Facelift, Browlift and Endoscopic Browlift
Facelift surgery (also known as rhytidectomy, rhytidoplasty, or facial uplift procedure) is very frequently requested
by our patients, and after several years of using revolutionary techniques, we have been very successful in achieving
unusually good results. The goals of facial or facelift surgery are: a natural, higher, more youthful facial contour;
the removal of folds, excessive sagging, large wrinkles, and double chins; and neck sculpturing.
In the early days of plastic surgery, mini-lifts and minor procedures were often performed; it became clear, however,
that the results were limited and of short duration. By utilizing modern surgical techniques, we can bring about dramatic,
natural and long-lasting improvements in the appearances of our patients. The surgery can be performed on both men and
women, and is often combined with eyelid lift, light chemical peels, facial fat suctioning, or cheek, nose, or chin
surgery for even better results.
You may first become aware of the aging process when looking in a mirror, viewing recent photographs, or when family,
co-workers, or friends comment that you look tired. As we age, we tend to lose the thin layer of fat that supports and
plumps out the skin of the face. This, together with loss of elastic support, creates a drawn, tired, look. Other early
changes are drooping of the sides of the eyebrows downward or eyelid hooding, drooping and small folds at the corners of
the nose and mouth, the early appearance of jawline jowling, and increased folds at the neck. Combined with very fine,
sun-related wrinkling of the skin, these are the first signs that make you feel you are starting to look more mature.
We are all products of both the aging process and heredity. Women, for instance, often inherit structural facial
changes from their father and sons from their mother. The chronology of the face, however, is also affected by other
factors, such as general health, exposure to the sun, muscle tone, skin elasticity, skin care, nutritional changes,
extreme fluctuations in weight, and the use of alcohol, drugs and tobacco.
Surgical treatment of the top third of the face involves a "coronal (or brow) lift" in which a zigzag incision is
made approximately 1 1/2 to 2 inches behind the hairline or, in individuals with high hairlines, just at the hairline.
Loose forehead wrinkles, deep furrows between the eyebrows, descending eyebrows, "hooding" of the eyelids, and wrinkles
near the eyes (crow's feet") are all improved or eliminated. The hair is not shaved during the procedure, but specially
parted. The newer endoscopic browlift is used equally as often incorporating a shorter incision.
Early signs of aging in the lower two-thirds of the face include: thickening and loosening of the folds between the
nose and mouth or the cheek folds; some flattening or loss of cheekbone definition; fullness and loss of definition of
the mid-cheek fold; wrinkling of the skin in front of the ears; loss of the normal jawline contour and jowling at the
mid-portion of the jaw; looseness, folds of skin, and loose muscle at the mid-neck area; and, often, crepe-like skin
and looseness of the neck skin. Treatment of these conditions involves the actual "facelift" procedure.
During the procedure, you are completely asleep under the care of an anesthesiologist. While asleep, a long-acting
local anesthetic is injected so that you feel, at most, minimal discomfort following surgery.
What additional procedures can be done along with these procedures?
As the skin begins to sag and the fatty tissue layers are lost, contour imperfections of the face may be very
noticeable. In such cases additional procedures can be performed to support or augment the bony structures of the face.
At the level of the cheekbones, for instance, flattening can be improved through placement of naturally shaped, silastic
cheek implants. Made from a form of soft plastic, these are introduced through either the lower eyelid or facial incision
lines. Likewise, silastic chin implants can enhance the contour of the chin and help to sculpt the neckline. This bony
augmentation is an important, modern technique for creating a youthful, yet natural appearance.
Often these techniques are combined with facial suctioning, or buccal fat excision, in which excess cheek fat is
removed through a 1/2" incision inside the mouth, resulting in a more sculptured appearance to the cheeks. Another 1/2"
incision can be made at the cleft underneath the chin in order to sculpt and reposition loose neck muscles (or turkey
gobbler folds). Fatty tissue removed from the face or other parts of the body can often be liquefied and used to fill
out thinning lips or small depressions of the face at this time.
A facelift, however, cannot remove fine wrinkles. These may need to be improved by a superficial "ironing out"
called a superficial facial peel. If, in the judgment of the doctor, you would benefit from a light peel, this is
usually performed a few days to a few weeks after you have healed. Small areas needing peeling, such as the lower
eyelids or around the lips and mouth, may be lightly and safely peeled at the time of your facial surgery.
Many years ago, surgeons attempted to correct these fine wrinkles and sags by pulling the face as tight and flat as
possible. This gave a very unnatural, mask-like appearance. Today, a combination of coronal or forehead lift, eyelid, and
facial surgery (and, if indicated, cheek or chin augmentation) followed by a light peel gives the optimum in natural, yet
If approved by the doctor, nasal, chin, or suction surgery can be performed at the time of your facelift. Most of our
patients say that once the healing process is complete and they return to normal lifestyle, they look and feel younger,
fresher, and more attractive.
When can the surgery be done?
The time to consider a facelift and its associated procedures is when the aging process becomes noticeable and
bothersome to you. For some unusual patients this happens in their 30's. For others, it could be the late 70's. The
average "age" ranges in the forties and fifties for those who have facelifts. Facelifts look seven to ten or more
years younger. The aging process continues, but you will always look younger than the one who did not have a facelift.
The duration of the results, again, is based on your own individual aging process which is affected by age, heredity,
health, exposure to the sun, diet and exercise, smoking, and other habits. The better you take care of yourself, the longer
the results will last. Ideally, you should be within twenty pounds of your desired weight before the procedure is performed.
When properly performed, the surgery can be repeated.
These procedures can be safely repeated. Some patients are
so pleased with the results that they will have the surgery repeated; others are satisfied with one procedure their whole
life—and continue to look great.
A certain degree of apprehension and anxiety is normal with any operative procedure. This information can alleviate much
of your concern prior to surgery. Fear is generally associated with the chance of significant pain; however, severe pain is
very uncommon with this type of operation. Slight to moderate discomfort (similar to headache) is the rule. When the operation
is performed by an experienced and skilled surgeon, any fear you may experience should be minimized. Sufficient preparation
and pain medication can usually alleviate any discomfort.
For a facelift or browlift in Tulsa Oklahoma contact Dr. Joey Manduano at 918-749-5522
See Before & After Photos >>