How to Choose the Facelift That Is Right for You

A layperson using the term "face lift" usually means surgery that rejuvenates the entire area from the top of the forehead to the bottom of the neck, including every structure in between. But to the plastic surgeon, there are probably half a dozen different surgeries to improve that territory, including: brow/forehead lift; upper and lower eyelid lift; face lift; neck lift; chin and cheek implants; and various peels or laser treatments. What surgery or treatment do you really need to get you where you want to go? To know what you need, start with taking a "facial inventory". In a facial inventory, you take stock of your various facial features. All of the steps are done while sitting upright and looking in a full-size mirror.

STEP 1: Think of the face as being divided into three zones or areas:

Zone 1 - forehead, eyebrow line and upper and lower eyelids.

Zone 2 - nose, cheeks, nasolabial folds (the lines from the corner of the nostril to the corner of the mouth) and the upper lip.

Zone 3 - lower lip, chin and neck.

STEP 2: Examine each of these zones separately and evaluate the aging process:

Zone 1 - forehead wrinkles; low, drooping brows with loss of natural arch; puffiness, drooping, excess skin of upper and lower eyelids.

The area around the eyes says the most about our age, health and state of mind. When your face is totally passive, do you have deep wrinkles in your forehead and at the corners of your eyes? Do your eyebrows have a natural, youthful arch or are they level or inverted? Do your upper eyelids touch or almost touch your eyelashes? Look at your lower eyelids. Is there puffiness that is worse on some days and better on others but always there, especially when you rotate your eyes upward?

Zone 2 - drooping nose and tip of nose; deep nasolabial folds; thinning of upper lip; deep vertical lines of upper lip.

Place your fingers on your cheekbones and gently lift upward. Does it improve your appearance or make you look more youthful? When you look at yourself with only overhead lighting, is there a deep shadow from the corner of your nose to the corner of your mouth? Also, is there jowling at the corner of your mouth where the cheek tissue is creating a fold that may extend down toward your chin?

Zone 3 - thinning of lower lip; small chin with loss of projection; deep vertical lines of lower lip; loose neck tissue (turkey waddle).

Now look at your neck. Is it smooth and tight? Have you lost the natural almost right angle from the chin to the neck? Does your neck have an area of loose flesh, or have the muscles separated into two distinct bands?

Not all areas of the face necessarily age at the same rate. Some people will find that they have aging characteristics in each of the three zones and therefore may need to have a more comprehensive, corrective procedure. However, many others will find that their problems or changes are limited to just one or two areas.

Modern rejuvenation techniques allow the plastic surgeon to accomplish significant improvement with more limited operations than were required just a few years ago. Together, you and your plastic surgeon can decide on the area or areas of your face and particular aesthetic surgery that can help you achieve a more youthful or attractive appearance.

If you think aesthetic surgery is right for you, there are only two other considerations - the fear factor and the wallet factor. Aesthetic surgery, like all surgeries, carries a degree of risk. However, understanding those risks, you also recognize that they are generally uncommon and treatable if they do occur. Regarding cost, aesthetic surgery is elective. Insurance companies do not cover it.

Now that you may possibly know a little more about aesthetic surgery, and are still interested, it is time to talk to a board-certified plastic surgeon. Together, you and your surgeon can discuss how best to meet your expectations.

Getting Started
If you are considering a cosmetic medical procedure, consult a board-certified plastic surgeon about the process, risks, recovery time and costs.