Looking to have a facelift in Cincinnati, Ohio? Our plastic surgeons love performing this procedure because of the difference a facelift can make in how a patient feels about him or herself. To understand what a facelift does, it helps to understand how your face ages. For a detailed discussion, see our face blog, Let’s Face It. Otherwise, here is a more abbreviated version with illustrations for our visually oriented readers. Then, we will discuss how a properly performed facelift by one of our board certified plastic surgeons can provide very natural appearing results. 

Before    After

Aging Skin

Skin loses its elasticity as we age. This causes it to stretch and sag. The result is excess skin on the face, which droops and folds on itself, causing wrinkles.

Drooping Fat

Fat gives shape to our faces. It is attached to the bones of our faces and held in place by bands of tough connective tissue. As we age, these bands stretch, allowing the fat to drop. Essentially, the fat goes from the top of our faces to the bottom of our faces. Our faces have a more angular shape in youth with highlights high on our cheekbones. When the fat sags, the shape changes, becoming more squared, pushing the highlights to the lower face. 

     Facial Aging 

This diagram shows the dramatic changes of aging as described above. Notice how the light is reflected from high on the cheekbones on the youthful, left side of the picture. Also, there is shadow in the more hollow area under the cheekbones where the face tapers into the jaw. This is the angular shape of youth.

As the fat drops, the cheek highlight is lost and the face looks somewhat deflated over the cheeks. The dropped fat, fills the previously hollowed area under the cheekbones and hangs over the jawline. This displaced fat creates the jowls and nasolabial folds (smile lines).

Other obvious changes occur, including brow drooping and eyelid sagging. These changes can be improved with brow lifts and eyelid lifts.

How Does a Natural Appearing Facelift Work?

A facelift removes extra skin to smooth wrinkles and moves fat to a more youthful position to rejuvenate facial shape. A natural appearing facelift is NOT about pulling everything tight. Although pulling everything back tightly may smooth the wrinkles and jowls, it does not make you look like a younger version of yourself. It makes you look like someone else whose face is pulled tight. Pulling the skin tight tends to flatten the cheeks, which works against our objective of volumizing the cheeks (if you want to look natural). This is what tends to happen in a facelift where the skin is pulled too tight or when the skin is used to pull up the fat.

A better approach involves pulling up the fat separately and reattaching it to the bone to create a more youthful facial shape. The deep, fatty layer of the face is called “SMAS.” SMAS stands for superficial musculoaponeurotic system. In a SMAS facelift, this deep, strong layer is lifted as a separate layer from the skin. In fact, the direction it is lifted is a different direction than the skin should be lifted. When this is done, your facial shape is improved because the facial fat is contained in this layer. The shape improvement happens without skin tightness and both layers are lifted in the right direction for a natural result.

When only the skin is lifted, a bad compromise is made. The skin must be pulled tighter than it should be to raise up the fat, and both layers must be lifted in a non-ideal direction. This can create the stereotypical facelift appearance. We find that most women in Cincinnati and Northern Kentucky want to look as natural as possible, so this may not be the best option for most.

   Directions of Lift in Facelift 

The diagram above shows the typical incision location in purple. The dashed portion of the line indicates where the incision is hidden behind part of the ear or in the hair. The red arrows indicate the direction of lift for the fat or “SMAS.” The blue arrows indicate the direction of lift for the skin. These arrows indicate averages—we tailor the exact direction to fit the shape of your individual facial features. The picture below shows how well the scar hides after only 8 weeks of healing.

Facelift Scar at 8 weeks

Surgery Guided by an Artistic Eye

No matter how good a surgical approach is, it must be performed by a plastic surgeon who appreciates these subtleties, can visualize how to make the right changes and can perform the procedure skillfully. The direction of lift is slightly different for every patient. This is why not just any surgeon can learn to perform a facelift well. Sometimes it seems a bit clichéd when a plastic surgeon is compared to an artist, but it truly takes someone with an artistic eye to do this operation properly. The right technique plus the right surgeon produces the synergy necessary to create a natural appearing result.

Before After  

Our patients’ success with their facelift results begins with a detailed evaluation to determine your goals, followed by your plastic surgeon developing an individualized plan. Your plan includes determining the ideal direction of lift for your facial fat and your skin.A Facelift System Designed for Maximal Results

Next, our system includes a personalized skin care protocol designed through collaboration between your plastic surgeon and a skin care professional at Kathy Jones Skin Care. This regimen will get your skin in the best shape possible prior to your procedure and maintain your results longer. We also include products to minimize bruising, swelling and speed recovery.

Our Surgeon

Dr. Jean Loftus is highly skilled and focus on creating natural results for women and men. She accepts patients from across the United States and have locations throughout Cincinnati and Northern Kentucky. Our patient coordinators are among the nicest people you have met! Contact us to arrange a consultation.