A facelift, also known as a rhytidectomy, is a popular plastic surgery that restores a youthful appearance to the face by removing loose skin. The skin loses elasticity with age, which causes lines, wrinkles, and skin folds. During a facelift, Richmond facelift expert Dr. Matthew Bridges M.D. FACS, a  facial plastic surgeon, surgically tightens deep facial tissue and excises the excess skin from the face. 

There are various techniques used today to perform a facelift. Facial anatomy, skin laxity and the overall aesthetic goal of the patient will determine the best approach. Each procedure will be unique to the patient and will vary based on the type and location of the incision, the number of tissue layers affected, the plane of elevation and the level of invasiveness.

The skin only facelift has been around since the early 1900s. Known as a cutaneous facelift, this technique addresses the skin only.   The problem with this technique is that the lifting places tension on the skin closure causing widening of scars.  Because deep tissue and muscle are not tightened, the amount of contouring possible by affecting the skin only is minimal.  This technique has been abandoned by most modern facelift surgeons.  

The SMAS facelift is the more modern facelift technique . This surgery produces results that are more significant and longer lasting. The technique involves manipulating the tissue beneath the skin known as the superficial musculo-aponeurotic system (SMAS). This facial tissue layer connects with muscles in the neck.   The SMAS and neck muscles (platysma) are tightened, creating youthful facial contours.  Excess skin is then excised without tension, producing fine scars that are typically nearly invisible.  

The deep plane lift goes a step further than the traditional approach.  The deep plane technique involves dissection below the SMAS layer, providing more mobilization of tissue and greater ability to lift.   

There are lots of "mini" facelifts described and advertised around the country.  Most of the mini lifts also give mini results.  They typically do not create long-lasting results.  Mini lifts typically involve incisions in front of the ear only, without the typical extension of the incision into the hairline behind the ear.  Dr. Bridges does not typically perform the type of mini-lift that gives minimal results.  Instead, he offers a lifting procedure utilizing the state-of-the-art deep plane techniques achieved through a short scar typically used in mini-lifts.  The facial tissues are elevated in the anti-gravitational vertical direction, which achieves the best correction of the sagging neck and jowls.  Although the incisions are "mini", there is nothing "mini" about the result.  For most patients, incisions in front of the ear are all that are needed.  Sometimes a short extension behind the ear and occasionally an incision under the chin are required.  This short scar, deep plane vertical lift is Dr. Bridges' preferred technique.  Dr. Bridges is one of the only facelift surgeons in Richmond who performs this type of advanced lifting procedure.  
 

Most facelift procedures are performed under general anesthesia at an accredited surgical facility. The length of the surgery will vary, but it generally takes between 3-4 hours. This surgery is considered an outpatient procedure. However, some patients may be required to stay overnight in the hospital. After surgery, patients will be bruised and swollen and the face and neck will feel tight. This will gradually improve within a few days. It is common for patients to feel anxious about how their face will appear. Patients need to understand it can take several full months for the final results to appear.  Incisions typically heal rapidly and are hard to see, even after 3-4 weeks.

BOTOX®, injectable fillers, microdermabrasion and chemical peels are examples of some non-surgical procedures that can assist in smoothing out wrinkles, improving fine lines and adding facial volume. These procedures also help to even out skin tone. However, these are treatments that will only affect the skin’s surface. Patients with loose skin, drooping jowls or a sagging neck will need to consider surgery if they want these features improved.

In the days immediately following facelift surgery, patients will feel tight and pulled. These are some short-term effects, but they will subside. It’s important to find a reputable surgeon skilled in facial surgery. Surgeons who know what they are doing will make every effort to work within the confines of the patient’s bone, skin and muscle structures so a younger, more natural look can result.  

Facelift surgery does require  incisions. However, these scars are well hidden as they fall just along the hairline and around the ears in the natural folds and shadows. In most cases, the scars are be barely visible.  Dr. Bridges short scar deep plane vertical lifting technique limits the length of the incision to minimize the scars.

The common age range for patients who undergo a facelift is from the mid to late 40's and older. It is typical for most patients will look 5-10 years younger following a facelift procedure. Younger patients (40-50 years old) generally have stronger skin elasticity so their results may last longer than older patients. However, older patients may have results that appear more dramatic and, for them, this can be very worthwhile. Patients should think of a facelift as a process to turn back the aging clock. You will still age, but you will appear a few years younger.