“How long does a facelift last?” by Dr. Marin
by Plastic Surgeon Dr. Vincent Marin
Facelift procedures have been around for many decades and encompass many different techniques. Surgeons first under took what was termed a “skin only” approach to improve facial appearances. None of the deeper tissues or muscle layer was addressed during this procedure. The excess skin was removed, but skin has a tendency to relax more easily than muscle leading to a more rapid return to a patient’s baseline. Thus, these procedures were shorter lasting and left patients less satisfied. As a result, in the 80s surgeons attempted to counteract this by pulling harder on the skin. Unfortunately, skin does not like tension and this resulted in patients looking wind-blown with widened scars and less than ideal outcomes.
In the recent past, many marketing surgeons have emphasized the quick return to work in the form of a “lunchtime facelift< or the “Lifestyle Lift. Most of these techniques are designed to give a quick result without much concern for longevity. These techniques result in a quick return to your surgeon for a second procedure as the results infrequently stand the test of time. There are occasions where a “skin only” facelift is appropriate, but this is often in revisionary procedures or very specific circumstances.
As surgeons became more aware of facial anatomy and the relaxing properties of skin, deeper approaches were then investigated. This was first popularized by Dr. Skoog in 1974, commonly termed the Skoog or “deep plane” face lift. Surgeons have found that attention to tightening and elevating the deeper layers of the face provided more attractive, reliable and longer-lasting results.
Deep plane facelifts where the tension is placed on the muscle layer immediately below the skin while the excess skin is also re-draped provide the best and longest lasting results. This allows the surgeon to address the characteristic issues associated with facial aging. The tension is not placed on the skin which helps to alleviate some of the telltale sign of a facelift – most notably widened scars, a wind-blown appearance and a tethered ear deformity. Also, repositioning the underlying muscles and soft tissues helps to restore volume where it has been lost in the cheeks and mid-face.
Facelift results also depend upon how well a patient takes care of their skin, their history of sun exposure and their individual genetics. Some patients can have one procedure their entire life while maintaining a youthful appearance. However patients with excessive laxity of their skin may see their surgeon more frequently despite the perfect technique. On average, most patients should have an average 10 years where they still look younger than their original preoperative appearance.
Most patients don’t want to look different or unlike themselves after their surgery. Usually patients are looking for a rejuvenated, younger version of themselves. In doing this, care is taken to not over-correct or excessively tighten the skin in these procedures. This allows patients to return to their normal daily activities more quickly and limiting the recovery. This too can have an effect on the duration of the result. The more a patient can tolerate “down time” the more aggressive the surgeon can be with the procedure. However, most patients need to be able to return to work and their life as soon as possible. Most will only tolerate 1-2 weeks of recovery.
Finally, the most important determination a patient can make when considering a facelift procedure is finding a surgeon who is experienced in the deep plane technique and can show before and after photographs representing an outcome that you as a patient might be happy with. Quick recovery procedures or marketing gimmicks are just that – and if it sounds too good to be true, it usually is.
Do your homework.