The Mini Facelift procedure is one of the most common procedures performed by Dr. Chang. He has, in the last 18 years developed an international reputation for performing natural appearing facial rejuvenation procedures. Patients and Doctors have come from all over the world to have and learn about the surgery. Dr. Chang has developed a version of the mini facelift that he has published on youtube ( see below ) and taught to other surgeons. The immediate goal of the procedure is to elevate the jowls, improve the jawline, bring fat back into the cheeks, and reduce facial lines. The neck is often also improved.
For the most part, it is this lower facial area that falls and bothers most patients most when they are in their early to mid-40s. Dr. Chang’s method can be performed in the office under oral sedation and local anesthesia. You can choose to go to the hospital surgery center if you want but the vast majority of my patients decide to have the procedure in the office.
Turn Back Time
All facelifts are not the same. The most common procedure that we perform is a mini-facelift. It is most appropriate for younger patients in their 40s to 50s who are beginning to develop jowls and a drooping jawline. It helps the upper neck also but this should not necessarily be counted on. Depending how how you are aging, many patients in their 60s and older will need both a face and a neck lift to properly get their jawline elevated as well as tightening a loose neck and central muscle separation.
Whether you need a mini-facelift, a facelift, or a face and neck lift, you most likely benefit from other procedures. This is because these procedures are all excisional surgeries that do not add volume, improve the aging eyelids, or improve the skin quality. Most patients will therefore also benefit from adding volume by adding facial fillers or a fat transfer, eyelid surgery to remove extra skin, and skin care laser procedures to improve the color and texture of aging skin.
Are you healthy but bothered by the appearance of sagging skin?
The goals of any of the facelift procedures is to :
- Elevate sagging jowls and improve the jawline
- Round out the face that has turned more square
- Replace fat that had fallen into the jowls back into the cheek
- Reduce the appearance of deep creases and wrinkles of the nasolabial fold and marionette lines
- Reduce the appearance of fine lines
- Improve the appearance of a drooping neck
A good candidate is in good health, does not smoke and has realistic expectations
What are the steps in performing a facelift ?
Patients are given the choice of having the procedure under local anesthesia in the office or under general surgery at the surgery center at INOVA Loudoun Hospital. Most patients will only be having aa mini-facelift will have the procedure under local anesthesia. You can see the procedure in detail in our educational procedure video *** Note that it is graphic.
If the patient is having the procedure under local anesthesia in the office, they are first given valium and oxycodone. They are then injected with long-acting local anesthesia similar to what one would experience at the dentist.
The extra skin is removed from in front, below, and in back of the ear. The skin is elevated off the fat, SMAS, and muscle
The fat and SMAS are the lifted up and backwards and held in place with permanent sutures in the areas of the jowl, in the neck, and into the temple.
Elevation of the soft tissue will provide more volume in the cheeks and remove the unwanted volume that was in the jowls. Most patients will also benefit from more volume in the temples, under the the lower eyelid, and in the cheeks. This can be provided by fillers, PRP, or a fat transfer.
The procedure is completed by redraping the skin and closing the skin in 2 layers. The bottom layer uses absorbable sutures and provides strength the the closure. These will dissolve over about 1 month. The second is a suture that precisely closes the external skin to give you the best scar possible.
Many facelift procedures are combined with other procedures to give you, the patietient, a more complete facial rejuvenation. These can include non-surgical injections such as botox, fillers, or laser skin procedures. Or they can include surgical improvement of the brow, upper or lower eyelids, neck liposuction, or a neck lift.
Patients are often worried about looking unnatural or weird. This is avoided by lifting and repositioning tissues to a more youthful position while not overstretching them.
The Results are Worth the Recovery
For most patients, the answer is an absolute yes. The goal is obviously to give you a more youthful but NATURAL appearance that more closely matches your spirit, mental, and psychological age. The best way to demonstrate this is to take a close look at the before and after gallery. Here, you will notice that Dr. Chang’s patients look natural, relaxed, and more youthful without looking pulled or over-stretched. This is why patients have travelled from all around the world to have Dr. Chang perform their facial rejuvenation procedures.
Depending on the procedure, your recovery will significantly vary. Those having only a mini-facelift will be back to work in about a week with negligible bruising and swelling. For those having a face and neck lift, they will often be asked to wear a compression wrap to help the elevation of the neck for 1 week. These patients will normally be back at work in 2 weeks with negligible bruising and swelling.
For those having upper and or lower eyelid surgery, they will often have significant bruising around their eyes. Bruising can be dramatic for a week. The second week, it turns a yellow/green tinge which can often be covered with make-up.
In summary, most patients having only a mini facelift are back at work in a little over a week while patients having any additional procedures will want about 2-3 weeks to return to work. Most patients will experience some numbness around the ears particularly in the area immediately in front of the ear. This can last up to 6 months or longer. Scars don’t completely mature for a year and may require some makeup to camouflage the scars while they heal. Most patients will also notice some rippling of the skin and incisions behind the ear. These may take 3-6 months to flatten out completely. Finally, although infection is rare, many patients will experience local stitch infections due to the absorbable skin sutures. These sutures are designed to provide strength and provide you a better scar. Unfortunately, they don’t always absorb as they should and turn into small pimple-like infections.
Choosing A Facelift Surgeon
Facelift surgery is a technically demanding procedure that requires the highest level of surgical skill. For this reason, it is very important that you choose a surgeon that is highly skilled and experienced. For this reason, many local plastic surgeons don’t even perform facelift surgeries.
Dr. Chang’s technique and skills have been taught and displayed internationally. His technique of performing a mini facelift has prompted plastic surgeons from around the world to watch and learn his technique. This technique is also on display in the the live surgery video that is posted on youtube for his patients and students.
Dr. Chang is an expert facelift surgeon and is highly experienced with a variety of facelift techniques including the mini facelift for which he is famous, the scar facelift, the deep plane facelift, the SMAS facelift, the MACS facelift, and the endoscopic facelift. The choice of lift depends on your unique and individual features and will be discussed during your consultation.
Frequently Asked Questions
How do you know if your ready for a facelift
This is a very subjective question. The simple answer is that you will know when you are ready when you become bothered by the inevitable signs of aging. This may be when you are in your 30s or this may be when you are in your 60s. We now have the techniques and technology to treat patients anywhere in between with a high level of safety and satisfaction. The average age in our practice for a mini-facelift is about 40 to 50 years old. The average age for a face and neck lift is somewhere around 55-60 years old. In some younger patients, I offer a procedure I call a 2 stitch facelift plus filler that provides a minor lift with no facial scars.
What causes Facial aging?
Facial aging is inevitable. If you look at pictures of yourself throughout the years, you will see that you looked very different in your teens, 20s, 30s, 40s, and 50s. This progression in facial aging is precisely why having a one size fits all approach to treating facial aging is wrong. The components of facial aging are relatively predictable. They begin with loss of facial volume loss of tissue elasticity. Think about a balloon. As the air escapes, the balloon deflates and the walls begin to look stretched and wrinkled. This process in general becomes more obvious in a person’s late 20s and are affected by your genetics, sun exposure, smoking history and your exposure to life stresses.
Some consistent findings include:
Loss of facial volume: This is particularly true in the temples which decreases the oval shape of a youthful appearance and makes the face look more skeletonized. It is also true in the cheek mound. The loss here causes the lower eyelid to look older as it exposes the the lower eye socket and leads to decreases the prominence of the cheek bones and makes the nasololabial fold look more obvious. Loss of volume around the mouth leads to thinning and lengthening of the lips as well as increasing the appearance of vertical lines ( smoker’s lines ).
Loss of tissue collagen and elasticity: This causes the tissue to descend with gravity and sag.
Surface skin changes: Sun injury and smoking cause cumulative changes in the appearance of your skin. This can include increases in wrinkles, age spots, prominent blood vessels, enlarged pores, and growths, resulting in wrinkles, blemishes, and discoloration. The repeated and chronic contraction of the facial muscles produces smile, worry, and frown lines that become deeper and more permanent.
What is comprehensive facial rejuvenation plan?
When you come in for your consultation, we will together develop a comprehensive roadmap for facial rejuvenation. This plan will in general touch on the 4 factors that affect facial aging. These include:
- Redraping and tightening of sagging skin and support tissues ( surgical elevation of tissue )
- Replace loss of facial volume ( injectable fillers, PRP, or fat transfer )
- Treat the surface skin changes such as brown spots, fine lines, texture changes ( forever young BBL, photofacial IPL, Laser Skin Resurfacing, PRP peels, Profractional laser, and Micro Laser Peels )
- Relax hyperactive facial muscles with Botox ( forehead, crows feet, glabella, lips )
Can non-surgical treatments deliver the same result?
In a nutshell – NO
Nonsurgical methods of facial rejuvenation will never equal the results of a facelift. However, not all patients are good candidates or even need a facelift. For example, patients in their 20s are never candidates for a facelift; patients in their 40s and 50s might not be mentally ready for a facelift. These patients are better candidates for volume replacement, treatment of surface skin changes, and relaxation of hyperactive muscles. At least they will be treating 3 out of the four pillars of facial rejuvenation. For these patients, we offer treatments like injectable fillers, PRP, fat transfer, laser skin treatments, and botox.
But it the patient is affected by loss of collagen and sagging skin and tissue, there is no nonsurgical treatment for surgical skin re-draping. We have tried ultherapy and thermage. There is negligible improvement from these options. That is why these companies continue to reinvent themselves in order to sell more lasers. We have owned a few of these devices and promptly sold them back to the company in order to give our patients the best technology for their care.
What kind of result should you expect from a facelift
Here are some statistics for you.
87% of patients reported positive reactions from others and a boost in self-esteem
Only 6% of patients reported a negative reaction from others
97% of patients thought they looked younger after surgery by an average of 12 years
97% of patients thought they looked younger after surgery by an average of 12 years
95% of patients were pleased with their results and felt that the surgery met their expectations.
The most important goal after your facelift procedure is that you look and feel natural. Your friends and family should feel that you look rested and refreshed. There should never be an attempt to take 20 or 30 years off your look. The results should look and feel natural. The main goals of all forms of facelift are to tighten the jowls, define the jawline, lift and fill the cheeks, and to improve the neck to varying degrees. The 2-stitch facelift will not lift the neck much at all, the mini-facelift will lift it about 60-70% and a neck lift will lift a little more than 80%.
The goal of a facelift should of course make you look younger. A combined procedure to improve the appearance of the eyes, forehead, and/or skin is often referred to as a Total Facial Rejuvenation. Depending on your finances and the ability to have time to recover ( about 2-3 weeks ), this option will provide the most complete result.
The result is that you will look more rested, refreshed, and younger, often like you have lost weight. You will still look like yourself, and you will look natural.
A facelift will help improve only some of the visible signs of aging of your cheeks, jawline, and neck; it will not restore lost facial volume and cannot reverse sun damage to your skin such as sun spots and wrinkles.. For best results, you may wish to consider treatments to restore lost facial volume such as fat grafting and PRP stem cell treatments and to treat sun damage and skin care, procedures such as laser resurfacing, or intense pulsed light photofacial treatments ( Forever Young BBL )
What are the main goals of a facelift
- Tighten the jowls
- Define the jawline
- Lift and fill the cheeks
- Smoothen the neckline
- Achieve natural looking results
- Provide long lasting improvement
How long will my facelift result last?
The longevity of a facelift depends on many factors including genetics, history of weight changes, sun-damage, skin quality, maintenance of the procedure with botox and/or fillers, and the type of facelift. Elevating the SMAS, the strength layer below the superficial skin is the key to longer lasting procedures; and that is part of all the facelifts that we perform. As a general rule, the results for younger patients with better collagen will last up to 10 years if the patient maintains the result. The longevity of the results decrease as you get older as the collagen begins to degenerate and decrease. The advent of stem cell replacement with PRP Fat Transfers have demonstrated great promise in increasing these results. What we are doing with a facelift is resetting the clock; and depending on the quality of your collagen, you will continue to age accordingly.
What are the Risks of Facelift Surgery
All surgical procedures carry a small degree of risk. Fortunately, significant complications from facelift surgery are infrequent. The most frequent risks are healing and scarring issues which are common to every type of surgery. Local infections from the absorbable sutures are also common. These sutures are strategically placed to give the skin closure strength. A strong dermal sutures takes off tension from the surface skin to give you a better appearing scar. Unfortunately, these sutures don’t always absorb fast enough and develop an infection that resembles a pimple. These are easily dealt with in the office.
The most common risks are listed below :
- Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
- Abnormal scarring
- Adverse reaction to anesthesia
- Delayed healing
- Tissue loss
- Altered sensation particularly in front of the ear. This is common and returns in 3-6 months.
- Damage to underlying structures
- Allergic reactions
- Unsatisfactory results that may require additional procedures.
Unsatisfactory results are subjective and at a minimum, you may be charged the facility fee.
How much does a facelift cost?
The cost of a facelift procedure can vary greatly depending upon many factors. These include:
- The type of facelift that is needed ( 2-stitch facelift , mini-facelift, face and neck lift )
- The addition of other procedures ( eyelid surgery, forehead lift, fillers, botox, laser skin procedures , etc )
- The type of anesthesia ( oral sedation vs general anesthesia )
- The facility ( office vs surgical center, vs hospital )
- The need for special implants or equipment, lab tests, and special medications.
- The cost of a facelift surgery in Loudoun County can range from $6,000 to over $40,000. We will discuss all of these variables during your complimentary consultation.
Financing options are available.