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Facial Gender & FFS:
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Facelifts

 

It is quite common for FFS patients to have facelifts. This is partly because people feel that if they are having FFS, then why not look a little younger at the same time? But it's also because on older FFS patients, chin and jaw surgery can leave the soft tissues around the lower face and neck more slack than they were before. Younger patients don't have this problem as their soft tissues are very elastic and will easily tighten back up around the new jaw and chin as the swelling goes down.

The age at which you might need to consider a facelift after chin and jaw surgery will vary from person to person – one 50-year-old for example, might have very elastic soft tissues while another 40-year-old might already be having noticeable sagging.

It is very important to have any lifting done after jaw/chin surgery and not before it, or during it. There are 2 main reasons for this:

1.
Chin and jaw surgery cause a lot of swelling and it's impossible to know in advance how much swelling a particular patient will experience.

2.
It's not possible to know in advance how well your soft tissues are going to adapt to the new bone structure. You can certainly make a guess based on the patient's age and by feeling how elastic the tissues are, but there is still a lot of guesswork involved.

This means that the best way to achieve the optimum result is to wait a few months for the swelling to go down and for any re-adaptation to take place - you can then see clearly exactly what, if anything, needs to be done with the soft tissues.

 

 

Types of Facelift:

There are many different kinds of lift working on areas like the neck, lower face mid face, eyebrows and forehead. Some are relatively quick procedures, others are more involved and work on deeper layers of tissue. Many facelifts include endoscopic procedures which are done with tiny cameras and tools inserted through small incisions.

To go into facelifts in detail would make for a very long article and would probably be worth a separate website so I am going to give you a good overview here instead. Here then are some of the main types of facelift:

1. SMAS
SMAS stands for “superficial muscular aponeurotic system” and this refers to layers of soft tissue under the skin. The problem is that if you lift the skin alone, it soon starts to sag again so you have to go a little deeper and lift some of the underlying layers at the same time. This is sometimes referred to as the “Traditional Facelift”. It treats the lower face.

2. Deep Plane Lift
This is like the SMAS lift but works on even deeper tissues. It's particularly good if you have very deep naso-labial folds but it is also a little riskier.

3. Composite Facelift
This is like the deep plane lift but also includes muscles around the eyes.

4. Mid face lift
This is good for people whose problem area is mainly the cheeks and who don't have lots of slack tissue along the jawline. It involves small incisions in the hairline and inside the mouth and the procedure can be performed endoscopically which means that tiny cameras and instruments inserted through small incisions. The scarring is minimal but it is not suitable for more severe sagging.

5. S-Lift
Also known as a mini face lift. It doesn't include the neck, so it's good for people who don't have any problems in that area.

6. Subperiosteal Facelift
This technique detaches soft tissue and lifts them vertically.

7. MACS facelift
MACS stands for minimal access cranial suspension. It's a lift for cases that aren't too severe and it involves quite small incisions.

8. Thread Lift
A minimally invasive lift using special stitches.

9. Neck Lift
There are also procedures that only address a sagging neck.

 

As you can see it, it's a complex area with various possibilities and facelifts are often combined with other rejuvenating procedures like fat grafting, liposuction, brow lifts and eyelid surgery (blepharoplasty). You can read more about these procedures in other parts of this site - there is information on fat grafting on the cheeks page, liposuction on the chin page, brow lifts are on the eyebrows page and blepharoplasties are on the eyes page.

I can simulate lifting to various areas and advise you on whether a strong lift or something more mild is likely to be needed but the particular procedure you need will depend on many things and would be something to discuss with your surgeon.

 

Some Questions:

 Can I have a facelift done at the same time as FFS?
It is very important to have any lifting done after jaw/chin surgery and not before it, or during it. There are 2 main reasons for this:

1.
Chin and jaw surgery cause a lot of swelling and it's impossible to know in advance how much swelling a particular patient will experience.

2.
It's not possible to know in advance how well your soft tissues are going to adapt to the new bone structure. You can certainly make a guess based on the patient's age and by feeling how elastic the tissues are, but there is still a lot of guesswork involved.

Do I need to go to and FFS surgeon for a facelift?
You don't need to go to an FFS specialist for a facelift - there are only a handful of good FFS surgeons, but there are very many good facelift surgeons.

I am young and have no sagging but my surgeon says I will need a facelift at the same time as jaw and/or chin surgery. Is this true?
If you are still in your 20s, you are extremely unlikely to need any lifting as your soft tissues are almost certainly elastic enough to re-adapt to the smaller bone structure. This is generally true for people in their 30s too. As you get older, the chances of FFS causing some slackness in the soft tissues become greater, but even then, you should have the facelift several months after FFS and not during (see the first question above).

Do facelifts feminise the face?
Faces do seem more masculine as they age. I suspect there are 2 particular reasons for this – firstly, fat is lost from the cheeks as you age making them more hollow and hollow cheeks are a masculine trait in younger people. Secondly, the lip to nose distance gets longer with age and a long lip to nose distance is also a masculine trait in younger people.

A lack of cheek fat would be treated with fat transfers to the cheeks and that is often done during various facelift procedures. A lip lift corrects a long lip-to-nose distance and could also be done at the same time. But remember - if both male and female faces go through these same ageing changes then your eye should expect to see a thinner face with longer lip to nose distance on a more mature female face.

So it's probably best to think of a face lift as mainly a rejuvenating procedure but one that can sometimes be mildly feminising.