Verve visited three of Auckland’s top plastic surgeons to get the lowdown on facelifts — what’s involved, approximate costs and recovery time. Because when it comes to plastic surgery, research is crucial.
Zac Moaveni trained in Otago and spent time with global surgical leaders in the field of aesthetic and reconstructive facial plastic surgery the US, UK and Asia.
What Have You Noticed About Patients Who Undergo A Facelift?
People often think about surgery for a long time before coming for a consultation. They’re also often concerned about two things. One: what will people think? And two: will it look natural? Even in this day and age, there is still a degree of taboo around plastic surgery.
You Specialise In Facelifts?
My aesthetic practice is exclusively facial surgery, which is an area I love. Most common procedures would be rhinoplasty (nose jobs), upper eyelids (blepharoplasty), lower lids and face and necklift for men and women. If I had to pick one, I’d say a well designed and executed lower face and neck lift can have a gratifying rejuvenation effect and produces almost universally delighted patients!
Does A Facelift Look Natural?
Looking natural is the number one goal for me. One of the best compliments is to hear patients say, “No one’s said anything” or “people are saying that you’re looking well, have you done your hair differently?”
Pictures of surgery gone wrong are usually the result of repeated operations. Some Hollywood actors look strange because they’ve undergone multiple procedures whereas a properly planned ‘deep plane’ operation resets the framework and looks natural. I liken a facelift to refurbishing a house. Fresh paint and wallpaper refreshes but sometimes we need to address the foundations and rethink the framework and design – that’s what a good facelift should do.
Have Facelifting Techniques Changed?
Things have shifted hugely in the last 10 years. Surgery used to be about pulling and tucking (two-dimensional tailoring) but we’ve moved to three-dimensional sculpting. Skin and soft tissue should not be tight but sit naturally.
The relationship between non-surgical and surgery has matured and non-surgical treatments like Botox and fillers work better for some things than surgery. For example, endoscopic brow lifts were quite common a decade ago but I don’t do many now because Botox works so well and so reliably.
When is Non-Surgical Treatment Preferred?
In general terms Botox and fillers work well for the forehead, midface and the lips whereas surgery is more effective for eyelids, face and neck. If small amounts of volume are needed and everything else looks good in the midface fillers are great, but surgery is necessary for lower lid bags, and lower face and neck.
Surgical fat transfer technique (which I often do with a face or necklift) works best for deep layer filling (temples, brows, cheeks, base of nose and upper lip, chin) but for more superficial filling such as a lip pout or taking care of deep creases, injectables are better.
What Happens During A Consultation?
I ask a person what their concerns are and run them through how the face ages and the layers of the face using computer imagery. I also show them before and after pictures to give them an idea of what to expect and sit them in front of what I call the ‘Mirror Of Truth’, which is a larger mirror where we talk through concerns and options.
How Does The Face Age?
The brow drops and loses volume. The upper lids hollow out, the eye drops back and you may get fat bulging beneath. The cheeks drop and we begin to see nasolabial folds (nose to mouth), the upper lip thins and elongates and the corner of the mouth drops causing what we call marionette lines (sides of mouth to chin). The nose splays a little bit and drops. The midface is key because there is generally visible volume loss and the neck and jawline drop leading to jowls.
Deflation & Ptosis
Ageing is a combination of volume loss (deflation) and sagging of the tissues (ptosis). A facelift is a combination of lifting and sculpting to restore this.
Layers Of The Face and Methods Of Face Lifting
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Skin
Laser, peels and Botox can be helpful.
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Subcutaneous Fat
Youthful faces have a generous amount of subcutaneous fat resulting in plushly lined soft tissue. Fat in the face is compartmentalised with sections like temple, forehead, mid-cheek, nasolabial fold, jowls.
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SMAS(Superficial Muscular Aponeurotic System)
This is the foundation of the face and where all the deeper tissues of the face are. A durable and worthwhile face and neck lift works on this layer and repositions the tissues. Anything more superficial only tightens skin and won’t last. People worry about looking ‘pulled’ but if we’re working with the SMAS layer that won’t occur. Terms such as deep plane extended SMAS lifts are used to describe these gold standard operations.
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Ligaments & Deep Fascia
The skin and the deep tissues are strongly attached by ligaments. They need to be divided and lifted and will reattach naturally as part of a deep plane SMAS lift.
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Fat Transfer
This technique uses your fat to give volume. Surgery addresses ptosis by lifting and fat transfer addresses deflation. The fat contains stem cells, which improves skin condition too.
What About Scars?
The incisions we make are designed to be well-hidden and minimally visible even with short hair, tied back hair or in men. They are individually tailored to a person’s hairline and anatomy.
How Long Is Recovery?
The face and neck lift requires one night in hospital and I’d count on being out of social circulation for 10-14 days. Most people can go out with makeup on after two weeks.
What Is The Cost?
For lower face and neck lift in the region of $22,000-25,000.
The Final Outcome
I believe plastic surgery is about improving quality of life. How you present yourself to the world changes if you’re feeling good about yourself. This taboo around plastic surgery is quite strange in that about 95 percent of the people I see are normal, everyday people like you and I who have got something that bugs them. Once they come and address it they never look back.
