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Jeffrey Rosenthal MD
Board Certified Plastic Surgeon l Former, Chief Plastic Surgery at Bridgeport Hospital

140 Sherman Street, Fairfield, CT 06824
Rosenthal Cosmetic Surgery & Skin Care Center

"Where Art Meets Science"

Which Type of Facelift Is Best?

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Facelift Best: Is removal of GLANDS (along w/ fat) when sculpting under chin during a neck lift a typical/normal or severe/aggressive approach?

A facial plastic surgeon said he removes glands and fat when manually sculpting under the chin to get the best result. Surgical techniques are “his version” of a deep plane FL and “modified” corset platysmaplasty. Does the removal of glands and use of deep plane technique signify an aggressive approach? Would this have potentially more risk and recovery time than not removing glands and SMAS-level techniques? Anything else I should consider in assessing this approach? Thx!

Answer:

The Best Facelift is one that is safe & Individualized

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The Best Facelift is one that is safe & Individualized for each patient. Most patients who require a facelift show evidence of lax facial and neck skin along with loss of the underlying neck muscle tone.

The fat in the mid-face has descended causing jowls and loss of volume in the cheek area. Ideally, the plastic surgeon will address these facial and neck changes with a facelift that smooths the jawline, lifts the fat into the hollows of the face, tightens the neck muscles and sculpts the remaining fat along the jaw or neck.

The SMAS or fibrous structure under the skin are lifted and supported to produce a sling. With the SMAS elevation the overlying tissues are lifted and supported back from which they have descended.

There are various levels from which the SMAS is lifted, with the deeper plane lift seldom being the choice in my practice. This; however, is the preference of the plastic surgeon and the decision for deep plane lift should be justified for each patient. Deeper plane lift can prolong the swelling after surgery.

When dealing with the overlying skin, it is important to free the skin and smooth it out rather than pulling upon skin vigorously. Gentle movement of the skin will produce a natural and refreshed appearance rather than a wind blown look. Likewise, the scar placement is important to preclude an operated appearance that displays the surgical procedure.

Properly positioned, the facelift scars should be barely visible. Removal of glands to contour the jaw potentially adds risks and complications. These are salivary glands that are necessary to produce saliva. As we age the amount of saliva produced is normally diminished. Hence, removal of the glands can add to this condition. This is a decision between you and your surgeon.

Additionally, there are potential complications as nerves and blood vessels course through the glands, which could result damage to these structures.

The ideal or best facelift is one that maintains your personal identity, is artistically performed and affords you an amazing & natural facial rejuvenation.

 

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Art of Plastic Surgery Fairfield CT