Facelifts in Garland, TX
A facelift is a confusing term that has been used to describe various types of lifts. Dr. Lam’s facelift lifts and suspends the midface, lower face (jawline), and neck. He believes that you cannot properly lift the neck without lifting the lower face at the same time. The key to a natural result is not to pull on the skin (the deeper structure called the SMAS is elevated) and not to distort the outer mouth or the outer eye (called the canthus). He also believes that a so-called deep-plane approach is critical to release four ligaments that prevent a proper lift and that would otherwise limit the longevity of the result. He has tried more limited approaches without great success. However, Dr. Lam’s incisions are very short compared to those of other surgeons and allow you to easily wear your hair up without seeing the scars and there should be no hair loss or change to your hairline. In addition, the recovery of about 10 days is about half as long as most facelift recoveries.
- Dr. Lam’s results are very natural because the skin is never pulled and he does not distort the outer eye (canthus) or the outer mouth (commissure) that are telltale signs of a poor facelift. He uses natural vectors of elevation so that there is no “windswept” appearance. Over aggressive facelifts do not look natural.
- Dr. Lam employs what is known as a deep-plane facelift. The key difference with this technique is that four ligaments (zygomatico-cutaneous, masseteric-cutaneous, mandibular, and cervical retaining ligaments) must be released or there will not be significant lift or longevity with the result.
- Dr. Lam’s incisions are well-hidden inside the ear and follow the natural curvature of the ear to make the incisions virtually impossible to see. He has created what he calls the “M” incision where incisions can be most visible from the point of the tragus (middle part of the front of the ear) to the lobe. By visually breaking up this area and following a natural skin dimple he makes it very hard to see the incision. Further, he does not extend the incision up into the temporal hair where the incision can be very visible or behind the hairline where it can shift the temporal hair back and cause hair loss (which can actually age someone further). He also does not extend the incision low in the hairline behind the ear where the incision can be unattractive for a woman who would like to wear her hair up or for a man with short hair.
- The recovery is typically very quick and relatively pain free. Most people are able to return to work within 10 to 14 days, sometimes earlier than that.
How long is my recovery and what is the nature of the recovery?
Most people think a facelift recovery should be 3 to 4 weeks with a lot of discomfort because they have seen their friends go through this kind of recovery. Dr. Lam’s recoveries are relatively quick with most individuals looking presentable by around the 10th day, i.e., a week plus two weekends or so. However, he has seen individuals look presentable as early as day 5 or last late as day 14 in some cases. It is important to be realistic about one’s recovery, as there will still be some swelling even a few weeks following the procedure. The goal is to define guidelines in terms of what would be socially and/or professionally acceptable. Dr. Lam uses drains for the first 3 to 5 days. These drains are not pretty but they have remarkably halved the recovery time by draining some of the blood and swelling from the face. They are painlessly removed a few days after the procedure. Also, by having drains for a few days, Dr. Lam no longer uses conforming dressings on the face after the first night.
How long should I expect my result to last?
Results are truly permanent but the aging process is not stopped. The tissues that are elevated and removed are forever that way. But over time if one’s genetics or environment are poor there can be a return of aging even a few years later. However, you should always look better than if you never had a facelift. Typically, a facelift is performed again 10 to 15 years later as aging progresses but could be needed sooner.
I’m afraid of the incisions. Please tell me about them.
Dr. Lam’s incisions are very carefully crafted for optimal camouflage. There are several principles to keep incisions virtually invisible even at close inspection. First, there can be no tension on the skin at closure. All tension must be below the skin in the tissues that are suspended. Second, the incision should be hidden in the ear for maximal camouflage. Third, the incision should be curvilinear, i.e., there should be no straight lines, and the incision should follow the natural curves of the skin in front of the ear. Fourth, the incision should stay away from the temporal hairline and the lower hairline behind the ear. These are areas that are very unforgiving and can be telltale signs of having a facelift. Fifth, when making incisions at the hairline (sideburn and upper hairline behind the ear), a “trichophytic” incision should be made to permit the hair to grow through the scar to make the incision virtually invisible. Dr. Lam closes all his incisions personally himself under loupe magnification for precisely controlled results.
I have wrinkles in my neck. Does a facelift fix that?
Not necessarily. Some wrinkles of the neck can be improved as the neck is suspended and supported since they are elevated and drawn upward. However, a facelift does not fix wrinkles per se. It is primarily used to suspend sagging tissues and not to resurface the skin. It is very hard to completely manage neck wrinkles since lasers cannot be used very deeply in the neck. Dr. Lam principally uses Sculptra injections to improve superficial neck wrinkles.
Are there alternatives to a facelift?
Not really. There really is not a good substitute for a facelift. Threadlifts, which are now in vogue again, simply do not work, and they never have worked. Dr. Lam performed these procedures in 2006 and have since abandoned them. Kybella is only used to reduce fat in the neck but will actually make a neck look worse if you are over 40 years of age (in many cases) or have any early neck sagging. It can make the banding in the neck appear worse once the fat is reduced. If there is early vertical banding, then Botox is an effective treatment for neck sagging and as a preventative measure as well. With moderate to advanced neck bands (turkey gobbler), Botox has limited benefit. With early jowls, Dr. Lam can help make the jowls look better with fillers in the pre-jowl area (in front of the jowl) to blend it in and thereby to improve the jawline.
Are there special considerations for me if I am a man?
Yes. Men are concerned that with short hairstyles that incisions will be more obvious. During the healing phase of several weeks to maybe even a couple of months, men may need to wear a touch of makeup camouflage to hide any minor residual redness. But long-term the incisions heal very well and should be difficult to see even with short hair. Secondarily, because men have hair in the beard region there are a few concerns that need to be addressed. No shaving is permitted for the first 2 weeks. Thereafter for the following two weeks, shaving must be performed with an electric razor. After the first month, a regular shaving routine may be resumed. There is a slight possibility of losing a millimeter of hair around the incision under the chin, which every patient should know about. Also, the beard can be migrated closer to the ear, so shaving may need to progress more carefully. Dr. Lam decides between a pre-tragal (in front of the ear) and a post-tragal (behind the ear) incision. He can perform a post-tragal incision in a man if there are few beard hairs in front of the ear, the man is willing to have electrolysis to remove hairs if needed, and the texture of the skin in front of the ear is fine and will look normal on the tragus of the ear.
I have heard of using glues instead of drains. Why does Dr. Lam not use these glues?
Glues have not worked well to help a facelift limit swelling and bruising, and in some studies glues have shown to produce more bruising. In addition, Dr. Lam prefers to avoid using human products to reduce the risk of infection but, more importantly, the risk of significant allergy to the product, especially if someone should be exposed to this product a second time.
Does Dr. Lam perform a minilift?
The term minilift is way overused. It is used to describe a short-incision and short-downtime procedure but also to describe a very small surgical procedure. Dr. Lam’s incisions are far shorter than most surgeons’ incisions (especially in the most critical anatomic areas, as described above) and the recovery is relatively pain free and short (less than 2 weeks in most cases). However, Dr. Lam believes the limited lifting capacity of a minilift provides mini results that last a very short time. Dr. Lam prefers a deep-plane facelift that facilitates truly favorable rejuvenation with all the benefits of a “minilift” in terms of incision length and recovery time.
Does Dr. Lam perform a ____ lift?
There are countless names of facelifts that are used primarily as marketing tools. Dr. Lam does not name his lift because these marketing terms are practically devoid of meaning. He prefers to describe in detail what he does and what he prefers not to do during a facelift procedure.
Is a browlift part of this procedure?
Dr. Lam lifts the midface, lower face, jawline, and neck but he does not routinely lift the brows. He believes that most people do not look good with a high brow but in very select cases will lift the lateral (outer) brow only. That is a separate procedure that the majority of individuals simply do not need. To understand Dr. Lam’s philosophy and method of rejuvenation for the eyelid and brow region, please review the details in that section.
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All facelift procedures are performed by Dr Lam personally, at his Cosmetic Surgery center in Dallas Texas. To schedule a facelift consultation call 1-888-866-3388 or email us. The details of your facelift (both the limitations and the benefits in your particular situation) will be explained to you during your facelift consultation with Dr. Lam and his team.