Surgical Procedures

 
 
   

Face Lift

"I did not want to look dramatically different after my facelift. Everyone tells me I look rested and refreshed ..."

 

The facelift has come to symbolize many of the good things - as well as some of the not so good things- about cosmetic surgery.

Mostly people are wrong about how a facelift can make you look and feel. Today's facelifts can provide soft, natural facial rejuvenation and a healthy, rested look to reverse the effects of time.

 Understanding how the face ages is important in order to choose the correct "tool" to treat the specific problem.

 The face ages in three generally predictable ways that we call the "Three D's". Everyone ages by a combination of these factors so in some cases combination treatment (Surgery plus Fillers, Fillers plus IPL) is required

 The first and earliest sign of facial aging is caused by skin Deterioration.

This means texture, color and tone changes. The skin becomes thinner, blotchy in pigmentation and rough in texture. Exactly how your skin deteriorates depends on ethnicity, lifestyle and sun exposure. Surgery is not useful for problems associated wit deterioration. There are excellent non surgical options such as the Obagi Skin Care System, Intense Pulsed Light treatments (link to these on website) as well as surgical options such as Laser Resurfacing.

For more information about non-surgical options please go to  the "Non Surgical" portion of this website. 

The next sign of facial aging is Deflation.

 This is the gradual- or not so gradual- loss of facial fullness due to loss of the facial fat pads. This commonly occurs in the perimenopausal years in women. In men the process is delayed as they have more facial fat and a larger bone structure. This loss of volume produces a gaunt "unwell" appearance. Remember, all very aged individuals have gaunt faces whereas infants have full "chubby" faces. A fuller face is a younger looking face. The treatment of deflation is non surgical because surgery cannot restore volume to an empty face.  A facelift done on an gaunt, empty face will produce a tight, gaunt empty face. Deflation is best treated using our exclusive FAVORLIFT TM protocol. 

 

Descent is the final sign of facial aging. The deteriorated facial tissues cannot shrink as the facial volume is lost so they hang (descend) instead. This descent produces low brows, sagging upper and lower eyelids, marionette and nasolabial lines, jowls and neck bands. Descent is treated surgically with Brow lifts, Eyelid Lifts, Face lifts and Neck lifts.   (link to these procedures in the site)

 

Surgery remains the "Gold Standard" in treating skin descent and facial tissue laxity. Nothing else even comes close in terms of results including FraxelTM, ThermageTM, IPL, or the various energy modalities.

 

The concept behind a facelift is to remove and redistribute loose, sagging excess skin from the face and tighten the underlying tissues. It reverses the effects of gravitational Descent of the facial soft tissues.

If the neck is also involved a Neck lift (Link to Neck lift) can be done at the same time. Bags or pouches around the eyes can also be treated at the same time with an eyelid operation. Low brows caused by descent of the forehead require a brow Lift (link)

 There are a number of different types of facelifts- too many in fact.

 For years it was thought that more surgery produced a better longer lasting result. This turned out to be incorrect. More surgery produced more problems and a longer recovery time- not what the customer wanted.

 We have changed our surgical philosophy and practice in recognition of the Three D's and our patient's needs for safe effective procedures without prolonged downtime.

 What are we doing differently?

 

1.    Recognize that the entire face, jowls and neck are descending together

2.    Recognize that treating a single subunit can produce a "disharmony" of appearance. ( Buy new drapes and suddenly the sofa looks "wrong")

3.    Recognize that skin tension based facelifts ( the commonest)  produce a weird "windblown" appearance

4.    Recognize that patients want minimal incisions and scarring

5.    Recognize that patients want minimal downtime

6.    Recognize that the biggest concern regarding facial cosmetic procedures was looking "altered"

7.    Recognize that more surgery did not produce better results

8.    Recognize that shorter anesthetics are better

 

As a result of these insights we now usually no longer do individual traditional Facelifts or Neck lifts but combine them into a single procedure called a MACS lift.

 

MACS stands for Minimal Access Cranial Suspension Lift.

 

Minimal Access means that the incision is very short and the amount of tissue undermining is "minimal". The incision extends from in front of the temporal hairline, under the sideburn, in front of the ear to the earlobe. No incisions behind the ear or under the chin. This short incision, combined with less undermining, results in a much faster recovery time.

 

Cranial Suspension means that permanent- invisible- sutures lift and secure the tissues for long term support by attaching the sutures to the immobile tissue just above the lateral cheek bone. 

 

The result is a very natural restoration of a younger neckline, jaw line and face with less time in the operating room than traditional Face and Neck lifts.

The MACS produces batter results and treats more areas of cosmetic concern with less operating time. Usually less than two hours.

The MACS lift is ideal for individuals with minor to moderate degrees of facial descent. This represents about 80% of our patients. If you have a very flaccid neck or major degrees of descent then modifications to the procedure or additional procedures may be necessary.

 

Of course if your situation is different we can tailor a procedure to your particular needs and circumstances.

 The goal of a facelift is not to change the way you look, but to return you to the way you used to look.

 The MACS Facelift: How It's Done

After more than twenty years of doing facelifts, Dr. Weiglein has found that most patients prefer a general anaesthetic for their procedure. The Centre only uses fully trained and experienced certified anesthetists.

Once asleep the incisions are carefully marked and additional local anesthetic infiltrated into the cheeks and neck. This is to further reduce bruising. As part of a MACS lift the neck is always liposuctioned so that the redraped neck skin can adhere in its' new position.  At this point the incisions are made and the skin elevated to allow the two - three permanent sutures that will elevate the deep tissues to be placed. These sutures elevated the descended soft tissues that produce the jowl and nasolabial fold. They also elevate the descended cheek.  The excess skin is now redraped upward (not backward) and removed in front of the hairline and ear as necessary. The incision is then closed with dissolving sutures placed under the skin. After the procedure a special facelift dressing is applied. You will recover for about 2-3 hours in the recovery room and then be allowed to go home with a responsible adult.

 To minimize the bruising and swelling following a facelift it is important to have adequate blood pressure control, cold compresses and keep the head elevated with some extra pillows during the night following your procedure. Your initial dressing is removed the day after your facelift by our nurses here at the Centre. You may shower and shampoo after the initial dressing is removed.

You'll be up and around after a couple of days. Recovery time after a MACS lift is about two weeks. Most of our patients can go out in public by 2 weeks following their procedure.

Follow up appointments are scheduled to allow monitoring of your progress and answer any concerns you may have. Our nurses will manage your care and remove sutures. The final visit is usually at 6-8 weeks post surgery or as long as necessary to ensure that all is well. The face will feel tight and slightly numb for a while but everything should be back to normal after about 3 months.

The facelift lasts, on average, up to ten years and follow-up maintenance procedures can be done to keep you looking as good as you can for as long as you can.

 

The Three D's all act together to produce facial aging. We know that aging faces become lax. We know they lose fullness because of fat wasting. We know that the result is tired, worn-out and withdrawn appearance. This is distressing to the individual behind that face who may be lively, energetic and socially out-going. It is this mismatch between perception and reality that has made the face lift an enduring part of the cosmetic surgeon's palette.

The ideal candidate is a man or woman with some remaining skin elasticity and with a well-defined and relatively strong bone structure. Typical facelift patients are in their 40s to 60s, but facelifts can successfully be done on people in their 70s or 80s as well.

Our oldest facelift patient at the Centre was a man in his 90s.

 We are now seeing patients returning for their second facelift- a sure sign that the procedure has benefited them.

 A Face Lift can benefit you if you:

 

Questions about:

General anesthesia is required for the 2 hour procedure. Dr. Weiglein has found that brow lift is best done under general anaesthesia. The Centre only uses fully trained and experienced certified anesthetists.

If you are not healthy enough for an anesthetic we will not proceed. Anesthesia standards require that you are seen by an appropriate medical doctor prior to the procedure. All of our anesthetists are fully trained and certified.

Bleeding can occur after any operation. If it happens it will occur in the first 24 hrs. It is important to stop taking any medication (aspirin!) or supplements (green tea!) at least 10 days prior to any surgical procedure as many of these products act as blood thinners. Bleeding is very rare following our MACS lifts.

Scars are a necessary part of any surgical procedure. The MACS lift incision and resulting scar is placed along the temporal hairline, under the sideburn and along or within the crease in front of the ear and is usually nearly invisible when healed. We work hard to give you the very best outcome.

Numbness of the operated area is an expected side effect. This gradually disappears over a period of 2-3 months.

Facial nerve injury is rare but possible following any facial cosmetic surgical procedure. Most facial nerve injuries are temporary and resolve over a 3-4 month period but it may be permanent. The MACS Lift is designed to avoid this problem. 

Infection can occur after any operation. A surgically clean environment, careful surgical technique, healthy patients and suitable antibiotic coverage will minimize the risk of infection. We have not had an infection following a MACS lift.

Blood clots can form in the deep (not varicose) veins of the legs and pelvis during any operation. This is exceedingly rare with MACS lifts. At the Centre we use all known methods to decrease this unusual problem to its absolute minimum. We use the appropriate combination of TED stockings, Sequential Compression Devices, adequate hydration Intraoperative Warming and early mobilization. At home, you will continue with the TEDS, continued movement and other treatments if required.

Wrinkles are not eliminated with a face lift nor is the quality of the skin improved. Surgery redistributes lax facial skin. Other treatments are required to improve the appearance of the skin.  

 

From Initial Phone call to Post Op Visits: How it Works

Your initial contact with the office will be with Trish, our Patient Coordinator. She will guide you through the process. You will then meet with Dr. Weiglein to determine the best solution to your particular problem. This initial meeting is designed to be an information and educational meeting. It is actually a time when you "audition" us and we "audition" you. With your input a recommendation will be made and all questions answered. We have numerous pre and post operative photos for you to see. There are always former patients available to speak with you about their experience. We welcome friends / husbands/ others to this meeting.

You will then meet with Trish again to discuss costs, scheduling and logistics. If you require more time to consider your options, or wish another appointment, we will arrange it. If you wish to finance the procedure we will assist you.

We encourage you to see us as a second opinion.

If you elect to proceed you will then meet with one of our nurses for your pre operative visit. She will review the procedure and expectations. Any necessary lab reports will be reviewed. Anesthesia standards require a pre operative physical from a family doctor.

We will provide you with full written post operative care instructions, your prescriptions, follow-up appointment dates, contact telephone numbers and instructions for care-givers at your pre operative appointment. No question will be unanswered.

Need more information?
Please contact us if you have questions. 

 

We are one of the leading cosmetic surgery practices in Canada so you can rely on our expertise.