Complex Surgery continued...
Most surgeons would rank a facelift as a major operative procedure, says H. George Brennan, MD, a cosmetic surgeon in Newport Beach, Calif., and a spokesman for the American Academy of Cosmetic Surgeons.
"This is a complex surgery," says Brennan. "Not only do you want to consult with a board-certified plastic surgeon, but you have to get a doctor who has extensive experience in this mid-facelift itself. People sometimes get the idea that a facelift is not real surgery, but it is very real surgery. It comes with its own risks, and the best way to approach those risks is to go with highly qualified experts in this particular procedure."
According to Shan Baker, MD, president of the American Academy of Facial, Plastic and Reconstructive Surgery and director of the Center for Facial Cosmetic Surgery at the University of Michigan in Ann Arbor, "The facelift has changed radically in the last 15 years." Doctors, he says, are now performing surgery under the deep facial muscle tissues to achieve "a more natural, less operated-on look."
The new operation is becoming more common "because of the feeling that there was an imbalance in the upper face and lower face in traditional facelifts," Baker explains. "[The mid-facelift] was supposed to give a flatter, more youthful look at the fold from the lower eyelids along the sides of the nose and down." But, he says, that claim is debatable.
Does It Work?
The surgery itself takes about 60-90 minutes. According to Jacobs, it begins with the same lower eyelid incision, just under the eyelashes, that starts a traditional facelift. Working through that incision, he says "I like to go all the way down, past all the tissues to the corner of the mouth. And this is where the mid-facelift differs: I lift up the entire cheek and put the stitches on the inside and attach them to the bone around the eyelid socket area, all on the inside."
Why do it this way? "This procedure allows me to clean up the eyes and clean up the fold and lift up that cheek tissue that tends to descend as time goes on," Jacobs explains. By comparison, he says, "The classic facelift involves incisions around the ear and back into the hair and does very little on the fold of the midface around the nose."