Procedures

The Modern Facelift

The Modern facelift (rhytidectomy) that is performed by Dr. Babak Azizzadeh, Director of The Beverly Hills Center for Facial Rejuvenation, is extremely different from the tight-looking, severe procedures of the past. Dr. Azizzadeh’s facelift procedure is customized and individually tailored for each patient, leaving you with results so natural looking that nobody would guess you ever had a facelift.

Complementary procedures such as fillers, multilevel fat grafting, eyelid procedures are used to enhance the effectiveness of the facelift. Currently, there are several facelift techniques that can successfully address the areas of the face associated with the lower face and neck.

• Skin only “subcutaneous” facelifts
• “SMAS” facelifts
• “Deep plane” facelifts

How Does the Procedure Work?

The “SMAS” (medically known as the Superficial Musculo-Aponeurotic System) is a layer of tissue just below the skin, which serves as the foundation and structural support for the lower face. In the neck area, the SMAS converges to form the platysma muscle. Subcutaneous facelifts essentially elevate the skin without touching the SMAS. For the most part, SMAS facelifts use this layer to fortify the facelift. Deep plane facelifts go “deep” to the SMAS to lift the lax tissue.

Most sophisticated facial plastic surgeons employ either the “SMAS” or deep plane facelift techniques. Dr. Azizzadeh has significantly improved his outcomes by modifying the standard SMAS facelift which he coins “Short Flap Rhytidectomy –SFR.”   The Short-flap Rhytidectomy has the best of all worlds – quick recovery, long-lasting results, safe outcome and excellent healing process.  It is extremely important to make sure that your surgeon has a long track record with the technique that they utilize. Experience and expertise is key.

Before deciding on your surgeon, you need to look carefully at their before-and-after photos to make sure that their aesthetic eye matches yours. This is the most crucial aspect of facial rejuvenation surgery. Some surgeons love the over pulled look while others prefer a more natural look. Finally, make sure that they perform facial rejuvenation procedures on a routine basis.

How Long Does the Procedure Take?

Facelift procedures are outpatient procedures that take about two to three hours.

What Is The Recovery Time?

The recovery time for facelift procedures will depend on the facelift technique employed by your facial rejuvenation specialist. Most patients will be able to return to routine activity in about 10 days. Exercise can be resumed in three weeks.

What Are The Risks With Facelift Procedures?

The main risks with facelifts include bleeding, poor blood flow to the skin, scarring, numbness and facial nerve injury. Overall, the biggest problem is that 2-5% of individuals will have some blood collection under the skin in the first two to three days after surgery. Most of these “hematomas” will be limited and can be taken care of in the office.

Occasionally, however, they need to be urgently cleared in the operating room. Men have a higher chance of developing hematomas. Smokers tend to have a higher risk of having poor healing due to bad circulation that can lead to scarring and loss of tissue. Most facelift surgeons do not operate on smokers for this reason, the caveat here being unless you have stopped two weeks prior and two weeks after surgery (nicotine gum must also be avoided).

The Neck

For many people, the region of the neck is where some of the first and most obvious signs of aging begin to appear. Like the forehead, your neck is extremely visible and hard to camouflage; it is also particularly sensitive and, as such, quite vulnerable to the effects of the elements and aging as we advance in years. Over time, the skin of your neck has a tendency to become loose and slack, while deposits of fat and “flaps” of tissue can make us appear older than our actual age.

What causes these unsightly effects? Some of the factors that contribute to the aesthetic problems that develop around the neck area include:

• Loosening muscles: The muscles (also known as “platysma”) on either side of the neck begin to lose their structure and elasticity as well; this can contribute to loose skin and the “wattles” that affect so many of us as we age. Unfortunately, there are no exercises to make the neck of the skin firmer.

• Fat – it’s not just for your waistline anymore: As we age, deposits of excess fat can accumulate in the neck and jowls to create an undesirable effect.

• Beneath the skin – and beyond: Like the rest of your face, your neck has various layers that work both together and independently of one another. Much like your forehead can be a bad “upstairs neighbor” to your eye region, so can the sub-muscular area of the neck weaken the foundation of your appearance. In this case, the underlying structure of the neck begins to suffer from sagging, drooping, and loose excess skin in the neck area

• Loss of skin elasticity: The skin of the neck is particularly susceptible to loss of elasticity with age, meaning that even as it sags and bags, it continues to loose that sense of fullness that we so often equate with youth.

Fortunately, having a neck lift procedure can address each of the issues listed above. In some cases, a neck lift is absolutely necessary to restore and revitalize your appearance. In most cases, face and neck lifts are performed simultaneously, thereby creating a more natural appearance.

During the procedure, your physician will do the following as necessary:

• Join and tighten the muscles of the neck, creating a firmer muscle base;

• Remove excess fat deposits;

• Trim excess skin, and smooth the skin for a taut, more youthful neckline…

Below you will see before and after pictures from a successful neck lift procedure:

(Left) before and (right) after Face and Neck lift

Endoscopic Browlift & Upper BlepharoplastyEndoscopic Browlift & Upper Blepharoplasty

How Does the Procedure Work?

Your goals will be used by Dr. Azizzadeh to customize the procedure you get. How many are there? Well, depending on your specific needs and goals, your customized neck lift procedure might consist of one – or both – of two following different procedures:

• Skin and platysma lift: The skin lift procedure consists of lifting and tightening the skin in combination with the platysma along the neck. By removing excess skin, you can create a more youthful facial appearance. The incisions for an isolated neck lift can be placed behind the ears, thereby avoiding any visible scars.

• Platysmaplasty: A platysmaplasty is a procedure in which the underlying muscles are tightened and fat is removed. This procedure provides more dramatic results for patients whose underlying neck tissue is very lax. The incision tends to be just beneath the chin in a hidden crease. Many patients also undergo simultaneous liposuction of excess fat deposits through this tiny incision.

• Liposuction: Many patients will develop some fatty deposits under the neck during the aging process. This is an excellent area for conservative liposuction during the neck lift procedure. Younger patients may even be candidates for neck liposuction as a stand-alone procedure to rejuvenate the neck area.

How Long Does the Procedure Take?

Your neck lift will be considered an outpatient cosmetic procedure and typically takes from two to three hours.

What Is The Recovery Time?

The recovery time for your neck lift will be relatively short and most people will return to work and/or play in about one week.

What Are The Risks With Facelift Procedures?

The risks associated with neck lift procedures are very similar to those involved with facelift procedures described in the earlier section. Additionally, aggressive liposuction in this region can sometimes lead to “cobra” neck deformity. This occurs when the neck muscles are not addressed at the same time, leading to excess visibility of the banding.