Facelift 14

The patient is a 78 year old woman who wanted facial plastic surgery to help her better interact with her relatives and friends. She reported that her grandchildren told her that she looked old and that bothered her to the point that she decided to do something about it. Her plastic surgery procedure included a face lift with a neck lift including a platysmaplasty (described below) and a brow lift. She was happy with the improvement as can be seen from the facelift surgery before and after photos. She was relieved that she had an early return to helping and being with her family.

When looking at the bottom set of facelift before and after photos, one can see the vertical banding lines in the center of the neck. These represent the shortened and prominent inner edges of the platysma muscles. These muscles are flat and are under and attach to the skin. When they contract during communication with others and when chewing the muscles not only flex themselves but work on the skin to cause wrinkles and folds and thus accelerate the aging process.

Correction of platysmal bands not only removes the bands themselves but can halt the aging process caused by the platysma muscles. During platysmaplasty, which is performed through an inconspicuous incision under the chin, the bands themselves are released and lengthened and are repaired together, much like a corset is closed with laces. The repair can give a lasting result that not only looks good immediately but helps to maintain a smooth, band free neck for a very long time. After platysmaplasty, the platysma muscle no longer is damaging the overlying skin.

This patient also had a brow lift and care was taken to keep the hairline in good position while restoring facial proportion. Brow lifts primarily raise the brow and give it a natural arch. There are different ways to perform a brow lift and a thorough consultation with board certified cosmetic surgeon can help to identify which procedure is best for each patient and this is based on their anatomy including the hairlines current position. In some cases, the patient can have hairline lowering surgery and thus achieve a forehead reduction. In other patients, raising the hairline can expand the forehead to restore facial proportion. Most older patients have thinning hair and a slightly higher hairline and care must be taken to avoid movement of the hairline in these patients. This can be achieved with a hairline brow lift. Healing from a browlift is rapid and there is an early return to work and other daily activities.