Wish you could reverse the effects
of gravity on your face?

• Is the skin on your face developing deep lines and folds?
• Are your cheeks getting a hollow, “sunken” look?
• Does your jawline look slack and jowly?
• Do you have bands or prominence under your chin?

If so, it might be time to consider a facelift.

What is a facelift?

A facelift, or rhytidectomy, is cosmetic plastic surgery to rejuvenate the face by countering the effects of gravity.

How does Dr. Rappaport perform facelifts?

Dr. Rappaport performs several variations of facelift procedures. During your personal consultation, he will recommend the technique best suited to your needs. Sometimes he will combine a facelift with procedures such as a brow lift, eyelid lift, mid-face lift or chin implant to achieve the results you desire.

Where are the incisions made for a facelift?

Facelift incisions are hidden in the natural contour of the ears and in your hairline so scars will not be noticeable.

• A standard incision begins in front of the ear and goes around the earlobe and into the hairline at the back of the neck.
• A short-scar incision is S-shaped. It begins in front of the ear and goes around the earlobe like a standard incision, but does not extend to the back of the neck.

Dr. Rappaport answers questions about facelifts

How do you produce natural-looking results from a facelift?

“Old-fashioned facelifts had a telltale ‘windswept’ look because the skin was pulled and stretched. The secret to a natural-looking facelift is to do the corrective lifting in the supporting facial structure below the skin.

“After that work is done, I gently re-drape the skin without tension for a very natural look. This technique also minimizes the risk of tissue loss and poor scarring.”

Which areas of the face does a facelift address?

“That depends on the type of facelift being performed:

• A standard facelift rejuvenates the lower 2/3 of the face, from about the level of the cheekbones to the jawline, and from the jawline to the Adam's apple when the neck is included in the procedure.
• A mid-face lift—which can be done alone or in combination with a standard facelift—treats the tissue between the cheekbones and the corners of the nose and mouth. This procedure effectively restores volume over the cheekbones and slightly elevates the corners of the mouth and the jowls. A mid-face lift gets rid of sagging cheeks and smoothes the transition from the lower eyelid and the cheek.”

Where is the actual lifting done in a facelift?

“A facelift is not a matter of simply tightening the skin. The ‘lifting’ is done by manipulating the superficial musculosponeurotic system, or SMAS—an anatomical layer below the skin, but above the functional structures of your face. This strong layer of tissue adds support to your facial features.

Are there different techniques
of working with the SMAS?

“Yes. Depending on the amount of lifting your face needs, I may use one of three techniques:

• Imbrication. In this technique, the SMAS is lifted and imbricated, or overlapped like a soft pleat, and secured by stitches.
• Flap development. In this technique, we're creating a flap of tissue in the SMAS that I can then rotate and/or advance to contour your facial structures.
• “SMASectomy.” This technique involves removing a portion of the SMAS from the jawbone to the cheekbone, and produces a tightening effect in the middle of the cheek.”

Which technique do you prefer for mid-face lifts?

“I often use a new device called an Endotine^TM to perform a minimally invasive mid-face lift to elevate facial tissue back up on the cheekbones. I place the Endotine, a bio-absorbable implanted device with five tiny fork-like tines, at a 45-degree angle on the cheekbone, and lift the tissue onto it.

“In the six to 12 months it takes for the Endotine to dissolve, the tissue has time to re-attach to the cheekbone. This secures the tissues and enables them to maintain their new, lifted position.”

Where are the incisions for an Endotine facelift?

“An Endotine facelift is done through a small incision in the hairline and another small incision in the mouth.”

How does an Endotine lift compare with a mini-facelift?

“There are a number of ‘brand-name’ facelifts being advertised in the media—but the hardest thing in plastic surgery is to compare one procedure to another. A lot has to do with the individual surgeon. However, there are some office-based facelift techniques that don't last as long simply because they don't address the primary anatomical problem.”

If I have sagging skin around my eyes, will a facelift correct them?

“Depending on the degree of sagging around your eyes, I may recommend that we combine a facelift with a brow lift and/or eyelid procedure. These are very complementary procedures.”

Will a facelift help correct sagging
in my jawline and neck?

“Because the SMAS is continuous with the platysma muscle in your neck, a facelift will help correct jowling. If you have bands under your neck, I can also make an incision under the chin to tighten the muscle causing the bands. I may also use liposuction to remove excess fat in the neck.

“A chin implant can sometimes help improve the angle of the jawline. In younger patients, liposuction alone may be sufficient to correct the neck.”

Do you also perform facelifts on men?

“Yes. Although 90% of my patients are women, I do facelifts on men as well. Men have thicker skin than women, which helps because it tends to age more slowly. However, men tend to bleed more during surgery because of the blood supply to the beard.”

How fast is the recovery after a facelift?

“You can expect some swelling and bruising after a facelift. I tell my patients, ‘You can see your best friends in about 10 days, and your worst enemies in about two weeks.’ In some cases, the recovery from a mid-face lift can take longer.”

Does having a facelift mean I won't need facial fillers?

“No. Once you have corrected the effects of gravity with a facelift, facial fillers can help you maintain youthful volume—a very important component in a younger-looking face. Botox can also help by relaxing the muscles that cause frown lines. I also use Botox to lift the corners of the mouth and to create a subtle brow lift.

How can I maintain the results of my facelift?

“Clinical skin care—both at home and in our office—can help you maximize the effects of your facelift by giving you a smooth, dewy complexion that radiates youthfulness.”