Facelift (Rhytidectomy)

Detroit Facelift: Full, Mini Facelift, and Neck Lift

Most of the natural aging you experience takes place on your face, where wrinkles and volume loss can set in and make you appear older. Surgical and nonsurgical options are effective when treating aging skin, but the procedure you choose depends on the results you desire.

Board-certified cosmetic surgeon Dr. George T. Goffas performs both surgical and nonsurgical facial rejuvenation at Cosmetic Surgeons of Michigan, PC, but will suggest a facelift if you require a permanent and significant change to your facial contour. Opting for a surgical solution can take years off of your appearance and improve skin laxity that may be making you feel self-conscious.

Is facelift surgery right for you?

Many people wish to refresh their look as they continue to age, but not everyone desires invasive techniques that are typically associated with surgery. Deciding which facial rejuvenation method depends on the amount of enhancement you wish to receive.

If you are looking for a permanent way to achieve youthful skin, then a facelift will provide the results you’re looking for; however, if you prefer subtle changes that you are able to adjust over time, then nonsurgical injectable treatment may be better-suited for you. During your consultation, you can discuss your options with Dr. Goffas, who can help you decide which treatment to choose.

Signs of aging a facelift can address:

Facelift surgery can effectively address the following common signs of aging:

• Sagging skin in the midface and along the jawline
• Deep creases below the lower eyelids
• Deep lines along the nose extending to the corners of the mouth (nasolabial folds)
• Loss of muscle tone in the lower face, leading to jowls
• Displaced or fallen fat that was once evenly distributed around the face
• Loose skin and excess fatty deposits under the chin and jaw, creating a double chin or “turkey neck”
• Overall loss of skin elasticity and firmness
• Appearance of a tired facial expression due to sagging skin and deep wrinkles

Video transcript

“Depending on the patient’s age, if they’re younger and their aging in the forehead isn’t extensive, and as long as the eyebrow hairs aren’t underneath the orbital rim, which is the bone surrounding the eye, then we might use something that’s less invasive called an endoscopic forehead lift. You make several small incisions in the scalp, lift the scalp, and then secure it with the use of these small fixation devices. The advantage of the procedure is that it’s fairly quick, has easier downtime, and you probably get people back to work within a week or so. It helps if you don’t need a significant improvement.

Now, if you’re looking at an older patient, especially men and even some women where the eyebrow hairs are below the orbital bone and there isn’t much space between the eyelashes and the brow, then you’re looking at more of an open procedure. You make incisions in the scalp, bring that tissue back, and then tighten it. The advantage of that is it’s a longer-lasting procedure. I’ve never had to redo a brow lift, an open type procedure, but it’s a much stronger and better result. But it’s like anything else; there’s a higher recovery rate to it. You probably would need a minimum of two weeks to recover, depending on the person.

So those techniques in the upper face are good. In the lower and mid-face, there are several different techniques you can use for rejuvenation. The simplest is skin excisions. They’re easy, quick, and kind of the weekend facelift procedure of old. The advantages are that they’re quick, easy to recover from, and there isn’t much risk or much recovery, but you won’t get as strong of a result.

As people get older, you’ll start to notice that their fat pad and their buckle fat pad will get droopier or larger, and they’ll get weakness in their muscles and their skin laxity as well. With patients like that, you have to do more of a deep plane facelift because it’s just a longer-lasting lift, addressing all the factors — ligaments, fat pad, and tightening up the skin. Those are longer recovery procedures, usually a couple of weeks, but it’s the longest and strongest-lasting facelift that we have.

It can also be used more with smokers because you’re not really thinking that the skin’s doing most of the work; it’s more of the deeper tissues, and the skin’s just kind of along for the ride. Those are similar procedures that we would use in the neck too. You can do small excisions and submentoplasties if you don’t need much, but usually, the gold standard would be incisions behind the ear, and you can tighten up the neck with impunity. I don’t think there’s anything in any area that you can overtighten in a neck, whereas a face, you could do some bad results if people look like they’ve been through a wind tunnel. But a neck, I try and tighten as tight as I can, and I tell patients that it’s going to be very tight after. But that’s probably how it was when you were 20, you know, so you just have to get used to that a little bit.

All these different surgical procedures are intertwined with potentially fat grafting from the patients. A lot of times, now we know that we lose bone density as we get older, people get shorter and all that, and hunched over. But probably we lose a fair amount of bone in the face too. Since we can’t really replace the bone, a lot of times, we’ll use implants or the patient’s own fat. Most patients like their own fat, and I like it too because it’s a little more natural than an implant. So we’ll use that as well. If they have too much fat in their face, we’ll suction some of the fat out. Those different types of procedures are very individualized; not every patient is getting the same surgery. They’re getting a surgery that’s just right for them.”–Dr. George T. Goffas

Why Receive a Facelift?

The natural aging process is inevitable and can be made more apparent from years of exposure to the sun and other environmental factors, the effects of gravity and genetics. Each of these conditions can lead to wrinkles forming and your skin losing the elasticity that helped it look plump and firm in the past.

When you begin to lose volume in your face, it can make features appear sunken and worn, and many of these conditions can impact your confidence, making you feel self-conscious about aging.

Although there is no cosmetic solution that will stop the aging process completely, there are ways to slow down its progression. If you are displeased with the way aging skin is making you look, then discussing a facelift with Dr. Goffas may be your next step.

Video transcript

“Facelift evolution has changed a lot, kind of just from what society wants and what the doctors can perform. In my practice, initially, the facelift surgeries were traditional facelifts, deep plane, sometimes skin excisions, use of implants, and we got good results. But as society moved on, there was a big focus on minimally invasive procedures and quick recoveries, which are hard to do with what I would consider more longer-lasting facelift surgery. So I went through that phase with a lot of endoscopic and minimally invasive techniques, and that lasted probably about 5 years or so, and I just wasn’t getting as good of results.

Now I generally tell the patients if they really want good improvement, they’re going to need a real face and necklift, and they’ll probably need 10 to 14 days off of work. If they can do that, they’ll get good results. If not, we might be able to help them out with just skin excisions and other minimally invasive techniques.

But I think the pendulum is swinging a little bit back now again towards actual surgery versus the minimally invasive techniques for several reasons. One reason, I think patients realize that they’re in the doctor’s office more with the fillers and the Botox and these techniques and the lasers and all that. But when you get like a good surgical procedure, they’re good for 7 to 10 years. And if you look at the cost and the time involved, it could be a better deal in the long run.”–Dr. George T. Goffas

Your Facelift Consultation with Dr. Goffas

Dr. Goffas performs facelift surgery in a way that aligns with your cosmetic goals and your facial construct so that your results look as natural as possible. Your treatment is customized completely so that you receive significant rejuvenation that still looks like you.

During your one-on-one consultation with Dr. Goffas, your medical history will be reviewed to determine whether surgery is a viable option for you. We can also determine the areas of your face that should be targeted with surgery and design a treatment plant that specifically enhances the contours of your face. Dr. Goffas will carefully assess the laxity of your skin as well as the amount of volume loss and choose the best incisional technique that will allow him to tighten the skin.

You can view additional before and after photos of previous facelift procedures, receive post-operative instructions, discuss the cost of your surgery, and learn more about the procedural details that will help you decide whether a facelift is right for you.

Video transcript

“Facelifts in my practice are really somewhat patient-driven. I find out, again, addressing the chief complaint: why is the patient there? If they’re there because they feel they have a saggy neck but their eyebrows are bad, we’ll address the saggy neck first. But then I’ll explain to them why people might not notice the saggy neck repair, but they will notice that they still look tired because of their forehead or eye area. Depending on what the patient wants, I’ll kind of let them guide me as to what we’re going to do. But I do want to give them a good result because, like I say, a lot of people focus on their neck, but their eyes and forehead are the problem that makes them look tired. So if you don’t rejuvenate that, they’re not really going to have that great of an improvement.

Most of my patients, I explain to them that if the job’s done right, many times our best work goes unnoticed. And I think there’s a lot of truth to that because people will notice there’s a difference: they look rested, they don’t look tired anymore, they look energized. But they’re not going to know exactly what. But I think post-surgical if everyone’s like, “Wow, who did your facelift?” it was probably overdone.”–Dr. George T. Goffas

What Happens During Facelift Surgery?

All surgeries are performed either in a hospital setting or a private facility that is AAAHC-accredited. Either location is structured for your safety, confidentiality, and overall peace of mind. Your facelift will start once you are placed under general anesthesia, at which point Dr. Goffas will then make the necessary incisions into the face.

Dr. Goffas can create incisions in several ways, depending on the amount of change you desire from your facelift. Traditionally, a facelift incision begins at the hairline near the temples and continues around the ears toward the back of the head; however, shorter incisions around the ears are also used for a softer lift.

Once Dr. Goffas repositions the skin, he will close your incisions with sutures and transfer you to a private recovery room.

Surgery with both a face and neck lift

If you desire additional neck and jawline rejuvenation, Dr. Goffas may also suggest adding a neck lift to your face lift plan. The two procedures are typically performed at the same time. A neck lift, also known as platysmaplasty, targets the visible signs of aging in the jawline and neck area, for a more youthful and refined appearance.

The neck lift procedure begins with Dr. Goffas making incisions typically around the contours of the earlobes, extending around behind the ears, and possibly under the chin for additional access. This allows him to carefully separate the skin from the underlying tissues. In cases where muscle banding in the neck creates abnormal contours, the platysma muscle is tightened and realigned through these incisions, enhancing the neck’s overall contour and definition.

During the procedure, Dr. Goffas may also use liposuction to remove excess fat, particularly in the lower face and neck, to effectively reduced a double chin and create a more contoured, defined jawline. Dr. Goffas will then trim the excess skin and reposition the remaining skin to achieve a smoother, tighter skin profile. The incisions are meticulously closed with sutures, which may either dissolve on their own or require removal after several days.

Typically taking two to three hours, the neck lift dramatically improves the aesthetic of the neck by reducing sagging skin, smoothing out muscle bands, and enhancing the jawline’s definition. It is an excellent addition to a facelift procedure, as together they achieve a full facial transformation, especially from the side profile.

Combining Facelifts with other Procedures

Your facelift is also a perfect time to receive additional enhancement in specific locations. Many patients will receive an eyelid lift or brow lift for optimal improvement. The amount of excess skin to be removed is something you can discuss with Dr. Goffas during your consultation; he can decide whether any additional surgeries are necessary to achieve your desired results.

Recovery After Your Facelift

Dr. Goffas will provide you with recovery instructions before your surgery takes place, explaining the best ways to care for your incisions and limit any chances of infection. It may take several weeks for you to heal fully and see the results of your facelift, but following your post-operative instructions will ensure you see the effects of your facelift as quickly as possible.

It’s best to take precautions during your recovery process and refrain from handling your bandages and sutures until Dr. Goffas removes them. We also suggest using sun protection and avoiding putting on clothing over your head for the first few days after surgery.

You will experience some swelling and bruising immediately after surgery, which will subside as you continue to heal. Dr. Goffas may prescribe pain medication to soothe any discomfort you experience and schedule follow-up appointments that allow him to monitor how your incisions are healing.

Caring for your scars

One of the most important aspects of your facelift recovery period will be caring for your scars. Dr. Goffas will provide you with specific scar care instructions to ensure they heal as quickly and as beautifully as possible. Typical scar care will include the following:

• Keep Scars Clean: Gently clean the incision sites as directed to prevent infection, which can worsen scarring.
• Use Topical Treatments: Apply any prescribed or recommended creams or ointments that promote healing and reduce scar formation. Topical scar care might also include the use of silicone gel or silicone sheets, which are known to help reduce scar thickness and discoloration.
• Avoid Sun Exposure: Protect your scars from the sun by covering them with clothing or using a broad-spectrum sunscreen with an SPF of 30 or higher. UV exposure is proven to potentially darken scars, making them more noticeable.
• Health and Hydration: Proper nutrition and hydration are vital for optimal healing, and this includes your scars and skin. Foods rich in vitamins A and C can promote wound healing and help your body produce collagen.
• Avoid Stress or Excessive Movement: Minimize movement that can stretch the scars, especially in the early stages of healing. Avoid strenuous activities and follow guidelines for when you can return to regular exercise.
• Do Not Smoke: Smoking impedes blood flow and can significantly delay healing and worsen the appearance of scars.
• Keep Follow-Up Appointments: Attend all follow-up visits with Dr. Goffas. These appointments allow him to monitor the healing of your scars and intervene if any issues arise.

Initial Results

After several weeks, your skin will feel smoother and look tighter. Most patients begin to see their new facial contour as early as 2 weeks, but minor swelling may persist for several months. The final results of a facelift are typically visible within 6 to 12 months after surgery, as the skin fully settles and heals.

Caring for Your Facelift Results Over Time

In the months after your facelift surgery, it is essential you follow Dr. Goffas’ post-op instructions to a T to ensure you are getting the best outcome from your procedure. To get and maintain the best facelift results, it’s also key that you maintain a healthy diet and regular exercise routine, as well as protect your skin from the sun by using sunscreen with a high SPF, wearing hats, and avoiding direct sun exposure. Be sure tp avoid smoking and excessive alcohol consumption, as both can accelerate aging and compromise the quality of your skin.

Non-surgical treatments can also help keep your skin looking healthy and radiant, which further extends the longevity of your facelift results. These can include:

• Injectables: Expertly-placed Botox Cosmetic and dermal fillers can help minimize the appearance of new wrinkles and fine lines.
• Laser Treatments: Can effectively improve skin texture and tone, as well as address a variety of skin concerns.
• Chemical Peels: These medical-grade skin treatments can treat superficial skin imperfections and reveal a new, healthy layer of skin.

Frequently Asked Questions about Facelifts

What will my facelift scars look like?

Facelift scars are typically concealed within the hairline and in the natural contours of the ear. Over time, these scars should fade and become minimally noticeable, especially with proper care and following Dr. Goffas’ advice on scar management.

Will a facelift erase my wrinkles?

A facelift primarily addresses sagging skin and deep folds rather than fine surface wrinkles. While it can significantly reduce the appearance of deeper wrinkles and creases, complementary non-surgical skin treatments like injectable wrinkle fillers or laser skin resurfacing may be needed for surface-level wrinkles.

Will people be able to tell I’ve had a facelift?

A well-performed facelift by a board-certified cosmetic surgeon aims to enhance your appearance subtly, making it difficult for others to pinpoint that you’ve had facial plastic surgery. Dr. Goffas aims to make you look refreshed and rejuvenated, but still like yourself — not dramatically different.

Will my face look different after a facelift?

Your face will look rested, rejuvenated and more youthful after a facelift, with noticeable improvements in sagging skin and deep folds. The procedure is designed to reverse severe signs of aging and restore your natural contours, not to change your fundamental appearance.

When can I go back to work after a facelift?

Most facelift patients can return to work and most daily activities within two weeks post-surgery, depending on the nature of their job and the extent of the facelift. However, it’s important to avoid strenuous activities for at least four weeks after your facelift to ensure proper healing.

Are facelift results permanent?

While the facelift procedure can significantly turn back the clock on aging, it does not halt the aging process. Results typically last between 7 to 10 years, with variations depending on your skin quality, lifestyle, and genetics.

Can I get a second facelift?

A secondary facelift may be considered about 10 to 15 years after the initial surgery, depending on individual aging processes and personal desires. You can discuss the possibility of a second facelift with Dr. Goffas when you notice signs of aging reappearing. The good news is that a secondary facelift procedure is often less extensive than the primary surgery.

About Cosmetic Surgeons of Michigan, PC

Board certified cosmetic surgeon Dr. George T. Goffas has served patients in the metro Detroit area for over 15 years. He would be happy to discuss questions you may have about facelifts (rhytidectomy), and to help you decide if Cosmetic Surgeons of Michigan, PC is the right fit for you. To learn more about the facelift procedure, please schedule a personal consultation with Dr. Goffas, contact us online or call (586) 773-6900.

Areas served:

• St. Clair Shores
• Detroit
• Grosse Pointe

References »

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Quatela V, Montague A, Manning JP, Antunes M. Extended Superficial Musculoaponeurotic System Flap Rhytidectomy. Facial Plastic Surgery Clinics of North America. 2020. doi: 10.1016/j.fsc.2020.03.007.

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