Facelifts – what you need to know!

Naturally, patients are concerned about how long a result will last, whether it is a quick injectable performed to fill in lines around the mouth to procedures with longer downtime.

During a recent procedure, I was chatting with my patient and she said, ‘now Dr Madnani, I want to you pull as hard as you can with this lift’. I asked her why and she said that she wanted it to be as tight as possible so her neck and face would look better. She had heard of facelifts ‘falling’ after a few months and she did not want that do happen to her.

I have heard this many times, patients are under the impression that the harder you ‘pull’, the better the results will be, then there are the subset of patients that say ‘ Dr Madnani, I don’t want you to pull too hard, I want this to look natural.’

A facelift works by tightening muscles that have loosened and by removing excess skin that has formed. Neck muscles sag,  jowls form, the SMAS layer of the face, (the layer to which many of the muscles of the face attach to) and overlying skin, loosens over time.

During the procedure, I tighten muscles and lift the SMAS using visual and tactile cues. I can see the neck and jawline become more defined. My eyes and hands are in constant communication with the patients’ anatomy and as I am performing the procedure, the visual and tactile ‘dance’ determines how the ‘lift’ is performed. The ‘tightness’ of the lift is not important, what is important are the details such as the direction of the lift, the treatment of the SMAS layer, use of the natural creases around the ear, the position of the hairline and how the neck is sharpened are all details that are determined before and during the procedure.

A patient with a narrow face, thin skin and long neck gets a slightly different procedure from a patient with a shorter, wide face, thick skin and neck fullness. These surgical nuances are tailored for patient specific anatomy. Experience in a variety of techniques and variety of patient shapes and sizes, ensures the most natural and long lasting final results.

It is the fine details present in a bespoke suit that separate it from a regular suit. The quality of the fabric, the tailoring of the fit, the detail in the stitching, a flash of color inside the lapel; all contribute to the final look. It has nothing to do with the amount of fabric used or how ‘tight’ the fit is.

An artistic eye, finely honed skills gained from experience during thousands of facial procedures and natural results define my facelifts. I tailor as ‘tight’ as I need to leaving the patient looking refreshed, younger and natural.

Dilip D Madnani, MD, FACS is a dual board certified facial plastic surgeon in New York City and Long Island (www.drmadnani.com +12122038591) and cofounder of www.purehealplus.com skin/scar care products.