Facial Rejuvenation Surgery
By Barry J. Cohen, M.D., P.C.
Diplomate, American Board of Plastic Surgery
Pleased to Offer the Lower Facelift Under Local Anesthesia
The lower facelift rejuvenates the bottom third of the face by tightening the face’s underlying structures that slacken with age, addressing the cheeks, jowls, and neck. The procedure also trims excess skin, refining and smoothing the skin to eliminate facial creases, as well as removes excess fat in the neck and cheeks, giving a visual lift to the bottom third of the face. It increases the angularity of the jaw as well as the neckline.
With well over 200 lower face and neck lifts now done under local anesthesia with just oral sedation, I have seen a dramatic reduction in overall complications associated with general anesthesia such as no post operative nausea and vomiting, virtually no hematoma or significant post operative bleeding, and no wound healing problems. Local anesthesia also avoids many specific general anesthesia risks such as: blood clots, pulmonary emboli, as well as the inherent post operative grogginess. During general anesthesia, real blood pressure fluctuations are usually seen. When the blood pressure drifts on the low side of normal, patients bleed less than they do when the blood pressure is at the patient?s baseline. This is great during surgery, but not when the patient emerges from the general anesthesia and can start bleeding. During local anesthesia, there are little or no blood pressure swings. This markedly reduces post operative bruising and hematoma rates. The procedure is not only quite comfortable, but also much less expensive than when done under general anesthesia. It is truly a win-win situation for the patient, and in my hands I can accomplish EVERYTHING I normally do under general anesthesia with the local procedure. The recovery is easier, quicker, and more pleasant. The patients are home more rapidly with far less medications needed.
The average patient is back to work within 7-10 days. There is minimal pain associated with the procedure, and the scars are easily camouflaged by hair or makeup. The scars are just around the ears, and are typically fine lines that are placed in natural creases.
Candidates for Lower Facelift Surgery
The lower facelift rejuvenates the lower third of the face, which is an area quick to show signs of aging. The lift eliminates jowls, targets lax skin on the neck and jaw line, addresses deep wrinkles, and removes heavy or fatty necks.
For these reasons, candidates for lower facelift surgery are patients in relatively good health who have reasonably elastic skin and are showing aging in the bottom third of their face as well as the neck. Those with lax skin around the jaw line and/or drooping corners of the mouth as well as a neck with excess skin, thick bands, or excess fat, are ideal candidates for lower facelift surgery.
Lower Facelift Procedure
A lower facelift can be performed through a small incision that begins in front of the ear and extends down and behind the ear. Working through the small incisions, the skin is separated from the tissue below. Excess fat is removed, facial muscles are tightened with sutures and restored to youthful positions, and skin is smoothed before the excess is trimmed away.
The lower facelift not only excises excess skin but tightens the structures that underlie the jaw line and neck and move downward and become lax with age. Liposuction of the neck, to eliminate excess fat, is commonly performed with the lift. With the combined fat removal in the neck, the lower facelift is able to restore a youthful, smooth look to the neck and lower third of the face. All of these additional maneuvers are what differentiates this lift from the more minor procedures seen advertised such as the Lifestyle Lift or the Thread Lift. This procedure holds up 8-12 years in a typical non-smoker.