The face is an intimate component of an individual’s identity, reflecting an individual’s thoughts and emotions in a single glance. As we age, the face we see in the mirror may not reflect the person we “truly” feel. Facial rejuvenation through procedures, such as a facelift, can help achieve more unity between the face we see externally and the way we see ourselves.

Facial Aging

face2Facial aging is the culmination of multiple factors that result in predictable changes in facial appearance that occur over a lifetime.

Some of these factors include:

  • Genetics
  • Long-term sun exposure
  • A history of smoking
  • Gravity
  • Underlying health and nutritional status

As a result of these factors, there is gradual increasing laxity of the facial skin and underlying soft tissue. This increased soft tissue and skin laxity is often accompanied with a thinning of facial fat, resulting in an overall loss of facial volume. The net result of these changes are some of the hallmark features of facial aging:

  • Increased wrinkling of the skin of the cheeks and mouth
  • Jowling along the border of the jaw
  • Loss of cheek fullness
  • Downward drooping of the cheeks
  • Hollowing of the cheek adjacent to the lower eyelids and nose (tear troughs)
  • Deepening of the cheek folds adjacent to the mouth (nasolabial folds)
  • Development of marionette lines of the lower cheek and chin

The youthful face can be thought to have the shape of an ice cream cone with fullness in the cheek that tapers toward the chin: this shape is lost as the aging process occurs. The goals of facial rejuvenation is to reshape the face to a more youthful anatomic shape. The facelift is one of the main procedures through which this is accomplished.

About the Facelift

A facelift is a surgical procedure that tightens and tones the skin’s surface to address sagging skin along the cheeks and that smoothes out lines and folds adjacent to the mouth. The procedure also restores the deep layers of tissue and muscle to their original, youthful position to address volume loss and hollowed areas of the cheeks. The surgical corrections of a facelift are accomplished through a series of incisions that typically start in or adjacent to the temporal hairline, run in front of and behind the ear, and then occasionally extend along the hairline or behind the ear. Upon completion of these incisions, the skin is elevated to expose the underlying muscular layer of the face. Various techniques can then be employed to tighten this muscular layer and reposition soft tissue to its youthful anatomic position. Once the muscles are tightened, the skin can be redraped into a more youthful position, and excess skin can be removed.

The MACS Lift

Although Dr. Zemmel is well versed in all facelifting techniques, he frequently performs the MACS lift to achieve his long-lasting natural results. The MACS (minimal access cranial suspension) lift is a facelifting technique developed by Drs. Tonnard and Verpaele in Belgium. The technique reflects the most current concepts of facial aging, and it provides natural facial rejuvenation through incisions, usually limited to the cheek. In this technique, the underlying facial muscles and soft tissue are lifted and tightened with a series of suspension sutures. Because the lift can be accomplished through relatively limited incisions, the recovery is usually much quicker than more conventional techniques. Furthermore, because the muscle tightening is achieved through a series of suspension sutures, the dreaded complication of injury to the underlying facial nerve branches are very rare. The MACS lift safely offers significant long-lasting correction of age-related changes with more limited incisions and a faster recovery.

Frequently a facelift is combined with other facial procedures to provide a more holistic treatment of facial aging. Some of these procedures include blepharoplasties, a neck lift, a brow lift, and facial fat grafting.

Richmond Aesthetic Surgery understands how important it is to choose the right facial plastic surgeon. Dr. Neil Zemmel has a long history of providing our facelift patients with natural-looking results. As the decision to undergo a facelift procedure is an extremely personal one, the physicians of Richmond Aesthetic Surgery design a custom-tailored comprehensive surgical plan for each and every patient to help them achieve a more refreshed, rejuvenated appearance and a renewed sense of self-confidence.

For more information on facelift surgery, or to schedule a consultation, please contact us today.

Facelift Consultation

Ideal candidates for facelift surgery include healthy men and women who are experiencing age-related changes to the face. During your consultation, you will undergo a thorough review of your complains and comprehensive examination of your facial anatomy. From this evaluation, our surgeon will develop a surgical plan that is tailored to your complaints and that reflects your unique facial structure. To aid in this process, our VECTRA 3D surgical simulator provides a visual prediction of the potential results to help ensure the patient and the doctor are working toward the same cosmetic goals. A successful facelift procedure depends on clear doctor-patient communication with our plastic surgeon: Dr. Zemmel will review your surgical plan in detail and provide you with realistic expectations of what you can expect from surgery. Since smoking can greatly compromise the outcome of a facelift, Dr. Zemmel recommends that all candidates are non-smokers or cease smoking well before surgery.

After the consultation, if you are determined to be a good candidate for a facelift, Dr. Zemmel will provide detailed pre-operative instructions in preparation for your surgery.

Your Facelift Procedure

All facelift surgeries are performed by Richmond Facial Plastics’ board-certified plastic surgeon at either St. Francis Hospital’s Ambulatory Surgical Center or at Henrico Doctors’ Hospital – Forest Campus. During this procedure, patients receive general anesthesia to maximize safety during surgery and minimize discomfort. Our patients at Richmond Aesthetic Surgery often choose to combine their facelift procedure with eyelid surgery, a brow lift, or a neck lift. A facelift typically takes about three hours to perform, depending on the needs and goals of the individual patient. When combined with other procedures, our facelift patients often elect to spend one night in the hospital for increased comfort and round-the-clock nursing care.


Your Facelift Recovery

Discomfort during recovery can usually be well-controlled with oral pain medication. Some patients may experience weakness of the facial muscles immediately after surgery that usually resolves within three to six weeks. In rare cases, the weakness persists for as long as six months. During the first days of recovery, you should keep your head elevated to help reduce any swelling. After one to two days, you will return to our Richmond office and Dr. Zemmel will remove your dressings. Patients are typically able to return to work within two weeks of surgery. Although you will see improvements in your facial appearance shortly after surgery, the final results of your facelift will become more readily apparent about three months after the procedure.

To learn more about the facelift procedure, or to schedule a consultation with our experienced plastic surgeon, please contact our office today.

Turn back the hands of time and renew your youthful appearance.


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