Could a facelift be the right choice for you or, more importantly, me? Having attained a certain age and stage of life, I find myself wondering about the ins and outs of going under the knife, even for just a mini-facelift or neck lift. I used to hear a lot more about facelifts – also known as rhytidectomies – when I was too young to care. Later, when the fine lines and other early signs of ageing started to appear, the traditional or deep plane facelift seemed to have been replaced with a promising array of non-invasive treatments that were becoming more advanced and effective with each passing year.
“Going under the knife” seemed almost archaic. Why would you unnecessarily go to the expense, pain and discomfort? Not to mention potential embarrassment if found out – or the dreadful possibility of an unsuccessful outcome.
Now, we had fillers to replace agerelated volume loss, Botox to iron out wrinkles, and IPL, laser, ultrasound and radiofrequency to refine and rejuvenate the skin. And I’ve been lucky enough to try almost all of them in the line of duty.
I truly believe they’ve helped keep me more youthful-looking, and I’m a grateful fan of Botox et al. But I suspect that these non-invasive treatments may not be the only way forward, especially in the longer term.
I’m getting the sense that traditional HA (hyaluronic acid) fillers are not without drawbacks. For starters, instead of being gradually eliminated by the body at a predictable and safe rate, they can be eliminated too fast or stay in place for years – or even migrate unpredictably.
Reversal can be super-tricky, too. My friend Anita was given fillers under her eyes; something went wrong, and the subsequent attempt to remove the HA caused an allergic reaction that has left her with long-term aesthetic damage.
Why the facelift isn’t dead
Looking at the numbers, the facelift is alive and well. In 2016, more than 131,000 facelifts were performed in the US alone. And according to a 2023 survey by the American Academy of Facial and Reconstructive Surgery, this number has increased by 60 percent since 2017. What’s more, the number of facelift patients aged 35 to 55 has also increased. Though it won’t slow the ageing process, remove wrinkles or improve skin quality, an expertly performed facelift can make you look 10 years younger – possibly for the rest of your life. That’s why it’s described as the gold standard for rejuvenation.
What facelifts can do that non-invasive treatments can’t
Singapore-based Brazilian plastic surgeon DR MARCO FARIA CORREA says that a facelift can…
- restore youthful contours by effectively lifting and tightening the skin;
- correct sagging by removing excess skin, especially in the lower face and neck;
- reduce deep folds, especially nasolabial and marionette lines;
- rejuvenate the jawline for a more sculpted appearance;
- correct “turkey neck”, with neck-lift so it looks smoother and more toned;
- improve brow ptosis, or hooding of the eyes caused by a drooping brow, by including a brow-lift along with a facelift.
Would I, Verne, be a good candidate for a facelift? Dr Marco answers some questions:
What is a deep-plane facelift, and am I a suitable candidate?
For the right candidate, a deep-plane facelift can achieve a more natural-looking and longer-lasting result. And no, it would not be right for me, says Dr Marco. That’s because I have fine, thin Caucasian skin that sags easily; and at my stage of life, a lot of skin to remove. I also have a “high hairline”, which means exactly what it sounds like. I can blame my high hairline on genetics – it’s been like this since I was a little girl and looks just like my dad’s did.
Where would the scar-line be?
For someone with my thin skin and high hairline, he would not propose a traditional facelift, where the incision and resultant scar are hidden well inside the hairline. Instead, it would have to be a hairline facelift.
With a hairline facelift, Dr Marco makes an incision – all just within the hairline – from the level of the eyebrows, moving downwards to the mastoidal bone behind the ear. From here, the incision would travel downward to the neck, still just within the hairline. “A lot of skin” would have to be excised in my case, he says.
Removing this skin would move the hairline forwards, a good thing in my case. Luckily, he says, I’ve got the kind of skin that heals well… but I would have to allow my hair to hide the scar.
What about the neck?
As for my neck, which I’d thought was the least of my worries, he remarked that I have “a lot of neck muscle expression”. This might sound like a good thing – it did to me – but no, it’s not. He would need to make a small incision under my chin to enable him to treat the platysmal bands, those ageing-related vertical lines more colloquially known as turkey neck. Urgh.
What about a mini-facelift? Or a neck-lift?
Again, not for me.
“While the mini-facelift has the perceived advantage of a shorter scar, it is more suitable where there isn’t much excess skin.” Says Dr Marco. “Also, it doesn’t allow me to address the deeper structures; and it doesn’t do much for the neck, either.”
It really depends on the degree of flabbiness. Where there’s no jawline flab, he can concentrate on rejuvenating the eye area. If the jawline is a bit flabby, he might suggest a mini-facelift.
“But when the jawline is compromised and the neck is flabby, too, I recommend a full facelift and neck-lift.”
So, should I have come to you earlier?
Yes, says Dr Marco. The earlier, the better. “The right time to consider a facelift is the first time you find yourself standing in front of the mirror, using your hands to pull up the sides of your face.”
That’s because living with a lot of redundant skin negatively affects skin health and blood-flow. Repositioning the facial tissues can reduce tension in the facial muscles, improve circulation and increase oxygenation, promoting a healthier pattern of bloodflow.
“That’s why a second facelift after five, eight or ten years gives an even better result… and the third is the best!”
Last word?
“Every face is different,” he says. “That’s why I treat each patient according to their own unique needs, ageing profile and physiognomy.
Facelift Facts
Traditional Facelift: Addresses sagging skin in the lower two-thirds of the face, including jowls and jawline.
SMAS Plication Facelift: Also includes moving the underlying SMAS layer upwards and laterally for more defined and youthful jawline, neck and cheeks.
Deep-plane Facelift: Moves SMAS in addition to underlying musculature, minimising tension on the skin for natural-looking and long-lasting results.
Fat grafting: Can be done at the same time if needed to restore lost volume.
Downtime: Highly individual, starting from as early as five to seven days for a mini-facelift, to ten to 14 days for a full facelift.
Cost: From $15K for a mini-facelift to $30K for a full facelift and neck-lift with SMAS plication.
#10-26/27 Mount Elizabeth Novena Specialist Centre, 38 Irrawaddy Road
6464 8075 | drmarco.com
This article on mini-facelifts and deep-plane facelifts in Singapore first appeared in the August 2024 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!
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