In searching for an experienced facelift surgeon it is important to take into consideration the background experience of the surgeon in general since an overall experience in facial and head and neck surgery is extremely important.
Your surgeon should have :
- Extensive and many years of experience in facial surgery
- A varied range of examples of facelift results in different types of faces
- Look for video results since a video is a true and accurate representation of results
- Appropriate qualification as a Plastic Surgeon goes without saying since there are many non-qualified doctors or other ‘specialists’ purporting to be Plastic surgeons. (A full list of qualifications is provided at the bottom of this page )
Look for a variety of age groups and face types in the results shown on their portfolio. Bear in mind that a patient in their 40s or early 50s with a strong jawbone and minimal jowls is likely to achieve a good result in the hands of an average surgeon. Many before and after photos simply show this kind of patient. It is therefore important to look for different age groups from 40s through to 60s and 70s to assess the quality of results. Also, some patients will have very thick and chubby necks and others will have very loose skin and muscle bands in their neck. Some patients may have a very small jaw bone while others will have poor skin quality and loss of volume.
No two faces are the same and therefore an individualized approach is needed to achieve the best and consistent results in a range of facial types. In order to achieve this good experience in a repertoire of techniques is needed. This includes:
- Deep plane and extended deep plane facelift surgery
- Necklift surgery
- Deep neck surgery such as platysmaplasty, and deep neck work
- Fat transfer including the latest regenerative techniques such a stem cell fat transfer both to provide volume and rejuvenate the skin
- Chin implant surgery
- Fractional and ablative laser treatments
- Good experience adjunctive treatments such as eyelid surgery and browlift surgery. Again no two eyes are the same and different techniques are required to compliment a facelift and provide a true overall facial rejuvenation.
Does the surgeon have a good range of examples of patients from different age groups?
If you view the examples of patients below each have a different anatomy due their age and each has required a different approach in the overall surgical plan and demonstrates that one procedure does not fit all faces. Therefore the best results are not just about a ‘deep plane facelift’ but how the technique is adapted and combined with other forms of facial surgery to fine tune and enhance the overall result.
Example in a young patient aged 39
This is a 39 year old patient with a heavy neck and jowls. You can see a carefully performed deep plane facelift with liposuction under the chin has made her look more elegant and more her age. At the same time an upper blepharoplasty was performed to rejuvenate her upper eyelids. This situation is very different to the 50 year old patient shown below.
Example in a patient late 40 years of age
In this patient in her late 40s the main issue is laxity in the jawline causing jowls and laxity in the neck . In a patient such as this a deep plane facelift is performed which has adequately corrected her jowls and enhanced a jawline. Her underlying anatomy is one of a strong jawline and chin and therefore this is a predictor of a good results after surgery. She also had some neck laxity which even in her 40s has required neck surgery to optimize her result and sharpen the jawline and neck contours.
Patient early 50 years of age with poor jaw bone definition
In contrast this next patient below has a weak jawline and poor definition to her jaw and chin. At the same time she has loss of definition in the angle between her chin and neck. The approach her was to improve the underlying structure of her jawline and chin by using a chin implant. We know that as ageing occurs there is not only thinning of the soft tissues but there is bone shrinkage even in the face and jawline. Improving and restoring the underlying structure therefore provides a powerful means to rejuvenate the jawline. In this case a deep plane facelift and necklift in combination with a chin implant has provided this result.
Another example of patient in early 50 years of age with both neck and jawline laxity
In this patient in her 50s the main issue is laxity in the jawline causing jowls and laxity in the neck but in this case with a strong underlying jawbone and chin. The other difference in this patient is that there is a very lax platysma neck muscle giving rise to the two bands in the neck which are called platysmal bands. In a patient such as this a deep plane facelift is performed but also the vertical neck bands required correction with a necklift using a procedure called a platysmaplasty. The deep plane facelift together with the necklift has provided the optimal result in redefineing her jawline and neck .
Example of patient in early 50 years of age only with jawline laxity and poor skin quality
In this patient no formal necklift was required since the main issues are along the jawline with significant jowls. A deep plane facelift was performed but also a full face fractional carbon dioxide laser treatment performed to rejuvenate the skin. This skin treatment has helped to allow the skin to appear more youthful by improving the complexion and reducing the degree of fine lines . She also underwent upper eyelid surgery. The lower eyelid rejuvenation was achieved with carbon dioxide laser treatment.
Example of patient in early 60 years of age with a heavy neck
This patient below in her 60s has an extremely heavy neck with large amounts of excess skin in her neck. This is an extremely challenging case due to the degree laxity. In this case a lot of work has been required in the neck to address the skin excess and tighten the neck tissues including the muscles. This is combined with a deep plane facelift to sharpen the jawline and improve the marionette lines and folds of skin below the corner of the mouth. This patient has very different anatomy and presents a very different challenge to the one above in her 50s and the technique has to be adapted to meet the different anatomy.
Patient in mid 60 years of age with poor skin quality
This patient had years of sun damage resulting in very deep skin lines on her cheek which would not have been helped by the facelift alone. In this case a deep plane facelift was combined with an advanced new fat transfer procedure called nanofat transfer where extremely fine fat is injected into the skin. Stem cells or the “cells of youth” are injected with the nanofat and these work to rejuvenate but also regenerate more youthful skin. You can learn more about stemcell facelift techniques here
This patient also underwent a necklift alongside the deep plane facelift with upper and lower blepharoplasty as adjunctive procedures.
The next two examples show how adding blepharoplasty surgery to an overall facelift plan can make a dramatic and yet natural difference.
Example of patient with blepharoplasty and no facelift
This patient looks like she has had a facelift and appears completely refreshed and rejuvenated but in fact only eyelid surgery has been performed. In this case an upper blepharoplasty has been carried out to reduce the degree of hooding of the upper eyelids. At the same time a lower blepharoplasty has been performed to remove the bags under the eyes. The lower eyelid surgery has been performed using a specialized technique which only a handful of surgeons are experienced in performing. This is a scarless procedure where the fat bags are not removed but repositioned over the teartrough. The technique is called a transconjunctival blepharoplasty
Another example of eyelid surgery combined with deep plane facelift surgery
In this patient below one of the most important factors and one which has made a significant difference is the combination of the lower eyelid surgery and midcheek fat transfer which was combined with the deep plane facelift. Again the lower eyelid surgery was performed using a fat repositioning with a transconjunctival blepharoplasty technique. She has loss of volume and hollowness in her cheeks which was addressed with fat transfer. This has rejuvenated her whole mid cheek with a beautiful transition from the lower eyelids onto her cheeks.
Concluding remarks…
It is evident from the above different examples of facial anatomy that different patients will have differing degrees of ageing in relation to their eyes, face and neck. Also, you will see from the above examples one theme which is that as the age of patients increases there is worsening skin quality which often requires laser treatments or nanofat transfer. Also, there is more volume loss and hollowness in the face as you age. This where fat transfer can help to provide volume at the same time as a deep plane facelift. The facelift itself will not compensate for the volume loss and an adjunctive procedure to replace this volume by way of fat grafting is what provides the best results.
Therefore choose your surgeon wisely since recognition of the underlying variance in anatomy and the required techniques only comes with experience.
What qualifications to look out for ?
Is the Surgeon a fully qualified Plastic Surgeon ?
This is easily seen by the presence of FRCS(Plast) after their name. Or in other countries they should be a Board Certified Plastic Surgeon
Are they on the Specialist Register for Plastic Surgery ?
This can be check on the GMC register of Specialists but check that the specialist status applies to Plastic Surgery since many other types of surgeons are on specialist registers for their own field who may be performing different types of Cosmetic surgery in a more limited way in their own field such as ENT or Dental Maxillofacial Surgeons.
Are they a member of a reputable Society of Plastic Surgeons ?
In the United Kingdom this is the British Association of Aesthetic Plastic Surgeons but in the USA it would be the American Societ of Aesthetic Plastic Surgeons (ASAPS)