Facelift Options By Age
|When undergoing facial rejuvenation surgery, the recommendations by your surgeon will depend a lot on your age. In the past it was thought the same approach could be taken for each age group, just by adding more of the same. In fact, the reality is that the focus needs to be completely different to gain the best most natural result.
Sydney cosmetic plastic surgeon Dr Darryl Hodgkinson explains: "There’s a different emphasis with each age group. You can’t do the same procedures for every age group and expect a good result."
In the 40s the skin will start to give way to gravity and the jowls will become apparent, the brow may droop and the skin around the eyes may become looser. However, because the muscle and skin tone is still quite elastic, patients in their 40s usually only want a few little rejuvenating techniques. "For a 40 year old the amount of incisions must be minimised," says Dr Hodgkinson. "We try to reduce the surgical incisions and that’s where endoscopic surgery and the limited incision surgeries such as the S-lift come into play. Usually just some tightening up of tissue underneath is enough."
"By the time you get to 50 there are also problems associated with the quality of the skin. Many women are going through menopause, they have sun-damaged skin and may require more than just tightening of the underlying tissues, they may want a resurfacing technique like laser," explains Dr Hodgkinson. The focus in this age group is not only tightening of the underlying tissue but also rejuvenating skin texture, smoothing fine lines and wrinkles and treating pigmentation. Fat accumulation or loss in the face may need to be addressed.
The whole idea of waiting until aged 60 to have the one-off facelift is gone. "Patients are starting younger so that they will have less procedures, whole maintenance procedures and more natural rather than more radical procedures," explains Dr Hodgkinson. "There are so many wrinkles by age 60 that the distribution of wrinkles after the facelift make it look operated on." Patients rightly fear being over-tightened.
To gain a natural appearance, an unoperated on appearance, by this age group the focus is completely different. "What happens in the 60s is that the bones are degenerating and the midface is getting smaller," explains Dr Hodgkinson. "Unless you concentrate on the volume, a natural result cannot be achieved and will look artificial. It is imperative to concentrate on bony shape and volume."
The skin also becomes very lax in the 60s so longer scars are usually needed to remove redundant skin. However, while dealing with extra skin is part of the process, the focus should be on the bony structures.
Dr Hodgkinson explains "It’s better to put tone back in their face. I make a 60 year old look natural by concentrating not only on the skin and muscles, but also on the shape of the face.
The young face has a more inverted cone like appearance. The older face has a longer oblong appearance. I concentrate on re-establishing the cheek projection and jaw line and I often put more in than I take out."
This is where volume enhancement procedures such as cheek implants and fat transfer are often used to help rejuvenate the shape of the face.
Focusing on minimal incisions for aged 40, skin rejuvenation for age 50 and volume and bony structure for age 60 will rejuvenate the face more naturally.
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Dr. Darryl Hodgkinson is an experienced cosmetic plastic surgeon and is the Surgical Dean of The Australasian College of Cosmetic Surgeons as well as serving on the editorial board of the international journal Aesthetic Plastic Surgery. He is an invited guest lecturer and teacher to plastic surgeons internationally on the topics of facelifting, rhinoplasty, body contour surgery and general cosmetic surgery and has more than 30 years of experience in performing a range of surgical procedures. His Double Bay clinic is a fully licensed and accredited day surgery centre.
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