The Procedure: Mid Facelift and Traditional Facelift

Surgeons use the term “facelift” to describe any procedure on the face that results in a tighter, more youthful appearance. I will discuss the two most recognized approaches: the midfacelift and the “traditional” facelift. The midfacelift is a powerful new way to rejuvenate a person’s appearance who is just starting to show signs of aging. Unlike a traditional facelift, which pulls the entire cheek skin and neck skin in an upward and backward fashion to improve sagging jawlines and necks, the midfacelift pulls the area between the lower eyelid and upper lip in a more vertical direction. This serves to soften the fold between the nostril and the corner of the mouth (naso-labial fold) as well as add more fullness to the cheekbone and shorten the aged, elongated lower eyelid. Because the incision is inconspicuously located within the lower eyelid or within the temple, there is no obvious scar.

The traditional facelift, on the other hand, is a powerful procedure for improving the jawline and neck. With some of the more extensive modifications, naso-labial folds and sagging cheek fat can also be repositioned to produce a more youthful contour. The incisions are hidden in the hairline and around the ear and may or may not include a smaller incision under the chin. This latter incision is useful in approaching the anterior neckbands that may need to be modified through cutting, removal or suture tightening.

Hairline

One of the most distressing male features in someone transitioning from male to female is the male pattern of baldness. This usually starts out as temporal recessions but may proceed to a significant loss along the entire frontal hairline. A female hairline is rather straight  across and appears to be positioned approximately one third the height of the frontal face when measured up from the eyebrows. Correction to achieve this goal may involve a scalp advancement, hair transplants or a combination of the two.

FACIAL AGING

It has been said that facial aging can be summarized by referring to the 3 D’s  Descent, Deflation, Deterioration.

By descent we mean the sagging of the facial tissue caused by gravity. The treatment for this would be pulling back the tissue to where it was many years earlier via a facelift, necklift, browlift or eyelid lift. By deflation we mean the gradual atrophy of the fatty tissue in the face, which had given it the attractive fullness… characteristic of youth. To reverse this, we transfer fat from another part of the body to areas of the face that are deficient. In some cases, we can even use synthetic implants.

By deterioration, we mean the loss of elasticity and collagen in the skin and the general degradation that we see from aging and exposure to the elements. The treatment for this is re­surfacing via laser, dermabrasion or chemical peels, and appropriate maintenance with moisturizers, sunblocks and other topical creams such as retin­A and the alpha hydroxy acids like glycolic acid.