The facelift procedure was first described in 1901 by Eugene Hollander and in 1916 by Erich Lexer. Over the last century, the facelift has become the gold standard for facial rejuvenation and continues to grow in popularity. One of the reasons we can attribute this growth spurt to is the options and advancements in how facelifts are handled. Let’s delve into the fascinating realm of modern facelifts, exploring the incredible progress made in this field and how it has revolutionized the entire procedure.

Traditional vs. deep plane facelifts

Many people often associate facelifts with traditional methods that involve stretching and pulling the skin sideways to combat aging signs. However, today’s individuals seeking facelifts are focused on achieving a more natural, youthful, and well-rested appearance, moving away from the “windswept” look.

Among various facelift techniques, the deep plane facelift stands out as the most effective approach, as it addresses the aging process by repositioning deeper tissues and muscles to their youthful state, yielding authentic and natural results. This procedure requires an experienced expert with a keen aesthetic eye, exceptional surgical skills, and an intimate understanding of muscle and facial nerve anatomy beyond standard plastic surgical training.

To enhance the overall outcome, deep neck contouring has become an essential addition to the deep plane facelift, contributing to beautiful neck aesthetics. The combined results of these techniques create more appealing and genuine outcomes. Additional complementary surgical procedures, such as blepharoplasty, brow reshaping, fat grafting, lip lifts, buccal fat pad repositioning, and chin augmentation, may also be considered individually to achieve harmony in the final result.

As with any surgical procedure, inherent risks are associated with surgical and non-surgical options. However, selecting a skilled and experienced surgeon reduces these risks significantly. Engaging in open communication with the chosen surgeon regarding your health history and goals and thoroughly understanding the potential risks and benefits of the procedures will help you make an informed decision that aligns with your needs.

Are younger people candidates for facelifts?

Fillers, Botox, skincare, and energy-based devices, such as fractional lasers, Sylfirm, Morpheus, and microneedling, continue to play a crucial role in the comprehensive approach to facial rejuvenation, especially for younger patients. However, as our understanding of the aging process deepens, surgical techniques like neck contouring and deep plane facelifts are no longer exclusive to individuals over 50 years old. Facial anatomy and aging patterns can vary significantly among patients, and some individuals may have genetic predispositions that necessitate surgical intervention at a younger age.

Similar to how we perform rhinoplasty for young adults with genetic nasal features like a bulbous tip or bridge bump, some people are born with recessed chins and pronounced neck contours, which can be improved through surgical procedures like deep neck lifts and chin implants to enhance their attractiveness.

Moreover, some individuals experience a more rapid aging progression, necessitating early surgical intervention with deep plane facelifts and blepharoplasty to reverse the signs of aging. It is crucial to assess each person individually and tailor a personalized treatment plan that combines non-surgical and surgical procedures to meet their specific needs and achieve the most favorable results.

What type of anesthesia is required for a facelift?

When preparing for a deep plane facelift, patients can access various anesthesia options that prioritize their comfort and safety during the procedure. The choice of anesthesia is determined by factors like the patient’s medical history, the surgeon’s preferences, and the complexity of the surgery. A board-certified anesthesiologist or nurse anesthetist should always be present when any type of anesthesia is administered so the surgeon can be fully focused on the plastic surgery portion of patient care. The standard anesthesia options for a deep plane facelift are as follows:

1. General anesthesia: This type induces complete unconsciousness throughout the surgery. Medications are administered via IV or inhalation, ensuring the patient remains asleep and pain-free during the entire procedure.

2. Local anesthesia with sedation: In this approach, a local anesthetic is applied to numb the surgical area, complemented by intravenous sedation to induce relaxation and drowsiness. Although the patient isn’t entirely unconscious, they won’t experience pain or discomfort during the deep plane facelift.

3. Twilight anesthesia (conscious sedation): This form of anesthesia involves administering medications through an IV to induce deep relaxation and partial unconsciousness. The patient remains conscious but often has limited memory of the procedure and experiences minimal discomfort.

I prefer general anesthesia or twilight anesthesia, but the decision on which anesthesia to use is made collaboratively between the patient, the surgeon, and the anesthesiologist. Medical history, patient preferences, and the complexity of the surgery are carefully considered to ensure a safe and comfortable experience during the deep plane facelift.

Open communication with the surgical team is crucial for patients to express their concerns and preferences, allowing them to select the most suitable anesthesia option for their deep plane facelift.

Babak Azizzadeh is a facial plastic surgeon.