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FACELIFT

It is time to eliminate the term “facelift” from our plastic surgery vocabulary. It is important to make the distinction between “facelift” and “facial rejuvenation”. Facelift describes a procedure devised in the 1960’s and 70’s when little was known about the mechanisms of facial aging and the options were less than adequate. Many can recall seeing someone who has a “wind-tunnel” look whose natural features are destroyed in the name of looking young. Unfortunately, as the term has persisted so has the less-than-adequate technique that came with it! The shift from facelift to facial rejuvenation is not a matter of semantics. It has to do with understanding where aging begins and how it can be countered before the signs become etched and apparent.

Overall health and well being contribute to a youthful attitude. Next, the skin condition is addressed through preventive measures and non-surgical interventions. Aging starts with loss of volume in well-defined areas, extent of which varies from individual to individual. The key to natural rejuvenation is to address this loss of volume early on before the changes in the skin become permanent and apparent. Fat injections have become an evolutionary tool in addressing volume loss in the aging face. It can serve as a preventive as well as a therapeutic tool. Performed by a plastic surgeon who is experienced in doing the procedure, fat injection is a minimally invasive procedure with excellent longevity. It allows early intervention so that the natural proportions are preserved and the patient can return to life after a short recovery period.

Patients who already demonstrate signs of aging may require excision of some skin or repositioning of deeper structures. But this does should only be done while attending to their natural proportions and identifying features. For instance, in someone who has clear sagging of the midface, lower eyelids, and cheeks; attention needs to be directed towards replacing the lost volume using fat injections. Once the volume is restored, there will be less need for drastic cuts and aggressive surgeries. Excess skin can be removed through well-hidden incisions while the natural movement of facial structures is preserved. Fat injections can last many years and when needed, additional injections can be performed over the years as a minor procedure.

Reza Nabavian M.D.
Clinical Assistant Professor of Surgery
Director, Aesthetic Surgery Education
USC Division of Plastic and Reconstructive Surgery