Facelift Vs. Facial Lipo: Do I Need Both?

Facial rejuvenation is one of the most commonly requested surgical procedures among both men and women. However, the main worry patients have is looking “pulled” or “overdone” which represents a surgical failure. Great plastic surgery whispers, it doesn’t shout! The key to optimal rejuvenation is a natural, graceful, balanced appearance. Through advanced surgical techniques and artistic application of those methods, patients can achieve rejuvenation without telltale signs of surgery.

In an effort to avoid a facelift, many patients request facial liposuction as an alternative. While facial liposuction is a powerful tool, it is only used in a small percentage of patients undergoing facial surgery. Today, we’ll take a closer look at both procedures to help you get an idea about when facial liposuction is a reasonable alternative to a facelift (Spoiler alert – facial liposuction is rarely an alternative to a facelift.) At the time of your initial consult, we’ll discuss each of these options at length before customizing a treatment plan.

Note: It is important to understand the difference between facelift procedures and neck lift procedures.  While facelifts and neck lifts are often performed together, they are different and distinct procedures. In a companion blog, I will address Necklift vs Neck Liposuction.

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*Individuals Results May Vary

Facelift Procedures

Facelift procedures primarily address concerns on the mid-to-lower face. Facial aging involves skin changes – sag, loss of elasticity, and textural changes. It also involves changes in facial volume – loss and repositioning of facial fat.  During the facelift procedure, all of these issues are addressed. Skin and muscles that have begun to sag are tightened and re-repositioned. The artistry of great facelift surgery is understanding when and how far the surgeon can push tightening and repositioning as a method without creating the overdone look that all patients fear. A lot can be accomplished with the lift – as long as one uses the advanced two layer SMAS technique – but for many patients, it is essential to address volume as well.

Patients with round full faces often have the young “baby face” look.  They don’t need to be concerned about volume loss, and these are the patients who, on occasions, will benefit from very limited fat removal – be it with facial liposuction or removal of fat directly through surgical thinning of fat pads.

More often, if there is adequate fat in the face but it has sagged, the SMAS lift allows me to reposition the fat.  Moving the fat from where it has slid (like the nasolabial fold, or the jowl) to where it was lost (the malar eminence, or the cheek hollow) is not the same as reducing the nasolabial fold or jowl with liposuction.  Doing that would exacerbate the aging – making the face look even more hollow. So, the takeaway message is that fat is only reduced in the round full face – in the majority of cases, it is repositioned to where it was originally situated.

At your initial consultation, it is very helpful to see old photos.  Bringing photos of yourself in your younger years, where your face had a more youthful appearance, is a great tool to explain what needs to be done.  I can demonstrate where the fat was – where it’s gone – and if it’s missing or just repositioned.

Note: Aging often involves LOSS of facial fat.  If fat is lost, it often must be replaced to get the very best results.  Fat loss is volume loss. Correction involves volume replacement – either using your own fat as a transplant or using fillers like Juvederm® or Restylane®. And that’s a subject for yet another blog!

At the time of your in-person consultation, I’ll listen to your concerns and perform a facial

evaluation. I will then speak with you about all of your available options and suggest a

treatment plan to help meet your end-goals. After we’ve determined what’s right for you, I will walk you through every step of the process so you’re informed along the way.

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