Facelifts when properly done, will yield wonderful results without a tight or pulled look. This surgery will allow the plastic surgeon to lift and re-contour the face and neck in order to eliminate many of the tell-tale signs of aging.
A facelift requires lifting both the skin and deeper tissues of the face and neck, which will result in softening of the facial wrinkles and folds and correction of laxity and banding in the anterior neck. All patients, in my experience, appear significantly younger, although no one can accurately predict exactly how much younger the patient may look.
In my opinion, a skin-only facelift will not give an optimal result. This will frequently appear as a pulled, unnatural, stepped-into-a-wind-tunnel look. The skin was never meant to be used to tighten the facial skin laxity. A SMAS flap, which is a flap created from tissue deep to the skin, allows for a strong, even, lift to the face and neck which will last for many years. When the SMAS flap is used to do the lifting, the skin can then be re-draped in a soft natural fashion without appearing tight or pulled. However, not every surgeon does a full SMAS lift, as this flap is immediately adjacent to the facial nerves, which control the facial muscles.
Also, special fat grafting can be done to give the softer, fuller contours of a young face. The facial skin droops with age, but the face also looses fat and becomes thinner and more gaunt. The correction of this problem is achieved by use of specially harvested fat which is then used to create the proper facial contours with fat grafting. These grafts are placed deeply, using a special small cannula which creates micro-droplet placement of the fat grafts. These grafts work well and are usually permanent.
The very best way to know the quality of the surgeon’s facelifts is to ask to see a number of before and after photos and even ask to speak to one or two of his recent facelift patients.