Facelift
Surgery

A facelift resuspends the supportive tissues of the midface to soften deep lines around the mouth — nasolabial folds and marionette lines — and fullness along the jaw (the jowls). It can also soften deep lines and wrinkles in the skin, though it does not erase every line.

Facelifts should always be performed by a board-certified plastic surgeon with extensive training in facial aesthetic surgery. A poorly done facelift can distort the face; a well-done facelift enhances and restores your unique features. A facelift does not stop aging, but it can soften signs of aging for many years and can be tailored to your unique needs and desires.

Facelift surgery is often done simultaneously with other procedures such as a neck lift to address sagging of the neck or double chin, facial fat grafting to restore volume, brow lift to lift the brows and upper lids, lip lift to create a more youthful upper lip, and laser skin resurfacing to address skin changes. As we age, the facial bones shrink, the fat of our face shrinks, connective tissue stretches and loosens, and our skin begins to develop fine lines, wrinkles, and pigmentation changes. Best results come when all of these components of facial aging are addressed.

The SMAS (Superficial Muscular Aponeurotic System) is an important layer of tissue in the face and neck composed of the muscles of facial expression and their supportive tissues. As people age, the SMAS stretches and sags, resulting in heavy cheeks, deep nasolabial folds, and jowls.

A deep plane facelift works on the deepest layers of the face, underneath the SMAS. It is Dr. Poppler's preferred technique for patients with substantial facial aging. However, a deep plane facelift is more technically involved, involves greater risk for complications, takes more time, and is therefore more expensive than other techniques.

In deep plane facelift surgery, Dr. Poppler lifts the skin, fat pads, and muscles together as one unit. Going beneath the SMAS allows him to release the retaining ligaments that prevent movement of the SMAS — making this a potentially more powerful technique than alternate facelifts that do not go into this plane. The deep plane also preserves connections of the skin with the deeper tissues, which decreases facial distortion and the chance of some common complications. This method can give very natural, long-lasting results. It is especially good for people with sagging cheeks, deep folds, or a heavy neck.

Yes — there are many ways to do a facelift, and Dr. Poppler has training, experience, and expertise in all of them. The terminology of facelift surgery can be confusing, and many surgeons make up new terms to seem unique. However, these surgeons are typically performing the same basic steps as other facelift surgeons. Rather than focusing on a technique name, Dr. Poppler recommends an approach based on the problems you want treated — addressing your specific concerns in a way that makes sense and provides the best correction with the least risk and least scarring. There is no single "best" technique.

There are many more techniques and names beyond what is covered here. You are welcome to ask Dr. Poppler questions about other techniques or terms you encounter at your consultation.

The incisions are hidden around the ears and within the hairline. There are many different facelift techniques and they vary primarily by how they try to hide or minimize scarring. A traditional full facelift makes an incision that begins within the hair above the ear, passes in front of the upper ear in the natural crease where the ear and cheek meet, then passes behind the tragus (the nubbin at the front of the ear where the ear meets the cheek), and then passes around the earlobe. The incision can then continue up along the back of the ear and along the hairline of the back of the head if a neck lift is performed at the same time. A neck lift usually also includes a small incision under the chin.

After healing, these scars usually blend in very well and are nearly imperceptible.

For patients who are not ready for facelift or neck lift surgery, there are several less involved surgical and non-surgical treatments that can dramatically improve the face, neck, and jawline. These can often delay a facelift until the timing is convenient for you.

All of these treatments are available at Treasure Valley Plastic Surgery and Medical Spa. Booking a consultation with Dr. Poppler or one of our highly qualified medspa nurse practitioners and physician assistants is the best way to find out what options work for you and your budget.

There are many non-surgical skin-tightening treatments available at medspas — FaceTite, Morpheus8, and Ultherapy are common examples. At Treasure Valley Plastic Surgery and Medical Spa we offer SkinTyte, a form of broadband light (BBL) treatment that causes the skin to tighten. SkinTyte can be safely used anywhere on the body including the face and neck.

A threadlift places permanent sutures through the skin and into the SMAS without making any incisions. This technique is minimally effective and carries significant risks including unnatural distortion of the face, facial weakness, asymmetry of facial movements, infection, and scarring that makes a future facelift more dangerous, more difficult, and more expensive.

Facial fat grafting and facelift complement one another and are often done together. Facial fat grafting replaces fat that is lost as part of natural facial aging. Dr. Poppler has extensive experience with facial fat grafting and considers it one of his favorite procedures because of its excellent results.

Some surgeons perform fat grafting at the time of facelift. Dr. Poppler generally recommends having fat grafting after a facelift — because it affords an opportunity to correct any asymmetries present after facelift, and fat grafting can be done more aggressively and more accurately when you are fully healed. For patients looking to avoid or delay a facelift, fat grafting can be done safely before a facelift and will not negatively impact your ability to have a facelift in the future.

It takes about three months to fully recover from a facelift. Facelift is outpatient surgery — you go home the same day and can walk short distances that same evening.

Mild swelling persisting to three months is improved by gentle daily massage as directed by Dr. Poppler.

Following your surgeon's instructions — such as avoiding smoking, sleeping with the head elevated, and attending all follow-up visits — helps prevent problems. Revision after a facelift is uncommon. When it is needed, it is often a smaller touch-up that may be possible in the office.