Facelift Surgery in Toronto
When it's your face, you only want the best.
You cannot hide your face. So if you will let someone touch it, you want to make sure you find a surgeon who is skilled, experienced, and takes pride in his work.
Dr. Jugenburg is known for his exceptional natural looking facelifts, using the most advanced facial plastic surgery techniques to repair the signs of aging and restore a more youthful appearance. The goal is a natural looking face without being overdone – just enough to make people wonder.
Our Facelift surgeries take place at our luxurious Royal York Hotel, where your privacy, comfort, and safety are unparalleled.
How Do I Know If I Am Ready For A Facelift?
The effects of aging, gravity and sun exposure can leave your face looking older than your actual years. As you age your skin loses elasticity, and muscle tone decreases along with a loss of fatty tissue beneath the skin, resulting in sagging skin and wrinkles.
Gravity plays a role as well. As the skin loses its elasticity, gravity pulls down the eyebrows and creates loose skin around the cheeks and jaw. While there is no way to fight gravity or stop the aging process, Dr. Jugenburg can restore a more youthful appearance, making you look natural, without looking fake or overdone.
So who can benefit from a facelift?
Anyone who has lax, hanging face and neck skin, who has prominent jowls and neck bands, and people who can easily pinch and pull back their facial skin to restore a more youthful appearance.
Restore Your Confidence
Facelift patients often experience increased confidence and no longer shy away from making appearances because after the procedure they look more attractive and refreshed.
Dr. Jugenburg uses advanced facelift techniques to provide results that appear completely natural so that people will notice your rejuvenated appearance without the evidence of surgery. The days of looking “pulled” are over.
As the old saying goes, “When you look good, you feel good.” A facelift provides the youthful, rested appearance that will help you feel as good as you look.
Dr. Jugenburg offers different types of facelifts to suit the individual needs of his patients (more on these below). Facelift surgery can also be combined with a variety of other procedures for complete facial rejuvenation.
What is a Facelift?
While “facelift” is a generally descriptive term, it refers to a number of procedures that will change the look of the lower face, including cheeks, jowls, and neck. The procedure entails incisions placed in front of and behind the ear.
A “deep” facelift involves tightening the muscles deep beneath the skin. This is a more involved procedure that requires longer recovery and more discomfort.
A neck lift is a procedure that helps to address skin redundancy or deformity and involves an incision that is placed behind the ear and usually beneath the chin. Click here to learn more about neck lifts.
A “mini” lift is for patients that have minor concerns about the appearance of their cheeks and jowl. This procedure is often done on patients to refresh a previous facelift. Click here to learn more about mini facelifts.
Benefits of Facelift Surgery
- Tightening loose skin: Loose and sagging facial skin can make a person appear a lot older than they actually are, while taut facial skin is a sign of youthful vitality. Dr. Jugenburg’s innovative facelift techniques can completely remove loose skin from the lower face and neck creating a more vibrant, youthful appearance.
- Removal of wrinkles: When the skin on the face is tightened wrinkles are eliminated, helping to eliminate a telltale sign of ageing.
- Repositioning of facial fat: At times a facial contour that is undesirable is a result of fat deposits in the face. Dr. Jugenburg’s surgical technique includes repositioning of fat deposits to achieve a more aesthetically pleasing facial contour.
Am I a Candidate for a Facelift?
An ideal Facelift candidate is a person who has sagging skin of the neck and along the jawline. Their overall health is good, and their expectations are realistic. A well performed facelift will rejuvenate your face and restore more youthful feature.
Reasons for having a facelift include:
- Sagging in the mid-face area
- Tired sad look
- Significant jowls along the jawline
- Loose skin and excessive fatty deposits under the chin area, resulting in a “double chin” or “turkey neck”
- Facial fat that is displaced or drooping, creating exaggerated jowls
There are other factors that help determine if you are a good candidate for facelift surgery, including:
- Skin condition: Your skin should have some amount of flexibility. The facelift is designed to stretch the facial skin to lift sagging skin and remove deep wrinkles.
- Bone structure: A well-defined underlying bone structure in your face will provide needed support for the alterations that occur during a facelift.
- Good health: You should be in good health and be free of any major medical conditions prior to your surgery. This is key for proper healing and recovery after your procedure.
Most importantly, you should have realistic expectations about your goals for surgery. Ideally, you want to look like a revitalized, refreshed version of yourself. The best way to determine if you’re a candidate for a facelift is to schedule a consultation with Dr. Jugenburg.
You can click the above before and after images to enter our Facelift Photo Gallery
Our Innovative Facelift Surgical Techniques
There are many different types of facelift techniques used by surgeons, arranging from what’s a “deep” facelift to a superficial “skin only” facelift. Both techniques obtain remarkable results, but deep facelifts take much longer to heal and patients remain swollen for a longer period of time.
Dr. Jugenburg’s philosophy is to make patients look younger and more refreshed using minimally invasive superficial procedures rather than deep plane procedures. In fact, in a well-known study, renowned facelift experts performed facelifts on sets of twins. One twin received a more superficial facelift, while the other twin received the deep plane facelift. The experts followed the twins for over 10 years, and the results were very similar. And remarkably, the surgeon who pioneered the deep plane facelift now no longer does them.
To achieve his impressive results, Jugenburg utilizes the surgical technique that was championed by the renown Dr. Dan Baker (one of the best known facelift surgeons in the world), and Dr. Harold Silver, who was known for his “3 day facelifts,” because by using his technique a patient could go back to work looking normal within 3 days. Dr. Jugenburg also includes the ‘High SMAS’ technique taught by the world famous Dr. Tim Marten.
Dr. Jugenburg’s minimally invasive technique combined with neck liposuction and fat grafting to add volume to the face (if needed) has the lowest chance of injury to the facial nerve and least amount of surgical swelling and bruising, while effectively erasing years off the face. In addition, Dr. Jugenburg is able to do the procedure in 2-3 hours, so the cost is lower than deep plane surgery, which can take 6-8 hours. Most importantly, there is much less chance of a major complication when surgery is kept below 4 hours of general anesthesia. Beyond 4 hours there is increased risk of blood clots, pulmonary emboli and cardiac complications. While the risk is small, it’s greater than procedures that take less than 4 hours.
By using these innovative surgical techniques, the Dr. Jugenburg is able to obtain beautiful results for patients while decreasing the recovery downtime and significantly lowering the risk of complications (click here to read about Facelift risks), all at a lower cost than deep plane facelifts.
What is SMAS?
SMAS refers to Superficial MusculoAponeurotic System. It was first noted in 1799 by Sir Charles Bell, later described by Gray in 1859 and finally studied and analyzed by Mitz and Peyronie in their anatomic study in 1976. Since that description in 1976, the SMAS has become a recognized unit to be manipulated during a facelift.
The SMAS consist of a superficial fascia that envelops the facial muscles responsible for facial expressions. It is in continuity with a similar layer below in the neck, and above in the temporal area.
The key anatomic feature of this structure is that the Facial Nerve, which provides innervation to the facial muscles, travels below this layer. Thus, when the SMAS is being moved and dissected during the facelift procedure, surgeons must be exceptionally careful when undermining the SMAS to avoid a potential injury to the Facial Nerve. It is for this reason that sub-SMAS facelift techniques are more risky than Skin-Only Facelifts.
Existing Facelift Techniques
Skin Only Facelift
The very first facelift was performed in 1900s as a direct skin excision. In 1927 it was recognized that undermining the facial skin achieved a more effective lift, and the ‘classic subcutaneous lift’ was born. This ‘classic’ technique underwent various modifications over time to improve its results and longevity. Fatty tissues under the skin would be plicated or suspended to correct for age-related sagging. These were the earliest know techniques we today refer to as SMAS plication and SMAS suspension.
Skin only techniques are regarded today as limited in their ability to improve signs of aging and are used in a limited fashion.
Unlike Skin-Only Facelifts, SMAS-based facelift are ‘deep’ and involve some form of SMAS manipulation. SMAS refers to the Superficial MusculoAponeurotic System, a layer of facial muscles and its investing fascia.
Most modern facelifts involve the SMAS in some way. Either as SMAS plications or as some form of repositioning of the SMAS layer.
Moving the SMAS is thought to produce longer lasting results at the expense of a deeper, more dangerous dissection
SMAS plication and SMASectomy procedures are best represented by the work of Dr. Daniel Baker in NYC. This is a Skin-Only like procedure but adds minimal SMAS manipulation with minimal danger to the Facial Nerve. Results of these techniques have been shown to create beautiful and long lasting improvement.
Two-Layered Lift developed by Dr. Connell elevates the skin and the SMAS as two separate layers, allowing for independent repositioning of the facial fat and muscle layers, and the facial skin.
High SMAS Facelift, developed by Dr. Barton involved a more extensive release of the SMAS layers, leading to better enhancement of the cheeks and better correction of the nasolabial fold.
Extended SMAS modification by Dr. Stuzin is similar to the High SMAS but unlike the High SMAS which elevates the skin and the SMAS as one unit, the Extended SMAS elevates the SMAS and the skin as two separate segments to allow for variable repositioning.
S-Lift was described by Dr. Saylan as a limited incision technique where purse string sutures were used to plicate the SMAS without really cutting into it, thus limiting the risk to the Facial Nerve
MACS Lift described by Dr. Tonnard was a modification of the S-Lift and it became very popular because of its simplicity and effectiveness. However, more recently the MACS facelift has been falling out of favour as long term results seem to be less impressive as those of other SMAS based techniques.
Each surgeon performs their facelift procedure slightly differently, taking the best parts of each technique and individualizing them for their patients. Dr. Jugenburg currently aims to perform the Extended SMAS technique as popularized by Dr. Timothy Marten, however the surgical plan is finalized and adjusted only after the procedure has begun and Dr. Jugenburg elevated the facial skin. While most patients are candidates for the Extended SMAS, others may not be. Some may not be good candidate for a prolonged anesthetic and then a Skin-Only (simplest, fastest) technique may be selected. In some patients, because of anatomic variations, SMAS undermining may be found to be unsafe and a SMASectomy or SMAS plication is performed. To discuss these various techniques with Dr. Jugenburg, schedule a consultation with Dr. Jugenburg.
How the Surgery is Performed
The facelift surgery is generally performed using either local anesthesia with sedation or under general anesthesia. Dr. Jugenburg will determine the best type of anesthesia to use based on your procedure and medical history. In addition to the anesthesia, numbing medication is used in the facial area to make sure you will be comfortable when you wake up from the surgery.
Incisions are typically made around the ears, in the temple and behind the ears. The skin is carefully raised from the lower face and neck area, followed by liposuction and fat grafting as required. Finally, excess skin is carefully removed and meticulously sutured.
Because incisions are carefully placed within the natural folds found in front, inside and behind the ear, and the finest sutures are used, the scars fade to being barely noticeable. This type of surgery produces a natural, long-lasting effect, with minimal post-operative discomfort.
If an additional procedure is performed, like eyelid surgery, it will be done once the facelift portion of the surgery is completed. If you do have eyelid surgery, additional recovery instructions will be given to you.
The Recovery Process
After the procedure, a loose fitting bandage dressing is applied. There will be some discoloration and swelling around the face and neck area, but this should improve over the next 7 days or so. Pain after surgery is easily managed with prescription pain medication, although many patients only require over-the-counter pain medication. You will need to keep your head elevated as much as possible, and avoid strenuous activities for 2 to 3 weeks.
You will spend the first night in one of the beautifully appointed rooms in the Fairmont Royal York Hotel, and you will be seen the following morning before being released to go home. This makes for a safer recovery and more convenient for your post-surgical appointment – in your room. Having our staff visit you in your hotel room the next day is less straining on your system as opposed to driving back to the clinic to be seen.
Dr. Jugenburg will see you at regularly scheduled intervals during the weeks following the surgery. This is done so the doctor can personally monitor your recovery process, and to ensure that you have the best results possible.
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Your information will not be shared
Can I get a Facelift?
The best way to determine if a facelift is right for you is to have an initial consultation with Dr. Jugenburg. You will have an opportunity to discuss your goals and expectations about the surgery with the doctor, and ask any relevant questions you may have.
During your initial consultation, Dr. Jugenburg will:
- Review your medical history and any medications you are taking
- Discuss the procedure and any related procedures
- Provide recommendations based on your needs and goals
Facial Fat Grafting
Facial fat grafting is an innovative facial rejuvenation technique that helps reverse the signs of aging and providing a more youthful appearance. Dr. Jugenburg uses this process to restore lost facial volume that is a result of the aging process.
Generally, there is a loss of volume in the cheeks, below the eyes and around the lips. It also helps patients with deep wrinkles or sunken eyes. Dr. Jugenburg may use this procedure, along with other innovative techniques, in patients looking to correct:
- Thin or “gaunt” face
- A face that is “bottom heavy”
- Chubby face
- Mid-face flatness
- An asymmetrical face
Using liposuction, Dr. Jugenburg will remove fat from different areas of the body, like the back area or “love handles.” The fat is purified and injected deep into the facial structures to accentuate areas like cheekbones, lips, mid-face, chin and jawline. In addition to providing donor fat for the facial areas, the patient also enjoys body contouring benefits from liposuction at the sites where fat is removed.
Additional Procedure: Eyelid Blepharoplasty Surgery
Eyelid surgery is the most common procedure done with a facelift. In fact, these procedures are performed together more often than not. While a facelift focuses on the cheeks, jowls and neck area, eyelid surgery addresses other issues that may affect your appearance.
Reasons for having eyelid surgery in conjunction with a facelift include:
- Puffiness around the eyes that make you look older than you actually are.
- Hooded eyelids that make you look permanently fatigued, even if you are full of energy.
- Hooded eyelids that are affecting your eyesight and your ability to see
- Sagging skin and wrinkles under the eyes.
There are two types of blepharoplasty surgeries. Depending on your needs and goals, you may need one or both performed:
- Upper Blepharoplasty
Surgery on the upper eyelid involves the removal of excessively stretched skin that can cause multiple wrinkles or hooding on to the eyelash line. If there is an underlying droopiness of the lid, a muscle repair can be performed through the incision at the same time.
- Lower Blepharoplasty
During surgery on the lower eyelid, Dr. Jugenburg will redistribute the fat within the lower eyelid, which removes the appearance of bags and under-eye puffiness.By addressing these problems at the same time as a facelift, a greater portion of the face can be rejuvenated, providing a more enhanced appearance. Another procedure that can be employed is a brow lift, in order to minimize wrinkles on the forehead.The best way to determine if this procedure is appropriate in conjunction with a facelift is to discuss it with Dr. Jugenburg during your consultation.
Facelift Surgery FAQs
Anyone who has loose and lax facial and neck skin can benefit from this procedure. There is no particular age restriction for a facelift.
There are many different types, including deep plane surgery, S-lift or “mini lift” surgery, SMAS facelift, or “traditional facelift,” mid-facelift and others. Each has its own recovery times and is usually decided by the surgeon.
It is more important for you to find the right surgeon than for you to try and decide with technique is “best.” Look at the results of facelifts done by a surgeon, regardless of the technique used. If you like the results, you’re on the road to finding the results you are looking for.
A facelift takes anywhere from 2 – 2.5 hours; if additional procedures are added at the same time, such as eyelid surgery, the procedure will take anywhere from 3 – 3.5 hours.
The length of time it takes for a procedure depends on the type of the technique used (some techniques take much longer than others) and on the surgeon’s comfort with the procedure. Many surgeons still perform the older deep plane technique. In this procedure the facial nerve can be exposed and therefore it is crucial that a slow and meticulous technique is used to avoid injuring the facial nerve. In contrast, Dr. Jugenburg’s technique does not expose the facial nerve and therefore the step which requires careful and slow dissection is not required. The benefit is not only a lower risk of nerve injury, but a much shorter operative time (and thus lower risk of overall complications)
A “mini” facelift is most effective in younger patients needing only a small amount of correction. A traditional facelift addresses the neck, jowls and mid-face.
Most often, a facelift is combined with eyelid surgery to correct drooping upper eyelids and puffy bags below the eyes. A brow lift is also often employed to smooth wrinkles on the forehead.
You should stop smoking at least two weeks prior to surgery, as smoking can seriously impede the healing process. Avoid aspirin and aspirin products in the weeks leading up to your surgery. In addition, Dr. Jugenburg will review your medications with you during your initial consultation, and may recommend stopping certain medications before your surgery.
Incisions are usually concealed in areas of the skin where creases naturally occur. Facelift incisions heal well and often go undetected after only a few months.
Most patients can return to work in 1 to 2 weeks. Any type of physical activity that will raise your blood pressure should be avoided for about 3 weeks.
Losing a few pounds won’t make that much of a difference. If you plan to lose a large amount of weight, greater than 30 pounds, for example, then you should wait until you lose the weight and your weight is stabilized.
How long a facelift lasts depends on many factors. If you live a healthy lifestyle you can expect the results to last a long time, but gravity and aging will play a role in how long the appearance lasts. A facelift doesn't stop facial aging. You will continue to age, but from a new starting point.
As with all cosmetic surgeries, there are some risks involved. These risks include bleeding, infection, swelling, scar irregularities and blood clots, but they are rare. Our operating suite is state-of-the-art, and we do everything we can to minimize the risks associated with surgery. Most importantly, Dr. Jugenburg and his team have various protocols in place to prevent complications from occurring.