Facelift San Francisco
Performed by Dr. Maas
The term facelift has become one widely used for all types of aging facial plastic surgery in San Francisco and beyond.
Traditional surgical definitions would describe a facelift as a surgical procedure that elevates sagging tissues from the cheek area down to and including the neck. However, with recent aggressive marketing campaigns that describe a small incision in front of the ear with an inch of skin pulled back to patients who refer to a “full facelift” that include a browlift, upper blepharoplasty, lower blepharoplasty and versions of volume augmentation like fat grafting, it is clear that traditional definitions are inadequate.
The Maas Clinic in San Francisco has developed a simple and thoughtful way of describing facelifts that accurately describe what is done rather than using vague marketing or even proprietary terms like “Lifestyle lift”, “Natural lift”, “Quicklift” and others. These terms while being aggressively marketed, do not clearly describe to the public what or how the procedure is preformed and or the risks and benefits for the procedure. In simple terms, San Francisco Plastic Surgeon Dr. Corey Maas, a recognized leader in San Francisco cosmetic surgery, has divided the face lift into three basic surgical strategies:
1) Lower facelift The lower facelift is a San Francisco plastic surgery procedure that is another way of describing what tradition text books would simply call a facelift. The lower facelift addresses the sagging tissues and skin from the cheekbone down to and including the neck with skin laxity and overgrown (hypertrophic) muscle (platysma) bands in the neck. In contrast to what many refer to as “the L.A. facelift”, with an over-stretched appearance, the San Francisco Bay Area facelift patient is typically looking for a natural restoration of the facial contours enjoyed in the 30’s and early 40’s. A lower facelift employing the SMAS (subcutaneous aponeurotic system) Call The Maas Clinic for more information about facelift surgery San Francisco
Using the SMAS in a lower facelift in San Francisco allows the “restoration tension” to be applied below the skin surface rather than over-tightening the skin. In extended SMAS facelift technique, in particular, the skin can be gently re-draped in a natural configuration. In a natural facelift particular attention is paid to several important areas by expert facelift surgeons:
- The hairline in above and behind the ear – every patient and different and, while some surgeons “do every patient the same way” it is the opinion of Dr. Maas that the San Francisco facelift is one that assures the hairline is maintained in the temple area and carefully aligned behind the ear. The incisions for men’s facelift and women’s facelift remain hidden behind the prominent cartilage in front of the ear – the tragus. Any hair hair-bearing skin that is moved into this area can have the hair ablated or removed at the time of surgery or subsequent to the surgery.
- The facelift in men and women never look over-pulled or over stretched. This is the value of the extended SMASplasty facelift technique developed by Dr. Maas at the University of California San Francisco and later refined at The Maas Clinic.
- Finally, the earlobe must rest in a natural position without looking pulled or distorted. This video demonstrates the precision used in placing the lobule (ear lobe)
2) The Mini-Facelift
The mini-facelift is a term that, unfortunately, has been described by various companies with slick marketing terms and advertising campaigns that often over-promise what this procedure can do. The reason for the mismatch between outcomes and the various names applied to the mini-facelift are that for each surgeon or company the procedure may be very different.
Some surgeons or “companies” offer a one hour office procedure with a straight vertical incision in front of the ear, a small amount of skin elevated, removed and sutures placed. Others surgeons offer much longer lasting and more technical procedure that offer more predictable long-term results. However a mini-facelift is performed, the refinement of this centuries old early facelift procedure was driven by patient’s fast-paced lifestyle. Many patients want a facelift that minimally impacts their busy lifestyle with shorter recovery times. Mini-facelifts may not always offer shorter recovery times however.
With that caveat, there are many things a mini-facelift can provide for the right patient. The mini-facelift offered by The Maas Clinic in San Francisco addresses the sagging tissues between temple and the jawline, including the nasolabial fold, cheek and “marionette lines”. This procedure is usually best applied to patients that need a little tuck up some years after a previous facelift or younger patients with a still nice neck line and satisfactory neck tissues that just need a lift in the areas described.
The procedure employs an incision that extends from the temple hair, is hidden behind the ear cartilage in front of the ear and ends just behind the earlobe. Dr. Maas’ approach to the mini-facelift is similar to the lower facelift in that it relies on extensive use of the underlying thick connective tissue SMAS (subcutaneous aponeurotic system) to provide long-lasting contour improvements with gentle and natural skin tightening. The recovery for this procedure is about one week of moderate facial swelling with brusing be the rate limited variable in re
turning to normal social activities. Recovery, in truth, is not significantly different than that of the lower facelift.
3) The Neck Lift
A 2007 article in Vogue magazine rated Dr. Maas, The Maas Clinic, San Francisco as one of America’s “top plastic surgeons” for neck lift. How one judges “the best surgeon” is probably beyond the scope of this discussion but is usually based on a legacy or reputation based on many patients over ten or more years with good results.
The endorsement notwithstanding, neck lifting is a unique procedure that involved a sophisticated combination of liposuction, platsymaplasty (bands or cords of muscles in the neck) and subplastysmal flap SMAS elevation in the neck employing small incisions around the ear lobule (lobe) and behind the ear. This carefully sequenced series of surgical maneuvers can substantially change neck skin laxity – bringing a square or near 90 degree angle to neck and chin line, fat under the chin (submental fat) as well as deep wrinkles under neck. The procedure, like all Maas Clinic facelift procedures as an outpatient with a compression dressing that is removed after one night. Very little swelling is expected and quite often bruising is minimal with this technique which, like the mini-facelift, is often reserved for younger patients with premature neck aging and patients that have experienced neck laxity relapse after previous facelift surgery.
“My recommendations are to ask the following questions while having a consultation with surgeon about facelift surgery in San Francisco.” Dr. Maas
- How many facelifts have you performed in the last month as the surgeon in charge or primary surgeon?
- How many facelifts have you performed in the last year as the surgeon in charge or primary surgeon?
- Are you Board certified by the American Board of Facial Plastic and Reconstructive Surgery or the American Board of Plastic Surgery?
- Have you ever had a complication with facelift surgery? … if the surgeon responds no – be suspicious while significant complications are quite rare any surgeon having done enough facelift procedures to be an expert will have experienced at least some complication and this should be discussed.
- What is the worst complication you have experienced with facelift and how did you manage this complication?
- Ask to speak with patients that have had a face lift in San Francisco with the surgeon in the last month or two. They can give a first hand account of their experience and whether their expectations were met.
- Ask to see before and after pictures and make sure that the pictures are of patients that your consultation surgeon was the primary surgeon.
- Finally, corporate facelifts or trademarked procedures are considered unethical in many states and illegal in some. I discourage patients from seeking these types of procedures without carefully credentialing the surgeons.
Introduction to the Facelift Procedure
This is Dr. Corey Maas on looking your best. I want to take a few minutes just to give a very short synopsis on face-lifting and the current state of face-lifting in our world. And there’s a lot of confusion about it but it really is become very important, as the techniques and the technology have made it quite simple. And with today’s world with people living much longer, living healthier lives, many working and being very active well into their 80’s and even 90’s, the face of aging is something that, really a lot of people are concerned about. We can change our bodies, we can stay healthy but those aging changes that occur and are often seen when we looked in the mirror are something that really are best addressed with a surgical intervention and we do have very good answers for that.
The surgical techniques involved are relatively well established and with advanced surgical techniques, like those that offered at the Maas Clinic, we’re actually using the thick connective tissue layers underneath the skin to restore contour to the lower face. As you can see here, this is often referred to as the so called “SMAS layer” and the SMAS layer, when it’s elevated, allows us to achieve really effective restoration of contour without giving that poled or windswept look that is so commonly seen in televisions in Southern California, and that’s just something that most of our patients are not interested in having.
The results of these surgeries are most commonly very natural looks when we see aging and jawling in this area, and we see the neck restored to a nice and natural contour with very good improvements. We’re very happy and the patients are genuinely happy. They go from a kind of a “grandmotherly-look” where this jawling effect that tracks along the jawline, and the hanging extra tissue around the mid-cheek area is restored.
In this case, the patient has also had laser skin resurfacing, and we really see that the patient transformed from someone that looks tired or weary into someone that looks much brighter and much fresher.
These can be done in any age range of patients but typically, we see patients that are in their early to late 50’s and moving on into their 60’s. We see these in both men and women as an example here, a gentleman who just said his neck bothered him, he looked like a grandfather, didn’t feel like one and wanted to see the improvement.
You can also see that after the surgery, even in a man, the scars that are hidden along the hairline and in behind the ear area are almost impossible to see within a few months after the surgery. So surgical scars are not an issue and the other issue that most people ask about is comfort. The techniques we use with anesthesia, monitored deep sleep anesthesia, as we refer to it now, are quite simple.
There are newer technologies you don’t have to be under general, where you’re paralyzed and have a tube down in the trachea, and on a respirator. We can keep you at a nice gentle level of sleeping and I use local anesthesia to numb the surgical areas up effectively so that there’s no pain that your brain even perceives during the procedure.
So we can see these reliable and consistent results with patients, and really have no scars or visible scars and really change somebody’s life by restoring that natural contour and improved appearance of the face.
This really has a big impact on the people that are looking at the professional workforce and getting back into it, or reentering it. The youthful workforce that is out there now associates aging changes with loss of energy which is completely untrue and we can restore a very natural and very long lasting youthful and vibrant look, with the procedure that can be done with a recovery period of not much more than about 10 days.
So the summary about facelifts now I think are putting to rest a lot of the older concerns, I’ll also mention that many of those that you see advertised on TV, that can be done in an hour, are much less than what we’ve describe here. Pulling a little skin up is certainly not going to give you an effect like you see demonstrated here, that last the patient for 10 to 15 years at a minimum and so we really want to make sure that if our patients are making an investment, they get a long term and effective return with the procedure, and a great result that they’ll be very satisfied with for the long term.
If you have any questions about facelift or any other aging face or balanced symmetry procedures, don’t hesitate to call the clinic at 415-567-7000.
Reach out to us at Massclinic.com there’s a contact form there.
You can visit my video blog at DrMaas.com, or of course we’re welcome to have you come and join us as a fan at Facenook.com/Maasclinic.
As always, I appreciate your attention. This is Dr. Maas on “Looking your Best”
Dr. Corey Maas and the staff at The Maas Clinic look forward to answering any questions you may have about your Facelift in San Francisco. To schedule an appointment, please call (415) 567-7000.