In youth, the cheek bone region is fuller compared to to the chin and jaw. It is much like a "heart" shape. The shape of the face becomes more rectangular as we age. A facelift is a facial rejuvenation surgery that aims to restore the “heart” shape. Sagging of the tissues in the jowls and neck are addressed by deeper tissue repositioning. The best facial rejuvenation approaches do not seek to "pull" tissues. We aim to gently reposition the descending, wider elements (jowls and lower cheek) to more youthful positions. Natural contour of the face is established by restoration of the lost volume of the upper face while correcting the jowl and neck area.

When are the nonsurgical options appropriate in facial rejuvenation?

Restoration of volume alone may be appropriate in select cases, as fillers (hyaluronic acid) or fat (autologous fat transfer from your own body) can reestablish the fullness in youth. However, when jowls begin to be prominent, and the skin and soft tissues beneath the chin and of the upper neck become lax, a facelift may be appropriate.

The descent of skin and soft tissues during facial aging can't always be "camouflaged" nonsurgically. When necessary, facelift surgery is frequently performed in conjunction with other facial rejuvenation procedures,such as fat grafting. This allows for more minimally invasive facelift approaches where appropriate.

When is facelift appropriate for me?

Usually, the first and most common sign of lower facial aging is the jowls. Jowls become prominent, the lower facial skin and soft tissues become lax, and when the neck begins to droop. Restoration the jowl and neck area usually requires a face lift procedure. The deeper tissue layers that require repositioning are called the SMAS, which is a firm connective tissue layer, and the platysma, which is a muscle sling in the neck. The deeper tissues (SMAS and platysma) are addressed in face lift surgery. After a comprehensive personal discussion and physical evaluation in Dr. Unal’s office in Istanbul, facelift and other facial rejuvenation options can be tailored to your unique goals and desires.

What are your facelift options?

Dr. Unal will always present what she feels to be the safest, most effective combination, and the least invasive methods, to achieve your goals. When a facelift is appropriate, the following techniques will be considered:

• Short Scar Facelift - this is a minimal incision facelift approach that allows repositioning of deeper facial tissues with limited skin incision.
• MACS Lift – is a short scar facelift technique where purse string sutures tighten the cheek and facial SMAS planes
  excision.
• Classical Facelift - deep tissue repositioning is carried out, and more skin can be removed. SMAS Plication, SMASectomy or SMAS Flaps may be used to redefine the deep tissue planes.
• Facelift with Necklift - an incision is often added beneath the chin, and the platysma muscles are repaired.

There are a variety of factors that might make an individual a candidate for a particular facelift technique. Subjective desires as well as the anatomy of the patient are always measured, and Dr Unal will provide information on the most effective combination of methods for each individual.

A facelift, as with any facial rejuvenation process, is about restoring natural balance in all features of the face and neck. As such, most will consider adjunct complementary treatments. Of these, the most common one is fat grafting. The facelift will restore the soft tissue position that has changed over years, and the addition of fat will restore the volume that has dissipated in the face. Upper and lower lid blepharoplasty (eyelid lift) is also a common complimentary of the facelift. A chin implant during a face or neck lift can further improve the definition of the jawline and upper neck. Definition of the chin helps to accentuate a more youthful appearance. Browlift can also be combined with facelift surgery.

How do I prepare for a Facelift?

It is important to avoid anything that thins the blood for two weeks prior to surgery. Maximizing skin "fitness" prior to surgery, using an at-home regimen that usually incorporates a retinol or Retin-A, is encouraged. In certain cases, other preoperative treatments (chemical peels) may be recommended to enhance the postoperative results. Routine blood tests may be required prior to surgery. At your initial consultation with Dr. Unal in her office in Istanbul, facelift instructions are given, and are reviewed with you in great detail at a preoperative visit two weeks prior to surgery. Prescriptions are given at this visit, and any questions you may have will be answered.

How do I recover after a Facelift

After your facelift, you will be cared for by a registered nurse at an accredited hospital in Istanbul. Dr Unal will perform a visit after your surgery and in the afternoon. You will need to stay at the hospital overnight, and be cared by the registered nurse. Small drain tubes are removed on the first morning after surgery.

Bruising and swelling can be expected after your facelift, and generally lasts for 7-10 days. Many will be able to return to work and social activities by 2 weeks, however depending on the facelift technique and adjunct procedures, return may be sooner, and in rare cases slightly later. Sutures are most often removed at 7 days. You may resume light exercises at two weeks, and unrestricted exercise begins at 4-5 weeks.

What do I do after my Facelift?

Dr. Unal will see you frequently in the first weeks after facelift, followed by a 12 week and 12 month postop visit. Dr. Unal and her staff are always available to you, and will discuss any questions or recovery related matters after your facelift. Skin maintenance after the procedure is also overseen, and combinations of moisturizer, serum, sun block, and retinol will be advised for your specific needs.