Facelifts: How Long Do They Really Last? 

Anne Taylor, MD

If you are researching whether you’re ready for a facelift, you are likely one step closer to your new rejuvenated look. And with this decision-making process comes a number of questions you’ve likely been thinking about—specifically, what procedure will give you the best results and how long will the new youthful look really last?

Facelifts have evolved over the past years, achieving a deeper, long-lasting correction. In this blog, I will discuss the types of commonly used facelift techniques, including those I use at my Columbus, Ohio, practice. I’ll also explain the other complementary treatments I recommend to maintain and enhance your fresh, new look.

How Facial Structure Influences the Facelift Technique

When talking about types of facelifts, we have to go more than just “skin deep.” I often compare the facial anatomy to an onion—layers of important structures. The skin is like the outer layer and just covers the deeper, more important layers. You can see an illustration of these facial layers on the Medical Aesthetics Information Platform and Solutions website.

For a facelift to be long lasting, the layer under the skin—the muscle layer—must be addressed. This is the important structure to lift—and usually, the vector for this lift is straight up, while the skin is pulled obliquely towards the ear to hide the incision in the crease there.

Facial aging comes in all the layers of the face—from the skin envelope that is looser and non-elastic (mostly from sun damage), down through the muscle layer to the fatty pockets that are the only place on the body the fat diminishes when we want it to stay put!

The final component of the aging process goes all the way to the facial bones—as these also are changing and shrinking, making the structures above it shrink and cave in. So, all of these must be addressed when it comes to rejuvenating the aging face. Let’s go through how these are done, layer by layer.

Facial Layers and Rejuvenation Options

The bony structure can be augmented with either a permanent implant or a semipermanent “filler” implant. The option of fillers has become more common and popular because it is an office procedure that can be done as a lunchtime treatment. Plus, there are many types of fillers to choose from to achieve the best result based on the particular anatomy.

So, for the cheeks, a thicker type of filler can be used that will “push” up more and fill in those hollows. As the area treated gets closer to the surface and the skin thinner, the filler options are more flexible and softer in consistency. This medium type of filler is used in the nasolabial areas and also the marionette lines. Finally, where the area is more delicate and the skin thinner, such as the eyes and lips, the fillers are the softest and smoothest. While these do not “push” up as much, they are a better choice since they are softer.

The skin excess and muscle layers are addressed with the surgical facelift procedures, which must pull up on the muscle layer and remove the excess skin. This is where the real “business” of the rejuvenation occurs.

Dermal fillers are fine to “buy some time”—but there will come a day when no amount of filler is going to be able to correct the underlying muscle and skin excess. I talk more about knowing when it’s time to choose facelift surgery in a related blog post.

It can be a difficult conversation to have with a patient who was hoping to just get an injection. I have to be really honest with some and inform them that they are welcome to try the fillers alone, but for their particular case, I would recommend surgery AND fillers to really get the best result. The lifting should be combined with the fillers, as these both complement and enhance each other.

What does a facelift do?

The types of facelifting procedures can seem overwhelming to the patients researching this because there is such a variety of techniques and approaches. The major concepts of moving the muscle layer up and then removing some of the skin layer encompass the two major concepts that are crucial.

The technical details on how this is done are not the key aspect for the patient. After all, do you ask the pilot how she will fly the airplane? at what airspeed? at what altitude? These details you leave to the flight crew, just as the details of the facelift are beyond a blog post. Suffice it to say that the safe trip is the goal, and viewing some pre- and post-op patient photos is an important step.

What does skin resurfacing do?

The icing on the cake of the surgical procedure is the most superficial layer of the skin—where the fine dermal wrinkles reside. Resurfacing or sanding down these very fine lines can be approached a number of ways—from a chemical peel to a laser peel to dermabrasion. Each of these modalities has unique pros and cons, such as limiting downtime with a trade-off of a more conservative change. There are some dermal wrinkles, like those around the lips, that usually require a number of modalities to treat completely.

What is the best face tightening procedure?

As you are probably now realizing, getting the best result is totally dependent on what formula of treatments is used. And this, of course, depends on each patient and their goals. The best recommendation is to prioritize your goals, and then search out a board-certified plastic surgeon who specializes in this type of case.

Of course, this is just an overview of the topics you will discuss with me and my A-team at my plastic surgery practice in Columbus, Ohio. You can request a consultation using our online form or call us at (614) 569-2649. We hope to see you soon and help you on this journey!

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