Fort Worth
Facelift

 

Facelift Surgeon Serving Fort Worth

Facelifts are the third most common cosmetic procedure according to national plastic surgery reports. Over 230,000 of them are done all over the United States.

As the years wear on, the skin loses its natural elasticity. The contours of the neck and face get altered gradually as the skin becomes laxer. A skilled facial plastic surgeon can provide facial definition via a facelift (aka a rhytidectomy).

At Law Plastic Surgery near Fort Worth, Dr. Huay-Zong Law restores a youthful and defined face by performing various facelift techniques suitable for each individual.

The Anatomy of the Face

The face has five layers of connective tissue. The topmost layer or superficial fascia contains fat and is continuous with a muscle in the neck, namely the platysma. The second layer is a mixture of fat and fibrous tissue. This is followed by deep fascia which protects the facial nerve and muscles for chewing. The facial nerve is responsible for the movement of all the facial muscles. The next layers or the deep plane protect the ligaments of the face. These include the zygomatic, maxillary, masseteric, mandibular, and cervical ligaments. It also houses the greater auricular nerve that is responsible for hearing.

Additionally, there are major arteries supplying blood to the face and ducts that drain saliva from the salivary glands into the mouth.

The loss of elasticity of the fibrous tissue can take place at any layer of the face. And so facial corrections are done at various layers depending on the area where the loss is more evident. This could be done at the level of the superficial fascia, midface or the deep plane.

What Is a Facelift?

A facelift is a rejuvenation procedure where the ligaments and muscles are tightened. In some cases, the fat compartments are restored and any excess skin is excised based on the patient’s needs.

There are various procedures for a facelift. That’s because people age differently. Individuals demonstrate a wide variety of visible changes with time. The fat in the cheeks could be lost or descend lower into the face or the folds near the nose deepen. Others have loose skin, drooping of the cheek, or formation of festoons or “bags.”

That is why Dr. Law tailors the method according to patient-specific areas of concern. So while one person may benefit from the repositioning of the cheek fat, another may require reattachment of the muscle to give the face more definition.

Who is eligible for a facelift?

For individuals in the Fort Worth area looking to get a facelift, it’s important to remember that any person interested in getting a facelift can seek a consultation with Dr. Law.

What can A facelift address?

• Facial asymmetry due to the paralysis of facial muscles.
• Lax skin in the lower face.
• Presence of festoons or “bags” under the eyes.
• Descent of cheek fat
• Facial dimples
• Presence of jowls or sagging skin under the chin
• Presence of folds near the nose and lips

The Initial Facelift Consultation

At Law Plastic Surgery near Fort Worth, Dr. Law meets with every individual during the initial consultation to understand their goals and what they hope to achieve with a facelift procedure.

After taking a complete history and physical examination, he will discuss what a rhytidectomy entails and what options are available. If an individual could benefit from alternative procedures instead of a facelift, Dr. Huay-Zong Law will recommend them instead.

Following the initial consultation, patients are given time to think about their options. They can always come back with more questions. Dr. Law would be happy to lay to rest any doubts about the procedure.

Can Someone Be Ineligible for a Facelift?

While Dr. Law performs facelifts on people of different ages near Fort Worth, there are some candidates that he suggests would be poor candidates for this surgery. This includes:

• Individuals with bleeding disorders who cannot discontinue anticoagulant therapy.
• Active smokers.
• Those with Body Dysmorphic Disorder or an obsessive-compulsive–related disorder.
• Individuals with poorly controlled hypertension.
• Individuals with poorly controlled diabetes.
• Those susceptible to keloid formation.
• Individuals with suppressed immunity like cancer patients and those undergoing chemotherapy or radiotherapy.
• Those who are obese.
• Individuals with autoimmune conditions like psoriasis and multiple sclerosis.
• Those with collagen vascular diseases like Lupus and scleroderma.
• Individuals at risk for cardiac and pulmonary complications from general anesthesia.

Types of Facelift and Various Facelift Techniques

Dr. Law uses many techniques to give the face more definition and contour it as necessary. He may decide to combine the main facelift procedure with other procedures for the eyes or the neck based on the patients’ goals.

SMAS/ Deep Plane Facelift

The superficial muscular aponeurotic system is the first layer. In the SMAS imbrication, the skin is incised near the ear and a flap is raised. The fat pad in this plane is lifted and placed higher. The ligaments are released and tightened as necessary. The SMAS flap is rotated and secured symmetrically. While re-draping the flap, any redundant skin is excised.

Minimal Access Cranial Suspension Lift

This facelift is very similar to the one described above. Here, the elevation is done over the level of the midface. The cheek fat pad is left down and suspended in the deep fascia with the help of purse-string sutures. Similar sutures are used if necessary to lift the lower face, tighten loose skin, and improve jaw definition as well.

Subciliary Midface Lift

This is another midface facelift procedure. In the subciliary midface lift, the incision is made at the level of the lacrimal point near the eyelids. Traction sutures are applied to the margins of the eyelid for a lift from above. This route is good for those individuals who need the eyelid fat pads to be reduced or repositioned.

Cheek Lift

There’s also an implant-assisted facelift where an implant is used to anchor the SMAS and the cheek fat. It is called the cheek lift. This prevents the fat from moving. Implants are usually absorbed in time and made of polylactic-polyglycolic acid polymer. They are completely resorbed over 6-8 months.

Mini-Lift

This type of facelift involves a series of small incisions concealed under the hairline to tighten up the skin. It is an option for those with very mild to moderate skin sagging. This technique aims to only smoothen out the skin and is less invasive with a shorter recovery period as compared to the other traditional facelift techniques.

S-Lift

The S-lift gets its name from the incision, an S incision that is used in this procedure. This is usually done for those who’re looking for a revision facelift or those with early sagging of the skin in the lower third of the face and neck. The S-lift mainly lifts the jowl area or the area under the chin.

Preparation for Surgery

After the initial consultation with Dr. Law, preparations are made to ensure a patient is ready. The team at Law Plastic Surgery works with you to complete a series of requirements. This will include pre-surgical testing, medical clearances from your primary care physician, psychological evaluation, measurements of the face and neck, photographs for surgical planning and discussion about medications.

Pre-Surgical Testing

Pre-surgical testing is required before surgery. These tests are important to stratify risk, direct the choice of anesthesia, and understand the overall health of the patient. The tests are determined by age, medical history, the findings of the physical examination and the presence of comorbidities.

Some of these tests include:

• Chest Xray
• Electrocardiography (EKG)
• Urinalysis
• Blood tests include a complete blood count or CBC, electrolyte, creatinine testing,
• Coagulation studies are reserved for those with a history of bleeding disorders or those taking anticoagulant therapy.
• Random blood glucose testing is done for all patients. A1C testing is done for those with diabetes.
• Liver function tests and others are prescribed as per Dr. Law.

Medical Clearance

In addition to tests, the primary care physician must deem each patient healthy to undergo surgery. These assessments are made by the primary care physician to optimize patients for surgery and minimize post-surgery complications. Based on the comorbidities, additional clearances are required from a cardiologist and pulmonologist.

Measurements and Photographs

Dr. Law may also ask his team to measure the neck and face. These measurements are taken to plan the surgery. Photographs are also taken for the same reason. Frontal, three-quarter, and lateral views of images are taken to adequately document the shape and position of the ear, symmetry of the face, the hairline, and patterns of muscle movement.

To assess the effectiveness of any facelift a chin down photograph is also taken. If necessary, advanced software might be used to demonstrate the contours of the face.

Medications Checklist

There’s a whole list of medications that must be reduced or discontinued before surgery. They include pain relievers like ibuprofen (e.g., Motrin), aspirin, naproxen (e.g., Aleve) and blood thinners (e.g., Coumadin).

Herbal supplements like Ginkgo Biloba, Kava, milk thistle, ginseng and St. John’s Wort must be stopped a week before surgery.

Vitamins like vitamin E, vitamin K and vitamin A also must be discontinued before surgery.

Doses of other antihypertensive, oral hypoglycemics for diabetes and other medications must be discussed with Dr. Law or your primary care physician. A full checklist of what medications to take and to avoid will be handed to the patient a week before surgery.

For those who smoke, discontinue any product that contains nicotine. This includes e-cigarettes, nicotine patches and vapes. Nicotine affects blood circulation since it constricts the arteries, thereby affecting the healing process.

Avoid alcohol for two to three days before surgery.

Day of Surgery near Fort Worth

On the day of the surgery, the patient arrives having fasted for a specific number of hours depending on the time of the scheduled surgery. Once a patient arrives at the clinic, the staff will talk you through the next steps.

Dr. Law’s team will also take some details of the person who will stay overnight with the patient and drive them back home the next day. Dr. Law will mark the incisions along the hairline and the ear with a marker just before the surgery. These are just temporary outlines.

During the Facelift Procedure near Fort Worth

Before the surgery begins, a single dose of intravenous antibiotics is given to prevent any bacterial growth on the skin. A single dose of an intravenous steroid injection is also given to prevent any local swelling and inflammation.

Local anesthesia with lidocaine is given before making any incisions on the skin. Deep plane facelifts are always done under general anesthesia. The choice of anesthesia depends on the procedure and the general health of the patient.

This procedure can take anywhere from two to four hours. The length of the surgery depends on what type of procedure Dr. Law has suggested and what technique is being used. If the patient opts for brow lifts or other simultaneous corrections, then the procedure will take longer.

In mini-lifts, a series of incisions are made along the margins of the face. In the traditional facelift, where more techniques are available, Dr. Law makes incisions near the tear duct, the chin and the hairline to work at different levels based on the patient’s needs.

Once the jowls, cheek fat, excess skin and lax ligaments are addressed, Dr. Law closes the incisions using sutures or stitches. The areas around the incisions are wrapped in gauze. In some patients, small drainage tubes are placed to drain any excess fluid. The tubes are removed once there’s no drainage. Patients are not permitted to drive for 24 hours following sedation and must stay overnight.

Post-Surgery Recovery

Following surgery, once Dr. Law is satisfied with the initial recovery, he will discharge the patient home with their designated driver or companion. The compressive head dressing is left in place for about 24 hours. The patient should wear the facelift dressing continuously for the first day and sleep with the head elevated for one week.

After one week, patients have a second follow-up appointment for suture removal and wound check. During this appointment, Dr. Law will remove any sutures or stitches.

While pain and tenderness are expected following surgery, Dr. Law will prescribe appropriate medications like Arnica for pain and swelling. If however, a patient is experiencing continuous pain, facial asymmetry, lack of sensations, then they must speak to Dr. Law immediately.

For the next four weeks, patients are advised to rest without any strenuous activity. In one month, the third follow-up appointment is scheduled for a final evaluation.

After this appointment, most patients return to work. The scars of the incision are usually well placed behind the hairline. These usually fade away with time.

Non-Surgical Rejuvenation Options near Fort Worth

Not all patients require a surgical facelift. Dr. Law may even recommend fat grafting, fibrin tissue adhesives, hilotherapy, Botox, laser skin resurfacing, and other adjunctive therapies. These are effective in some selected patients and Dr. Law can explain which is appropriate for each patient.

Potential Complications After a Facelift

The risks and complications associated with a rhytidectomy are higher based on the comorbidities a patient has. With a skilled, board-certified plastic surgeon like Dr. Law, the complications are minimal. Nevertheless, there are rare occasions when complications can develop.

Potential Complications Include:

• Formation of a hematoma or blood pooling beneath the incision is seen in less than 2% of cases.
• Infections.
• Sloughing of the skin, especially near the ears.
• Injury to the facial nerve may lead to facial nerve asymmetry.
• Injury to the auricular nerve may lead to numbness of the ear lobule.
• Alopecia due to hairline incisions.
• Pixie ear deformity due to excess skin tension near the ear lobe.
• Poor scarring
• Ectropion where the lower eyelid droops (This is seen in the subciliary technique only).
• Accumulation of fluid/ edema.
• Failure of wound closure.
• First bite syndrome where salivation triggers pain due to nerve damage.

A Successful Facelift with Dr. Huay-Zong Law

Rhytidectomies and their less invasive varieties like SMAS plication techniques are among the most common cosmetic procedures being performed today in the US. It does require a highly skilled team to ensure a successful outcome. An interprofessional team with Dr. Law at the helm with his experienced anesthesiologist, surgical assistants, and operative nurses can also minimize complications.

Dr. Law’s team near Fort Worth also provides close follow-up during the initial postoperative period with a wound care nurse. As an experienced clinician, he will monitor the patient closely for possible complications like a hematoma or facial nerve deficits.

A facelift is a powerful tool that can restore a youthful expression to an aging face. With a highly trained plastic surgeon performing your surgery, one can be sure to get results that will last for a decade.

Interested in a Facelift near Fort Worth?

Dr. Law is accepting new patients. His office is near Fort Worth and is open to everyone interested in getting a facelift. If you live in Fort Worth or the surrounding areas and want to schedule an initial consultation with him, you can call (214) 241-1997.

Dr. Law is one of the top facial plastic surgeons serving Fort Worth. He along with his team can guide you every step of the way should you decide to work with them.