaching it. This was effective at smoothing wrinkles, but the results didn’t last and patients often had the dreaded “wind tunnel” look.

Today’s surgeons almost always combine skin tightening with SMAS adjustment during a cosmetic surgery facelift. The SMAS (superficial musculo-aponeurotic system) is a strong, thin layer found between the skin and the muscle. I often refer to it as the Saran Wrap of the face. During a facelift, the SMAS needs to be freed up and adjusted separately from the skin.

Skilled plastic surgeons employ several SMAS strategies to give the most natural and longest lasting results, and the best technique is determined based on the patient’s individual anatomy. The SMAS can be cut and then lifted and sewn to a stronger area such as the bone behind the ear or over the cheek. Other times the SMAS is not cut but simply tightened with sutures. However it is achieved, successfully adjusting the SMAS creates much more natural facelifts that last.

#4 Address Wrinkles AND Volume

An unnatural facelift result often leaves the patient looking less wrinkled, but not younger. This is because older facelift techniques were mainly concerned with vertical movement. Mainly, eliminate wrinkles and sagging by pulling everything north. There was little attention paid to skin firmness or volume loss, two of the biggest indicators of advancing age.

By combining a facelift surgery with facial liposuction and/or fat grafting, a skilled surgeon can actually sculpt the face into a more youthful profile.

In addition, using fat harvested from another part of the patient’s body to replace lost volume in the cheeks, nasolabial folds, marionette lines and temples is a relatively new practice that yields outstanding results. Synthetic fillers made of hyaluronic acid, such as Juvederm, are great for patients who want a temporary, non-surgical option to replace volume. But facelift patients will achieve permanent results with a fat transfer.

#5 Be Open to Additional Surgeries

In my consultations with Bay Area plastic surgery patients, they are often surprised to learn that they may need additional procedures such as a neck lift, eye lift or chin liposuction to achieve their best possible facelift results.

Most people who are interested in a facelift are only focused on improving their faces. However, it is rare that someone would only need a facelift. As we age, our neck begins to sag and band and our eyes get baggy and wrinkled. These areas are not part of a traditional facelift surgery, so the vast majority of patients will need a facelift combined with a neck lift, etc.

If you only improve your face but your neck remains the same age, that is a recipe for a very unnatural result indeed. Therefore, be open to the possibility that you may need additional procedures but that it will be worth it in the end when you are one of those people who other people look at and think, “Wow. She looks amazing. What’s her secret?”


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