Dr. Lindsey's Newsletter #38: My Meticulous Approach to Facelifts

5 Key Elements of My Meticulous Approach to Facelifts

1. The skin - must be elevated as far as the anatomy dictates. In my hands the patient’s jowls dictate my surgical plan and will determine how far I elevate the skin and the very delicate subcutaneous fat layer that lives just beneath the skin.
2. The SMAS (Superficial Musculoaponeurotic System) - a crucial layer of tissue deep to your skin that is the strength layer of the modern facelift. I use a variety of techniques to lift the SMAS and stitch it in place. This results in a longer lasting more natural facelift. 
3. The plane - In my hands I either dissect deep to the SMAS (the classic deep plane facelift) or depending upon the integrity of the tissues I will adapt my technique to the tissues I am working with and keep my dissection superficial to the SMAS. My facelifts are usually a combination of some superficial dissection and deep. Factors that can influence this include patient anatomy, prior surgery, and prior procedures including injectables and heat-delivering devices like RF microneedling.
4. Fat grafting - there are many cases that need volume enhancement to complete the facial rejuvenation. Careful facial analysis and fat grafting can be the difference between a good result and a fantastic result. This is a case-by-case decision that I make. 
5. Drains - some surgeons swear you need them for only one night, others swear you need them for several days. I educate each patient on the risks and benefits and decide on a case-by-case basis how long you will keep your drains. This decision is finalized in the operating room during your surgery because it is tailored to your specific needs.

Perhaps the most important thing to look for in a surgeon is for a thoughtful and meticulous approach to their technique. You don’t want a rushed surgeon or an egomaniac. Choose a surgeon that listens, educates, and discusses expectation of outcomes during your consultation. 

As always, here's to choosing how we age, on our own terms!