| If you are considering a face lift or any facial | | | | tissue filler injections |
| rejuvenation procedure it is important to | | | | The newer skin tightening technology uses |
| understand what a face lift can and cannot | | | | radiofrequency energy or infrared energy to heat |
| achieve and the many variations of the face lift | | | | the deep layers of the skin to cause contraction |
| technique that are designed to correct individual | | | | and tightening but first cools the skin before the |
| variations in facial aging that appear on different | | | | energy is applied to prevent injury and ablation of |
| faces. Your face is unique and your face lift or | | | | the superficial skin by the heat energy. Thus the |
| facial rejuvenation procedure needs to be | | | | skin is tightened but the surface is not ablated, |
| customized to create a pleasing result on your | | | | thus non-ablative skin tightening. There is no down |
| face. | | | | time following non-ablative skin tightening unlike |
| Excellent results and beautiful rejuvenation can be | | | | the older CO2 laser resurfacing skin tightening. |
| achieved safely with modern face lift techniques: | | | | Several new skin tightening machines are available. |
| Most important for you is the skill and experience | | | | The LuxIR by Palomar, and the Titan by Cutera |
| of your doctor. Honest expert evaluation of your | | | | utilize infrared energy for skin tightening. The |
| face and a clear explanation of the procedure that | | | | Aluma by Lumenis and Thermage utilize infrared |
| is best for you are essential. I have written a | | | | energy for skin tightening. Refirme by Syneron |
| book called Save Your Face and in chapter 10 you | | | | uses a combination of light energies with |
| will find an important guide on how to choose a | | | | radiofrequency for skin tightening. |
| plastic surgeon, questions you should ask, and | | | | All of the machines achieve about similar results |
| warnings about potential situations that I think you | | | | when used properly. Generally there is less |
| should avoid. | | | | discomfort with the Infrared skin tightening |
| What a face lift can achieve | | | | machines. Complications have been minimal |
| · Restoration of a full youthful cheek | | | | although some serious complications occurred with |
| · A smooth tight jaw line | | | | Thermage skin tightening early on. |
| · A youthful smooth neckline | | | | In my practice I find that non-ablative skin |
| · Some elevation of the lateral brow | | | | tightening is most helpful for younger patients |
| · Removal of jowls | | | | who do not have severe aging changes and |
| · Correction of loose skin around the | | | | significant sun damage, people in their 30’s |
| mouth | | | | and 40’s who want to correct or tighten |
| · Improvement in Marionette lines and | | | | early skin sagging along the jaw line or jowl area, |
| Nasal labial fold lines | | | | neck and cheeks. I use the LuxIR on these larger |
| What a face lift cannot achieve | | | | areas. For skin tightening around the eyelids I use |
| · Wrinkle removal | | | | the Aluma which has a smaller treatment head |
| · Eyelid rejuvenation | | | | and a suction device that will pull the delicate peri |
| · Removal of crow’s feet | | | | ocular skin into the treatment chamber for skin |
| · Removal of eye bags | | | | tightening. |
| · Removal of eyelid hooding | | | | The field of non-ablative skin tightening is in its |
| The different Types of Face lift Procedures | | | | infancy and will definitely become more effective |
| There are so many different names used to | | | | in the years ahead. The companies are improving |
| describe the face lift that it can be very confusing | | | | their products frequently. For now however the |
| for you the patient. Terms like week end lift, mini | | | | people who benefit most from the skin tightening |
| lift, S lift, non-surgical face lift, thread lift, lifestyle | | | | machines today are younger people who still have |
| lift are often used and it is hard for you the | | | | thick healthy skin with early aging changes. |
| patient to know what these terms mean. Below I | | | | The use of the term non-surgical face lift to |
| will try to describe the variations of the face lift | | | | describe non-ablative skin tightening is an |
| procedure hopefully shed some light on this | | | | overstatement with technology available for skin |
| subject for you. | | | | tightening today. At best a 30% result is possible |
| The Standard Face lift | | | | when compared to a traditional face lift. |
| The standard face lift involves an incision around | | | | Result Oriented Face lift |
| the ear and undermining or freeing the loose facial | | | | A face lift can create a truly beautiful and |
| skin from the deeper facial attachments. Once | | | | refreshed look to your face: |
| the skin is free to move it is drawn tight back to | | | | The important components of a beautiful Face lift |
| a more youthful and normal position on the face | | | | result are: |
| and the excess skin is removed from the area | | | | * A smooth, firm neck and jaw line |
| around the ear and the incision is closed. This | | | | * A full elevated cheek high on the cheek bone |
| relatively straightforward operation can produce | | | | * A normal appearing ear lobe |
| excellent results and has “stood the test of | | | | * Hidden scars |
| time”. Elements of the standard facelift are | | | | * A normal “unoperated” appearance |
| used in virtually all of the facelift variations listed | | | | * Looking “like you” just younger |
| below. The main difference is that the underlying | | | | The Face lift is one of the most enjoyable |
| “musculo-aponeaurotic” tissues are | | | | surgeries that I do. After 25 years in practice I |
| not always tightened. | | | | usually achieve the result you want and it is a joy |
| One common variation of the standard face lift is | | | | for me to share your happiness and enthusiasm |
| the SMAS Plication which involves tightening the | | | | for your new refreshed look. |
| deep layers with a stitch rather than actually | | | | The Face lift requires experience and skill and is a |
| excising or removing some of the deep tissue | | | | complex procedure which requires both artistry |
| layer. The standard face lift with “SMAS | | | | and a clear understanding and shared image of |
| Plication” is the most common face lift I | | | | the final look you hope to achieve. |
| perform. Published reports document the | | | | Your Consultation |
| superiority and effectiveness of this technoique. | | | | When we meet I will talk with you and ask you |
| The SMAS Face lift | | | | to explain to me the specific facial rejuvenation |
| The SMAS face lift involves dissecting, and | | | | goals you hope to achieve. I will examine you and |
| tightening the deeper tissue called the SMAS layer | | | | tell you my findings and describe the areas where |
| in addition to the standard facelift dissection of | | | | I think improvement can be made. I will |
| the skin. This is done to provide additional | | | | demonstrate on your face the appearance that I |
| tightening of the face and presumably provide a | | | | believe the face lift will create on your face. |
| longer lasting result. Studies have cast doubt on | | | | I will then recommend the procedure I feel is best |
| whether SMAS lifting provides a longer result, but | | | | for you. I will discuss the procedure, your |
| most face lifts today include some modification of | | | | recovery, and expectations and answer your |
| the SMAS. | | | | questions. Photos of your face will be taken. You |
| The SMAS stands for “superficial muscular | | | | will be given an estimate or quote of the cost of |
| aponeurotic system” and describes a firm | | | | the procedure. Financing plans are available. |
| fibrous tissue layer beneath the facial skin that | | | | The Face lift procedure |
| attaches the facial skin to the underlying facial | | | | I perform different types of Face lifts designed |
| muscles. When this tissue is tightened during a | | | | to meet your specific needs for your unique face. |
| face lift additional facial tightening is achieved. | | | | A Full face lift elevates and firms the entire face |
| The classic SMAS face lift involves dissecting | | | | and neck, including the lateral brow, the cheek, the |
| beneath and elevating the SMAS layer, excising | | | | jaw line and the neck. A neck lift just tightens the |
| some of the excess and suturing the SMAS layer | | | | neck and lower jaw. A midface lift or cheek lift |
| to tighten it. | | | | tightens the cheeks and nasal labial folds. An upper |
| I achieve the same effect by “plicating | | | | face lift or brow lift elevates the outside of the |
| “the SMAS layer which means I do not | | | | eyebrow and the upper face. |
| dissect beneath the layer but fold the layer on | | | | A mini face lift is a less extensive full face lift |
| itself with a suture to tighten the SMAS. | | | | which is appropriate for people who have minimal |
| I do not dissect beneath the SMAS because the | | | | facial laxity and need only minor facial tightening or |
| facial nerves run below the SMAS and I fear | | | | tuck. The mini lift is usually appropriate for |
| damage to the facial nerve. In my experience the | | | | younger people in their 30’s and |
| placation provides the same result and is safer | | | | 40’s, or those lucky people in their |
| The Extended SMAS Face lift | | | | 50’s and up who have very little facial |
| The extended SMAS face lift involves a more | | | | laxity. |
| extensive dissection beneath the SMAS layer in | | | | A good face lift result requires tightening of both |
| an attempt to get a more extensive tightening of | | | | the skin and the deeper facial tissues which also |
| the facial skin especially down around the mouth. | | | | sag with age. I tighten the deep layers of the |
| In my experience I am able to get this correction | | | | face; the SMAS face lift, which tightens the |
| by undermining skin only and plicating the SMAS. | | | | deeper muscle like layer of the face. This is |
| I avoid the extended SMAS face lift because in | | | | necessary to achieve a good result that lasts. |
| my opinion the facial nerves are more exposed to | | | | Minor lifts that are advertised as being quick, easy |
| injury by this technique | | | | and with no down time usually only involve skin |
| The Deep Plane Face lift | | | | removal and they do not last, often only a few |
| The deep plane face lift involves a more | | | | months. A well done SMAS lift should last years. |
| extensive dissection beneath the SMAS layer and | | | | Face lift Vectors |
| some of the facial muscles such as the orbicularis | | | | A very important concept in face lifting is the |
| occuli. Proponents argue a more effective | | | | Vector. The vector is the direction of pull required |
| correction of cheek laxity and lower and mid face | | | | to lift the face to a younger more attractive look. |
| correction especially around the mouth. Longer | | | | The appropriate face lift vector is unique to your |
| lasting results are reported and this technique is | | | | face and the face lift must tighten your face |
| purported to be safer for people who have | | | | along the appropriate vector if you are going to |
| smoked in the past. | | | | achieve the result you want. |
| Beautiful results have been achieved by the | | | | When you see a person who has had a face lift |
| originator of this procedure, Dr Sam Hamra of | | | | and has the surprised look, or looks too tight, |
| Texas. Others have experienced an increased | | | | unnatural or like a “weasel”, it usually |
| incidence of nerve injury. My own experience is | | | | means that their surgeon did not tighten the face |
| that while excellent results are possible, some | | | | along the appropriate vector. |
| patients find an objectionable change in the | | | | I always examine your face, determine the best |
| appearance of their mouth. | | | | most natural vector for your face and draw the |
| Some studies have shown that the SMAS | | | | vectors on your face before I make my lines to |
| Plication technique mentioned above provides | | | | mark my planned face lift procedure. This helps to |
| superior cosmetic results. | | | | assure a natural looking face lift result. |
| Subperiosteal Face lift | | | | Scars |
| The subperiosteal face lift involves undermining | | | | No one wants scars on their face and everyone |
| beneath the deepest facial layer adjacent to the | | | | is concerned about face lift scars. |
| bone. This technique is designed to elevate and | | | | Usually face lift scars are not visible to those |
| tighten all of the lax soft tissue on the face. | | | | around you. 75% of the face lift scars are behind |
| Theory holds that undermining in the area next to | | | | the ear or in the hairline and people do not see |
| the bone, deep to the nerves, also helps avoid | | | | them unless they closely inspect you and look for |
| nerve injury. Nerves still can be injured by this | | | | them. Yes your hairdresser will know, but he/she |
| blind deep dissection. The subperiosteal face lift is | | | | is likely the only one other than your partner. |
| an extensive operation and in my experience | | | | The 25 % of the scar that is in a visible location is |
| offers no advantage over the standard face lift | | | | also hidden. This scar is placed into the fold in |
| with SMAS placation | | | | front of your ear. It is usually not visible and is |
| The Lateral Brow Lift | | | | easily covered by your make up. |
| The lateral brow lift is a modification of the face | | | | Your Ears |
| lift to treat laxity and sagging of the upper third | | | | In my opinion, the worst sign of a bad face lift by |
| of the face, the outside portion of the eyebrow | | | | an inexperienced surgeon is the “Spock |
| and the upper cheek. An incision is made in or on | | | | ear” or “elf ear” deformity. |
| the hairline on the side of the forehead, the skin is | | | | This occurs when the ear lobe is fused to the |
| undermined, pulled tight and the excess removed. | | | | cheek and pulled down to where it looks like the |
| This technique can be effective when only the | | | | ear is attached to the angle of the jaw. |
| side or lateral potion of the eyebrow and the | | | | I have developed a very specific technique for |
| upper cheek are lax. However care must be | | | | creating a normal looking ear lobe following a face |
| taken to avoid displacement of the hairline and | | | | lift-check my photos; you will not see the |
| injury to the frontal branch of the facial nerve, | | | | “Spock ear”. |
| which if injured can cause the brow to droop. | | | | Pre OP |
| The Forehead Lift | | | | The pre operative visit is the time when we will |
| The forehead lift is a procedure I rarely do since | | | | sit down and clearly define your face lift goals. We |
| the advent of Botox. Proper use of Botox can | | | | will discuss what you hope to achieve and what I |
| correct most forehead laxity caused by | | | | believe I can achieve with your face lift. I will try |
| contraction of the frown muscles and the | | | | to give you an honest image of what you can |
| standard face lift corrects most lateral brow laxity | | | | expect for a result. |
| of the outside portion of the eyebrow. | | | | You will also undergo a history and physical exam |
| A forehead lift requires and incision within or at | | | | to make certain that you are healthy and have |
| the hairline all the way across the forehead. The | | | | no medication allergies or contraindications to |
| results can be excellent if you are willing to accept | | | | surgery. An EKG (electrocardiogram) may be |
| the scar. One problem however is that for a long | | | | done if you have a history of heart problems or |
| lasting result the frown muscles must be | | | | have reached a certain age. You will also be given |
| removed and this can result in a permanent | | | | prescriptions for post operative medications. You |
| depression or contour deformity in the mid | | | | also will be asked to read and sign surgical |
| forehead in the frown area. In the past the frown | | | | consent forms which outline the risks, potential |
| muscles could be neutralized through an upper | | | | complications, limitations and expectations of face |
| blepharoplasty eyelid incision, but again Botox has | | | | lift surgery. |
| made this operation unnecessary for most people | | | | The Operation |
| who want to correct laxity of the middle portion | | | | A full SMAS face and neck lift usually takes me |
| of the forehead. | | | | about 90 minutes to 2 hours. If I am doing eyelid |
| The Mid face or Cheek Lift | | | | rejuvenation or 4 lid blepharoplasty at the same |
| The mid face lift or cheek lift is designed to | | | | operation, as is often the case, then the surgery |
| tighten the cheeks and help improve the nasal | | | | can take 3 hours. Mini lifts, neck lifts and cheek |
| labial fold lines. This is a modification of the face lift | | | | lifts usually take only an hour. |
| which involves an incision along the crease in front | | | | You are asleep during the surgery. I have very |
| of the top part of the ear extending up onto the | | | | experienced superb anesthesiologists who will be |
| hairline. | | | | taking care of you. Safety is our first concern. |
| The cheek lift or mid face lift is effective for | | | | We use modern, very safe anesthesiology |
| people who have laxity in the cheek and nasal | | | | techniques, and take precautions to avoid nausea |
| labial fold lines but have no laxity along the jaw line | | | | after surgery. |
| and neck. | | | | Following your surgery you will go to the |
| The cheek lift or mid face lift is becoming very | | | | recovery room where a nurse will take care of |
| popular among younger patients who have early | | | | you and make sure you are comfortable. |
| facial laxity in the midface. Cheek sagging is often | | | | Some patients prefer the comfort of an |
| the first facial aging change to occur, and younger | | | | overnight stay in the hospital. In this case I will |
| patients are choosing to have a cheek lift or | | | | examine you the next morning, remove two tiny |
| midface lift before further facial sagging extending | | | | drains from behind your ear, remove your |
| to the neck and jaw line occur. | | | | bandage, and have you shower and comb out |
| The Neck Lift | | | | your hair, and then discharge you. When you go |
| The neck lift is designed to tighten sagging neck | | | | home a small scarf placed over your head and a |
| skin below the jaw line and chin. The neck lift is a | | | | pair of sunglasses will usually hide the fact that |
| good choice for younger patients who only have | | | | you have had surgery. |
| loose skin beneath the chin and jaw line. | | | | For those of you who want to go home the |
| In some cases the neck lift can be accomplished | | | | same day after surgery, you will spend about 2 |
| through a small incision beneath the chin which is | | | | hours in the recovery room with a nurse taking |
| well hidden. This procedure is also called a | | | | care of you. As soon as you are comfortable, |
| platysmaplasty or corset platysmaplasty. In some | | | | able to drink and eat a bland food such as |
| cases with more extensive neck laxity an incision | | | | crackers or cookies, and able to go to the |
| behind the ear is also required. | | | | bathroom, you will be discharged. The nurse will |
| The Short Scar Face lift | | | | escort you by wheel chair to your car. |
| The short scar face lift describes a face lift | | | | We require that someone bring you to the |
| performed through an incision which runs only in | | | | surgery center and take you home, and that you |
| front of the ear in the skin crease. The incision | | | | have someone staying with you the first night |
| behind the ear and above the ear in the hairline is | | | | after your surgery. |
| avoided. | | | | Post op- What to expect |
| Some authors show very impressive results | | | | My patients do not always complain of pain |
| showing improvement in face and neck laxity with | | | | following a face lift. Your face and neck will feel |
| this technique. This procedure is effective for | | | | tight, which means that I have done my job |
| younger patients with mid face laxity and less | | | | correctly. After a few days the tight sensation will |
| extensive neck and forehead laxity. The smaller | | | | go away as the facial tissues relax. If you have |
| incision is advantageous cosmetically and should | | | | had a blepharoplasty for eyelid rejuvenation you |
| require less healing and down time. | | | | will have ice packs on your eyes to reduce |
| The Mini Lift | | | | swelling and bruising. |
| The mini lift or mini face lift means many things | | | | I place a bandage around your face which comes |
| to many people. Most commonly the mini lift term | | | | off the next day and you may shower and wash |
| is used by patients who want a face lift but | | | | your hair on the first day after surgery. I usually |
| don’t want to call it a face lift! | | | | place a tiny drain behind each ear which is |
| To me a mini face lift is a smaller procedure than | | | | removed the first day after surgery. |
| the standard face lift and is useful in patients who | | | | Bruising on the face is unusual; bruising when it |
| have early facial laxity in the cheek and jaw line | | | | does occur is usually on the neck and upper chest |
| who do not have extensive neck laxity. | | | | and is usually minimal and easily covered with |
| Usually I can use a short scar or an upper scar | | | | make up. |
| along the upper portion of the ear crease into the | | | | Usually after 1 to 2 weeks you will be |
| hairline. | | | | comfortable being seen in public and will be back |
| The mini lift or mini face lift is a less extensive | | | | to most normal activity. I ask you to wait 3 |
| procedure and works well for younger patients | | | | weeks before heavy weight lifting or aggressive |
| and older patients with minimal facial laxity. | | | | work outs. |
| The Lifestyle Lift | | | | I have you take an herbal supplement called |
| I include the lifestyle lift here because so many | | | | Arnica Montana before and after surgery which |
| people ask me about it. I only know what I read. I | | | | helps reduce bruising. I also have excellent mineral |
| have not trained in nor have I ever done or seen | | | | cover up make up to cover any visible bruising. |
| a lifestyle lift performed. I have seen patients | | | | Consultation with Dr Seckel |
| who claim they have had a lifestyle lift. As | | | | I can tell you a great deal more about face lift |
| advertised the lifestyle lift is done without general | | | | and how it would work for you if I see you in |
| anesthesia or IV sedation and claims are made | | | | person. Call me 978-844-3116 or contact me by |
| that recovery is less than a traditional face lift. | | | | email at If you would like to email me your |
| The Non-surgical Facelift | | | | photos I can email you my thoughts about how I |
| When most people use the term non-surgical face | | | | think a Face lift would work for you. For more |
| lift they are talking about skin tightening with the | | | | information on face lift read my blogs on face lift. |
| various new skin tightening machines. Some | | | | I look forward to meeting you. |
| misuse this term by applying it to extensive soft | | | | |