Facelift surgery is one of Dr. Bentkover's surgical passions. With over 28 years doing facelifts in Worcester and Boston, Dr. Bentkover is constantly honing his skills and evaluating the latest innovations.
Facial Rejuventation as a specialty is an evolving mix of art, science and committment to safe innovation. Each of the facial rejuvenation procedures we perform can compliment other procedures. Whether you choose an office treatment or a surgical procedure, we are committed to recommending for you the procedure or procedures that will most readily and easily achieve your partidular aesthetic goals. If you have considered a facelift, this page and the page on Mini-Facelifts should be helpful.
In this section of our website we try to put it all in perspective. We will discuss the different types of minilifts, and explain how they differ from each other. We will also discuss the traditional deep plane or sub-SMAS full lower facelift and more extensive variations like the triplane facelift.
A facelift can give you back your jawline and your neckline...
Sagging skin, wrinkles and loss of facial volume are the hallmarks of the aging face. Your chronologic age, history of extensive sun exposure, smoking and genetics all contribute to how you look today. The smooth, more rounded faces of children and young adults have more evenly distributed fatty tissues, abundant collagen and tight underlying muscles and deep connective tissues (called the SMAS - subcutaneous muscular aponeurotic system). Over time, the skin and deeper facial tissues loosen. Folds in the chin, jawline and neck become more prominent; and your midface and cheeks may tend to lose volume. Many of our patients say, "I look just like my mother." Some also say, "My mother has better skin than I do." You may have the some of same genetic aging factors as your mother that determine volume loss, but maybe mom did not bake in the sun as much as you did. (Baby oil and iodine, anyone?).
Sound depressing? Well, you do have some options.....
There are a number of different kinds of facelifts that can have a dramatic effect on your lower face and jawline, midface, and neck. These procedures can enhance your facial contour and profile.
Only a very few years ago most facelift procedures were basically the same, but today we have many different variations of facelifts that can customize the surgery to your particular needs and your liftstye. The days of the wind swept look should be gone forever.
So, what exactly is a facelift?
Facelift surgery, or rhytidectomy, is designed to restore a more youthful appearance by tightening and lifting the deep tissues of your face. Rhytid means wrinkle, and -ectomy means removal; but the medical term rhytidectomy is actually somewhat of a misnomer. A facelift really does not remove wrinkles. It involves tightening and repositioning the deep facial tissues (called SMAS) and a neck muscle called the platysma, as well as the removal of some excess skin and fat (liposuction).
Removal of wrinkles may require a skin rejuvenation procedure such as a Portrait® Plasma Skin Regeneration, carbon dioxide laser resurfacing, any of a number of facial fillers, or even Botox®. These procedures, some of which can be done in the office, are described elsewhere on this website.
As we have mentioned, today we can offer you a number of different shorter, minilift procedures. Minilifts achieve more limited results but often involve less down-time or quicker healing. However, there are no shortcuts to quality. Properly performed minilifts designed for the best possible longevity and most natural look are just as careful and delicate operations as a full lower facelift or triplane lift. They are best and most comfortably performed with general anesthesia or intravenous sedation.
Facelift procedures performed with only local anesthesia and oral sedatives can seem appealing; but without the comfort and safety afforded the patient with better anesthesia, the surgeon's ability to effectively tighten and reposition the SMAS layer of the face may be significantly limited.
The most common types of minilifts are as follows:
- Cheek Lift
- Neck Lift
- Submental Plastysmaplasty
- Mid Facelift
(For even more details on the different types of minilifts, please also go to our section of the website called Mini-Facelifts.)
With advent of so many types of minilifts, the traditional facelift is now commonly called a full lower facelift. It involves tightening of the neck and elevation of the cheek in the proper direction (or proper "vectors"). It is really a combination of two minilifts, a cheek lift and a neck lift.
FULL LOWER FACELIFT = NECKLIFT +CHEEKLIFT
A cheeklift lifts the tissues of the cheeks in a vertical direction to tighten the jaw line and the jowls. In this procedure the SMAS tissue is often cut in such a way as to be able lift a portion of it and place it in a higher position along the cheek. The SMAS tissue that is elevated and repositioned is called a SMAS flap. In an effort to achieve a natural looking, long lasting lift of the cheek and jawline, Dr. Bentkover does what is called a deep plane, sub-SMAS flap lift. The terms S lift and J lift simply describe the shape of the incision in the SMAS tissues and skin. In all these procedures, excess skin is trimmed as needed.
A necklift lifts and tightens the neck in a upward and outward direction. First, the area under the chin is tightened through a 1-1.5 inch incision (a submental platysmaplasty). Dr. Bentkover tightens the platysma muscle in this area along with liposuction as needed. If you need a chin or pre-jowl implant, he will do it through the same incision. Next, through an incision that begins in the lower part of the crease in front of the ear and extends behind the ear, he will tighten the back part of the platysma muscle, liposculpt the neck (if needed), and remove excess skin.
A midface lift is a minilift that elevates your cheeks. As you age, the middle of your face generally descends at about a 45 to 90 degree angle. A midface lift elevates this in such a way as to correct the hollows and washed out appearance that can develop in the middle portion of your face (under your eyes and along your nose).
When adding a midface lift to a full lower facelift, it becomes a so-called TRIPLANE FACELIFT, because the operation involves elevation of three separate types (or planes) of tissue, skin, muscle and the coating over the bone (periosteum).
A full lower facelift takes about 3-4 hours, and a triplane facelift takes between about 4 and 5 hours.
All types of facelifts can be combined with other facial rejuvenation procedures such as a blepharoplasty (eyelid lift), liposuction of the neck, laser resurfacing, Rhytec Portrait® Plasma resurfacing, a brow or forehead lift, cheek augmentation, chin augmentation, or various facial fillers or implants to specific creases and hollows. These procedures add more operating time.
As you can imagine, with the potential for such dramatic results, a full lower facelift is a very technical and exacting procedure. Hence, it often requires 10 to 14 days of recovery time away from work or strenuous activity. Minilifts often require less time to recover.
We have provided a lot of information on this page, but it is unrealistic to think that most people can pick the type of operation they need just by reading various websites. That is where the consultation comes in. Dr. Bentkover will spend an hour with you evaluating your face and discussing your personal aesthetic goals. If need be, he will also "morph" some images of your face on the computer. You will also meet with our aesthetic nurse to get her personal perspective on facial rejuvenation and many of these procedures. In addition, you are welcome to return alone or with family members or close friends for a second consultation at no additional charge.
