James M. Pearson, MD |
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Click here to learn more about him and his expertise in facial plastic surgery. |
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Facelift
Face Lift, Lower Facelift
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Facelift Overview
GOALS | Improve lower facial sagging including jowling and neck laxity. Improve the jawline contour. Define neckline. |
PROCEDURE | Facelift |
ANESTHESIA | Local anesthesia with sedation in the operating room |
LENGTH | Approximately 2-3 hours |
AFTER PROCEDURE | Dressings removed after 1 day. Most sutures are removed by day 7. |
RECOVERY | Most activities may be resumed after a couple of days. Swelling and bruising generally subside by day 7-10. Return to work in 10-14 days. |
Before & After Photos |
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Sample Patient 2
Sample Patient 3
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A well-performed Facelift is the single most powerful procedure available for facial rejuvenation.
The Facelift is one of Dr. Pearson's signature surgical procedures. Dr. Pearson is highly regarded for his ability to achieve substantial rejuvenation of the Face and Neck while preserving a natural, un-operated appearance, along with imperceptible surgical scars, and for his many satisfied Facelift patients.
Introduction
A Facelift primarily addresses loose or sagging tissue affecting the lower face and neck. The procedure involves several key steps including incisions around the ears,
removal of extra skin, treatment (tightening) of the facial muscle layer, as well as removal, repositioning or sculpting of facial and neck fat.
Dr. Pearson's Philosophy Regarding Facial Rejuvenation
Dr. Pearson understands that people want to look like themselves, only better - that is, the best version of themselves. The goal of facial rejuvenation is to retain your unique
facial features, while simultaneously minimizing those unfavorable characteristics which contribute to the appearance of perceived aging and loss of vitality.
In Dr. Pearson's opinion, the ultimate goal of facial rejuvenation services should be to restore a refreshed and rested appearance, while maintaining a natural and appropriate look.
The goal of a Facelift is not to look different, just better. In particular, one should never look 'done' or 'surgerized' as a result of plastic surgery. In order to achieve that,
the surgeon needs to avoid the tell-tale signs of surgery such as overly-tight or pulled appearance, poor incision site design and/or scars, or an overdone appearance in general.
A superior Facelift result is usually not even perceived as having resulted from surgery. Onlookers usually comment that our patients look refreshed, or especially well-rested as if
having recently returned from a vacation. Similarly, the thinning of fat in the neck and the transformation of a more heavy, square-shaped lower face into a more youthful oval-shape
is assumed to be related to having lost weight through diet and exercise. Our patients are often pleasantly surprised at their reception by friends and family, who may comment on their
refreshed appearance without assuming that it involved surgery.
We are grateful to our many patients who have generously contributed their before and after photos so that others may learn. Please view our photo gallery to see samples of Dr. Pearson's work.
Pictures may speak more clearly than words what we mean by 'the best version of yourself.'
Facelift Surgery
A Facelift is performed in the operating room. Through discreet skin incisions made around the ears (see below),
the facial and neck skin is lifted, allowing tightening of the deeper muscle tissues.
At the same time, fat sculpting is often performed on the face and neck. In the neck, excessive fat accumulation is thinned.
Candidates for Facelift Surgery
You may be a good candidate for a facelift if you are dissatisfied with the appearance of your lower face, especially with regard to the appearance of jowls, loss of muscle tone in the lower face,
laxity of the lower cheeks and neck, and deepened facial creases extending along the nose and near the corners of the mouth.
Dr. Pearson's preferred technique is the Extended Deep Plane Facelift
In the right surgeon's hands, the Deep Plane Facelift affords more significant improvement in the appearance of facial laxity, a more natural appearance, and greater longevity than most other approaches.
The Deep Plane Facelift technique involves release of those facial ligaments which tether the facial muscles in an unfavorable position, thus allowing re-draping of the facial soft tissues in a
natural-appearing and lasting manner.
The 'Extended' Deep Plane Facelift approach extends into the neck the same ligament-releasing and muscle-tightening approach.
Sample Patient 4
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Above, Profile view, pre-operative. A: yellow color delineates the facial areas primarily improved following a Facelift.
B: Yellow arrows illustrate incision site performed elsewhere. The scar is not well concealed and overly visible. Blue arrows mark the 'marionette lines' situated just in front of the jowls. Red arrow points to an undefined, overly obtuse angle between the chin and the neck.
C: Illustrations from parts A and B are combined.
Click illustration for higher-resolution image.
Above, Profile view. D: pre-operative view E: Post-operative result. F: Post-operative view illustrating improved angle between the chin and neck (red arrow), improved jowels and marionette lines
(blue arrows), and inconspicous scar concealed within the natural creases around the ear.
Click illustration for higher-resolution image.
Above, Oblique view, pre-operative. A: yellow color delineates the facial areas primarily improved following a Facelift.
B: Blue Color illustrates jowels and neck 'bands'.
C: Red Arrows illustrate jawline irregularity as well as lateral cheek and 'marionette line' hollows due to sagging of the jowels. Shadows detract from the anticipated smooth contour
of the youthful jawline and cheeks.
Click illustration for higher-resolution image.
Above, Oblique view. D: Pre-operative. Illustrations from parts A, B and C from above are combined.
E: Pre-operative view. F: Post-operative result demonstrates improved jawline contour, neck banding, and cheek. Inconspicous scar.
Click illustration for higher-resolution image.
Incision Site
Individuals considering a facelift often express concern about the incision site and associated scar. However, following surgery, the scar is rarely a concern.
With proper planning, careful placement of incisions, meticulous technique and appropriate aftercare, facelift incisions heal reliably well. Patients are routinely satisfied with the imperceptible
nature of their incisions sites, and consider the subtle scars to be a very reasonable tradeoff to obtain the improvement in facial and neck laxity that they seek.
The incision site itself typically begins in front of the ear, where it follows the natural skin crease separating the cartilage part of the upper ear from the facial skin.
The incision then follows the curvature of the ear, behind the tragus which is situated just in front of the ear canal. The incision then follows the natural crease around the earlobe
and in the crease behind the ear. Depending upon the need for neck lifting, the incision may course into the hairline behind the ear.
Dr. Pearson's Technique - Facelift Incision
Before, Planned incision site, Appearance at weeks 1, 2, 4, 8.
Dr. Pearson's Technique - Facelift Incision - Behind the Ear & At the Hairline
Above, Facelift Surgical Scars. Pre-operative and post-opeative images demonstrate the surgical scar following Facelift surgery performed by Dr. Pearson.
Click each image for higher-resolution views.
Dr. Pearson's Technique - Treatment of the Neck
As part of a facelift, the neck is usually treated as well. The platysma muscle is responsible for the appearance of neck laxity. Treatment of the platysma improves the neck contour. Treatment of the platyma muscle imparts a more significant, natural, and long-lasting result. This is typically performed through a discreet skin incision concealed within the natural crease behind the chin.
Above, Frontal view of the Neck. 1: Red line indicates site of skin incision site within the natural crease between the chin and neck (submental crease).
2: The medial edges of the platyma muscles are surgically approximated in the midline. At the same time, fat scupting is performed to contour fat in the submental area (under the chin).
3: Strategic muscle-relaxing incisions are made to enhance favorable muscle redraping. Click illustration for higher-resolution image.
Above, Oblique view of the Neck. The medial edges of the platyma muscles are surgically approximated in the midline.
2: In the midline, strategic muscle-relaxing incisions are made to enhance favorable muscle redraping.
3: The lateral plastysma is mobilized and suspended behind ear.
4: In the lateral platysma, strategic muscle-relaxing incisions are made to enhance favorable muscle redraping. Click illustration for higher-resolution image.
Complementary Procedures
Liposuction and fat sculpting of the area underneath the chin is often performed during a facelift. In addition facial sagging and jowling, facial volume is diminished during the aging process. Fat transfer (also called fat grafting) may be performed at the same time as facelift surgery. This technique uses your own living fat cells from another body site to restore regions of facial volume loss to more youthful proportions.
When appropriate, fat can be transferred from the abdomen, buttocks, or thighs.
Possible Non-surgical Alternative Treatments
Subtle signs of aging may be amenable to minimally invasive methods to rejuvenate the lower face. Dr. Pearson offers a full range of nonsurgical procedures including facial skin resurfacing,
Botox treatments, and volume replacement with a variety of fillers, including a combination treatment such as
The Liquid Facelift.
Caution is advised regarding 'Energy-Based Treatments'
Caution is advised for those considering energy-based 'lifting' or 'tightening' facial rejuvenation procedures. Understandably, there is a strong demand for non-surgical options to improve the
appearance of sagging facial skin. There are multiple FDA-approved devices which are heavily marketed as providing
'non-surgical' alternatives to a Facelift. These devices use laser, radiofrequency, or ultrasound energy in an attempt to 'lift' sagging facial skin. Often, patients are left disappointed
because the results that they had expected are generally not consistent with the results they experience. Most of these non-surgical options are relatively expensive, performed by non-physicians,
and deliver results that are typically so subtle that they are often difficult to discern.
Dr. Pearson does not offer or endorse any of these treatment modalities.
If you are considering one of these options, do your homework. Speak with individuals who have themselves undergone the treatment that you are considering. Ask to see photos which depict the average result obtained by the practice offering the treatment. Are results guaranteed? Ask about how you will be handled if no result or an unsatisfactory result is obtained. We have met many, many patients who have undergone such non-surgical, energy-based treaments, who then experienced disappointing results, and who were then told that they should undergo the treatment a second time or to wait for many months for a result to appear.
Ultimately, those patients desiring a discernible result typically undergo a traditional Facelift after all, but not before much frustration, wasted expense and lost time.
Sample Patient 5
>VIEW PHOTOS Click to view additional Facelift Before & After Photos |
Recovery after Facelift Surgery
Following a facelift, you can expect a few days of swelling and soreness which is well controlled with oral pain medications. Most sutures are typically removed between days 5 and 7.
Makeup can be used at this point to camouflage any bruising or scars. Swelling and bruising generally subside by 7-10 days. You can resume most normal activities after a couple of days,
except for intense exercise, which may be resumed at about 3 weeks. Most people are able to return to work with confidence in 10-14 days.
Facelift scars are usually not noticeable after enough time has passed for them to mature (see below). In any case, they are easily disguised in natural skin creases and by one's hairstyle.
Sample Patient 6
>VIEW PHOTOS Click to view additional Facelift Before & After Photos |
A Customized Approach
Dr. Pearson's technique is to customize the Facelift procedure to each individual. In our practice, there is no 'cookie-cutter' approach to facial rejuvenation.
Each patient's starting appearance including skin laxity, fat accumulation, volume loss, jowling, neck laxity, neck banding, and preferences are considered carefully and factored in to a
plan for rejuvenation.
Results Matter Achieving an outstanding result for your facelift is our highest priority. Dr. Pearson has a long track record of achieving oustanding, natural results. View our Facelift patients' reviews and Review our Photo Gallery of Dr. Pearson's Facelift results.
The Aging Process
As part of the normal aging process, the face undergoes several changes concurrently. There are skin changes including loss of elasticity, development of fine lines and wrinkles,
and age-related skin color irregularities. Separately, there is loss of the youthful fullness and gentle convex contour that accompanies youth. In other areas, there is an
accumulation of fat. This is especially common in the submental area underneath the chin.
In addition, there is an apparent deepening of facial creases including those around the mouth. Jowls appear along the jawline, so that a formerly smooth jawline is replaced with sagging tissue at the mid-jaw. Overall, the heart-shaped face reminiscent of youth, defined by an oval-shaped jawline on frontal view, is replaced by a more bottom-heavy, square-shaped lower face reminicent of aging.
Some of these changes can be addressed at their early stages with non- or minimally-invasive procedures. For a more lasting or definitive result, a Facelift may be considered.
Sample Patient 7
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Featured Videos - Facelift Patient Experiences |
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Patients describe their experiences and results following Facelift & Neck Lift procedures performed by Dr. Pearson
>VIEW VIDEOS Click to view additional Videos |
Reviews from Dr. Pearson's Facelift Patients
Click on Review to view larger version
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>VIEW ADDITIONAL FACELIFT REVIEWS |
Disclaimer: Results and patient experience may vary.
GENERAL CONSIDERATIONS
What is a Facelift? The term Facelift may have multiple meanings. In general, a Facelift implies surgical treatment of lower facial and neck laxity which involves an incision around the ears, and which enables tightening of the lower facial and neck muscles and often removal of excess skin. Similar terms for a Facelift include: 'Lower Facelift', 'Face and Neck Lift'. Modifications of a typical facelift may include:
What types of Facelifts does Dr. Pearson perform? Dr. Pearson does not perform one type of facelift. Dr. Pearson's Facelift is customized for each person depending on their age, skin type, degree of laxity and preferences. Dr. Pearson performs: mini-Facelift, SMAS Facelift, deep-plane Facelift, among other types. During your consultation, Dr. Pearson will explain which approach may be preferable for your situation. Which Facelift technique is Dr. Pearson's preferred and most-commonly employed method for the Facelift? Dr. Pearson prefers and most commonly uses the 'Extended Deep Plane Facelift' technique. The Deep Plane Facelift affords more significant improvement in the appearance of facial laxity,
a more natural appearance, and greater longevity than most other approaches. Does Dr. Pearson tighten the muscle during the Facelift? In most cases, yes. Muscle tightening imparts greater longevity, more substantial improvement of facial and neck laxity, less skin tension, and improved surgical scarring among other benefits. Where is the Facelift performed? When IV sedation is used, Dr. Pearson performs Facelifts in an accredited Ambulatory Surgery Center (ASC). Compared with a hospital setting, an ASC offers the advantages of lower cost, improved privacy and personalized attention. What type of Anesthesia is used for a Facelift? Several options are available for anesthesia during your Facelift. Most patients choose to have deep sedation (twilight) or general anesthesia. However, options including local anesthesia alone and light sedation are available. The advantages of deeper anesthesia include improved comfort, decreased operative time and enhanced ability to achieve a superior result. Where are surgical incisions placed? In general, Facelift incision placement is planned for in front of and behind the ear, then adjacent to the hairline behind the ear. A small incision is also planned for placement in the crease between your chin and neck. The particulars of your incision will depend on your anatomy and surgical goals. Dr. Pearson will customize the incision site placement to your face. See the graphic on this page for a more detailed explanation of Dr. Pearson's Facelift incision. What type of surgical scar may I expect? When surgical incision sites are carefully planned, meticulously performed, and appropriately cared for, Dr. Pearson's Facelift scarring is typically inconspicuous. Once sutures are removed, temporary pink discoloration of the incision sites may be concealed using makeup and / or hair styling. Once healed, scars are concealed within natural skin creases and the hairline rendering them usually imperceptible in social situations. Scarring depends on your own intrinsic healing, which Dr. Pearson will discuss with you. Is the neck included in a Facelift? In most cases, the neck is part of the Facelift procedure. Dr. Pearson will explain this in person during your consultation. Can a Neck Lift be performed alone, without a Facelift? Yes. However, in most cases, laxity of the lower face develops simultaneously as neck laxity. As a result, most Neck Lift candidates are usually also candidates for a Facelift. In addition, including the lower face during a Neck Lift usually helps to minimize 'bunching' of skin near the ears. There are several advantages associated with combining a Neck Lift with a Facelift. During your consultation, Dr. Pearson will explain how this may apply in your particular case. Are there risks involved with Facelift surgery? Yes. During your consultation, Dr. Pearson will discuss with you the potential risks of surgery. Precautions are taken to minimize risks. Most patients do not experience complications. As a Board-Certified Facial Plastic Surgeon, Dr. Pearson's surgical practice is limited to the Face and Neck. We believe that our high level of sub-specialization and practice focus enables us to minimize risks associated with Facial Plastic Surgery. Am I a candidate for a Facelift ? If you are concerned with the appearance of facial and/or neck laxity, you may be a candidate for a Facelift. Several factors are considered as to an individual's candidacy for a Facelift. Ideal candidates for facial plastic surgery demonstrate the following characteristics:
RESULTS How will I look after my Facelift? How much of an improvement may I reasonably expect? During your consultation, Dr. Pearson will demonstrate to you in the mirror what you can expect from a Facelift. Will I look like I had cosmetic surgery? This is a common concern among individuals considering a Facelift. In short, once the early swelling and skin discoloration has resolved, onlookers typically cannot tell that our patients underwent cosmetic surgery. Dr. Pearson is sought after specifically for his ability to achieve natural results. How a Facelift is performed makes a world of difference as to the results achieved. Careful incision site planning, meticulous surgical technique and avoidance of tell-tale signs of surgery are crucial. A natural appearing Facelift cannot be overdone; there should be no pulling, or windswept appearance. View our Photo Gallery to see a sampling of Dr. Pearson's Facelift Results. How Long Will My Facelift Last? Dr. Pearson will discuss this with you at the time of your consultation. The results of your Facelift are permanent. However, no surgical procedure can stop the aging process. Dr. Pearson's technique includes tightening of the facial muscle layer, which adds substantial longevity to the lift. For most people with normal skin elasticity, our patients enjoy a period of 7-10 years before they notice enough recurrent skin laxity to warrant further surgical treatment. PREPARATION How can I prepare for my Facelift? During your pre-operative visit, detailed instructions for pre operative preparation are provided and discussed. Prescriptions and supplies are also provided at that time. What type of pre-operative testing is requested? Pre operative testing is performed within about 30 days of one's surgery date. Depending on one's age and medical history, such testing may include blood work, EKG and medical clearance by your doctor. If your doctor is unavailable, we have a trusted team of doctors and cardiologists who are available for medical and/or cardiac clearance. How far out should I plan to schedule surgery? In general, we schedule Facelift surgery 6 or more weeks in advance. During certain times of the year, more advance notice is needed. If you know your preferred time and availability, we can schedule months in advance to reserve your appointment. RECOVERY AND HEALING What may I expect following my Facelift? (First 24 hours)
Will I have drains? Why? In many cases, Dr. Pearson uses small drains which exit the skin within the hairline behind the ears. Those are removed on the morning after surgery. Removal takes a few seconds and is not painful. The benefits drains use include diminished bruising and faster resolution of swelling. Recovery (after 24 hours)
When can I return to work / Resume social appearances? Most patients feel ready to return to work once they feel that their appearance is socially acceptable by day 10-14 (see above). By 4-6 weeks, most patients are pleased with the improvement in their appearance. When can I resume exercise? More intense exercise is typically resumed by 3 weeks. Depending on your swelling and healing progress, Dr. Pearson will advise you when exercise may be resumed in your case. FINANCIAL CONSIDERATIONS How much does a Facelift cost? This is an individualized question. Each Facelift and/or Neck lift procedure is customized by Dr. Pearson to the individual's needs and preferences. Some cases require additional work and/or time to achieve optimal results. Consequently, the cost estimate varies accordingly. Following your consultation with Dr. Pearson, a customized quote will be provided. The cost of a Facelift is substantial. However, people concerned with a diminished facial appearance related to facial and/or neck laxity consider the cost to be very worthwhile. Dr. Pearson's patients report a very high rate of satisfaction with their results and the positive impact on their lives. See some of our Facelift Reviews here. How do the finances work for cosmetic facial surgery? If you choose to proceed with surgery, we will work with you to find an acceptable date for your procedure. A deposit is requested at that time to hold your date. Our office begins the pre-operative planning at that time, including pre operative testing, pre operative meeting with Dr. Pearson to discuss specifics and logistics of your procedure, etc. Final payment is due a few weeks prior to surgery. |
James M. Pearson, MD |
Dr. Pearson is an experienced, double-Board Certified Facial Plastic Surgeon. |
Facelift Overview
GOALS | Improve lower facial sagging including jowling and neck laxity. Improve the jawline contour. Define neckline. |
PROCEDURE | Facelift |
ANESTHESIA | Local anesthesia usually with IV sedation in the OR |
LENGTH | Approximately 2-3 hours |
AFTER PROCEDURE | Dressings removed after 1 day. Most sutures are removed by day 7. |
RECOVERY | Most activities may be resumed after a couple of days. Swelling and bruising generally subside by day 7-10. Return to work in 10-12 days. |
>VIEW REVIEWS Click to read our Reviews |
Disclaimer: Treatment results may vary
Sample Patient 2
Sample Patient 3
>VIEW PHOTOS Click to view additional Facelift Before & After Photos |
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>VIEW PHOTOS Click to view additional Facelift Before & After Photos |
Facelift Illustration
Above, Profile view, pre-operative. A: yellow color delineates the facial areas primarily improved following a Facelift.
Above, Profile view. D: pre-operative view E: Post-operative result. F: Post-operative view illustrating improved angle between the chin and neck (red arrow), improved jowels and marionette lines
(blue arrows), and inconspicous scar concealed within the natural creases around the ear.
Above, Oblique view, pre-operative. A: yellow color delineates the facial areas primarily improved following a Facelift.
Above, Oblique view. D: Pre-operative. Illustrations from parts A, B and C from above are combined.
Click illustration for higher-resolution image
Dr. Pearson's Technique - Facelift Incision - Behind the Ear & At the Hairline
Click photos for higher-resolution images
Results - Surgical Incision Healing
Above, Facelift Surgical Scars. Pre-operative and post-opeative images demonstrate the surgical scar following Facelift surgery performed by Dr. Pearson. Click each image for higher-resolution views.
Above, Frontal view of the Neck. 1: Red line indicates site of skin incision site within the natural crease between the chin and neck (submental crease).
Above, Oblique view of the Neck. The medial edges of the platyma muscles are surgically approximated in the midline.
Results - Neck - Profile View
Above, Profile views. Pre-operative and post-opeative images demonstrate improvement in neck contour following Facelifts / Neck Lifts performed by Dr. Pearson
Results - Neck - Profile View / Downward Gaze
Above, Profile views / Downward Gaze. Pre-operative and post-opeative images demonstrate improvement in neck contour and skin bunching following Facelifts / Neck Lifts performed by Dr. Pearson
Complementary Procedures
Click thumbnails to view larger images and additional views
Click thumbnails to view larger images and additional views
Click thumbnails to view larger images and additional views
Patients describe their experiences and results following Facelift & Neck Lift procedures performed by Dr. Pearson
Reviews from Dr. Pearson's Facelift Patients Click on Review to view larger version
Disclaimer: Results and patient experience may vary. Contact Our Office Today - to schedule a consultation or service with Dr. Pearson
Contact Our Office Today - to schedule a consultation or service with Dr. Pearson |