The results of a facelift today are far more subtle and natural-looking than they were in our parents’ generation, and improvements continue to be introduced. Where it was often easy to pick out a person who’d had a facelift 30 years ago, today’s facelifts give a beautiful, youthful look that won’t prompt people to think you’ve had treatment at all.
The First 50 Years
The first facelifts were performed at the start of the 1900s. From the incomplete accounts of these early operations, we can assume they were limited to removing excess skin. A strip of skin just in front of the ears would likely have been cut out, and the remaining tissue pulled to fill the gap, tightening facial skin and reducing wrinkles.
The First World War brought advances in reconstructive surgery for the wounded, which led to progress in facial surgery for everyone. By the 1920s, the technique of performing a facelift involved separating the skin from the underlying layer of fat before tightening it. By leaving the fat in position, the facial contours looked a bit more natural after the procedure. Changes were also made in the placement of incisions to better conceal the scars.
Advances in the 1960s and 70s
Innovative plastic surgeons in the 1960s and 70s began to work with the tissue below the skin. In addition to separating the skin from the fat layer, they began to sculpt the fat. By the late 1970s, some plastic surgeons were working on the superficial musculoaponeurotic system (SMAS) — the muscles and connective tissue that cover the bones of the face.
As these innovations came into broader use in the 1980s, high-quality facelifts were being approached as multi-layer operations. The underlying muscles, which tend to loosen and fall with age, were tightened and lifted, the fat layer was sculpted, and the tightened skin laid back over that reshaped structure. Advances were also made in rejuvenating the lower part of the face by shifting fat and tightening skin along the jawline.
With these changes, the stretched, windswept look of skin-only facelifts that had marked the procedure since its earliest days started to become a thing of the past. By working on the underlying SMAS as part of a facelift, the foundational structure of the face could be lifted and tightened. Therefore, the skin didn’t need as much tightening, and the results were subtler and even more attractive.
Today’s Deep Plane and Volumetric Facelifts
In recent years, leading plastic surgeons have gone even deeper. They still tighten and lift the underlying SMAS as part of a facelift, but the best practitioners now separate the SMAS from the ligaments below them. This “deep plane” technique enables them to lift and reattach the facial tissue to restore it to a more youthful position, where it was before gravity and aging pulled it down.
Facelifts have also become more customized as complementary treatments, including microfat grafts and dermal fillers, are combined with the surgery to make “volumetric” enhancements. Hollowed areas in the cheeks or under the eyes can be filled in to create a soft, full, youthful look. So, facelift surgery today is not only customized to your anatomy and features; it can also be combined with other treatments for even more subtle and attractive results.
Learn What Today’s Facelift Can Do for You
Dr. Robert Singer is a board-certified plastic surgeon who is skilled in creating beautiful and natural-looking facelift results for patients in the La Jolla and the Greater San Diego area. Call us at (858) 455-0290 or contact us today to schedule a consultation with Dr. Singer.