The effects of aging, gravity and sun exposure can leave your face looking older than you feel. Delicate skin of the lower face and neck descends as we age, creating a heavier look with jowls, deep wrinkles, and a sagging neck. A facelift is designed to restore a youthful contour to the lower face and neck while maintaining a natural appearance; This procedure redefines the jawline, reduces deep facial wrinkles, lifts sagging jowls, and restores a youthful neckline.
It is of great importance for a facelift to look natural, and not obvious. The days of looking “pulled” are over; At SixSurgery with extensive surgical experience and the most up to date state of the art techniques, we are known for exceptionally natural looking results. Our Facelift surgeries take place at our luxurious Royal York Hotel, where your privacy, comfort, and safety are unparalleled.
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. A rhytidectomy, more commonly known as a facelift, will remove loose and droopy skin in the lower face, jowls and neck. By redraping the skin and tightening underlying facial musculature, a facelift enhances the tautness of the facial skin and restores a smooth and youthful appearance.
Our Facelift Toronto surgeries take place at our luxurious Royal York Hotel, where your privacy, comfort, and safety are unparalleled.
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. The most up to date and innovative facelift techniques can remove loose skin from the lower face and neck creating a more vibrant, youthful appearance.
A facelift can help smooth and reduce deep wrinkles, smile lines, and creases around the mouth and chin which are a telltale sign of ageing.
At times a facial contour that is undesirable is a result of fat deposits in the face. The SixSurgery teams surgical technique includes repositioning of fat deposits to achieve a more aesthetically pleasing facial contour.
An ideal candidate is a person who has sagging skin of the neck and along the jawline. The best candidates are those who can easily pinch and pull back their facial skin. Patients must be in good health and have realistic expectations.
Your skin should have some amount of flexibility. A facelift is designed to lift sagging skin and remove deep wrinkles, and not to leave skin in a stretched or pulled position.
A well-defined underlying bone structure in your face will provide needed support for the alterations that occur during a facelift.
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 is to come in for your consultation.
A facelift is a procedure performed on the mid to low face that removes excess skin and tissues, tightens underlying facial muscles, and repositions facial fat. The procedure involves discreetly placed incisions positioned in front of and behind the ear.
Involves tightening the muscle layer deep beneath the skin. This is a more involved procedure that requires longer recovery.
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.LEARN MORE ABOUT NECK LIFTS
For patients that have only a small amount of skin laxity and require a more subtle change. This procedure is often done on patients to refresh a previous facelift.LEARN MORE ABOUT MINI FACELIFTS
A Facelift is performed using either local anesthesia with sedation or under general anesthesia. The SixSurgery team 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 ensure that you will be comfortable when you wake up from surgery.
Incisions are typically made around and behind the ears, and discretely following the hairline. The skin is carefully raised from the lower face and neck area, followed by liposuction and fat grafting as required. The underlying muscular layer (SMAS) is addressed and 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, the scars fade to being barely noticeable. This type of surgery produces a natural, long-lasting effect, with minimal postoperative discomfort.
Mastered by the SixSurgery team, Dr. Jugenburg’s minimally invasive technique combined with neck liposuction and fat grafting to add volume to the face (if desired) has the lowest chance of injury to the facial nerve and least amount of surgical swelling and bruising, while effectively producing long lasting results.
In addition, the SixSurgery team is able to do the procedure in 2 – 3 hours, which reduces the chance of complications in comparison with other techniques that can take 6-8 hours. With surgical time beyond 4 hours there is increased risk of blood clots, pulmonary embolism and cardiac complications. By using these innovative surgical techniques, the SixSurgery team is able to obtain beautiful results while decreasing the recovery downtime and significantly lowering the risk of complications.
The SixSurgery team offers several techniques that can be used during a facelift to give individualized results to patients. Over the past several decades aesthetic surgeons have gained a greater understanding of how aging affects the skin and muscular tissue. A shift in focus away from “tightening” the skin, and instead focusing on repositioning underlying musculature has lead to more natural results. The SixSurgery team focuses primarily on a minimally invasive superficial procedure that involves the repositioning of the Superficial MusculoAponeurotic System, also known as SMAS. A SMAS facelift allows the superficial musculoaponeurotic system and skin to be separated and manipulated in different directions with different tensions. This, in turn, creates a natural and long-lasting result. A SMAS facelift is an effective and less invasive procedure than a deep-plane facelift. A deep-plane facelift involves the SMAS and skin being lifted and tightened together instead of being separated.
In a well-known study, renowned experts performed facelifts on sets of twins. One twin received a more superficial facelift, while the other twin received a 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.
Our SixSurgery team 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. The SixSurgery team also includes the ‘High SMAS’ technique taught by the world famous Dr. Tim Marten.
There are many different types of facelift techniques used by surgeons, ranging from “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.
SMAS refers to the 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 consists of a superficial fascia that envelops the facial muscles responsible for facial expressions.
SMAS-based facelifts involve some form of Superficial MusculoAponeurotic System manipulation. 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 New York City. These techniques involve minimal SMAS manipulation with minimal danger to the facial nerve. Results of these techniques have been shown to create beautiful and long lasting results.
A key anatomic structure closely associated with the SMAS is the facial nerve, which provides innervation to the facial muscles. 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.
The mid facelift is a new cosmetic procedure that has gained popularity in recent years. With traditional facelifts, the middle section of the face is generally not altered. This means that a patient may achieve an improved contour of the lower face, but around the mid part of the face they may still have loose skin and wrinkles. With a mid face lift, the middle section of your face is completely smoothed out and tightened, reaching areas around the nose, upper cheeks, and below the eyes that a traditional facelift procedure just can’t reach.
Flat upper cheeks are a tell-tale sign of the ageing process, but with the SixSurgery team’s innovative mid facelift procedure, you can reverse the signs of ageing, creating full cheeks and smooth skin under your eyes once again. During this procedure, the fat pad in the cheek is elevated, creating a completely revitalized, rejuvenated, and youthful appearance. This surgery is often performed in tandem with traditional facelifts in order to create improved facial harmony and a rejuvenated appearance across both the lower and middle sections of the face.
While a facelift will change and lift many areas of the face, it will not address the nose shape or size. For more information about perfecting the nose check out our Non-Surgical Rhinoplasty.
A mini facelift is a procedure that lifts the lower face and neck through several small incisions. It is less complicated than a traditional facelift and offers patients a shorter recovery time, although the change it can produce is less dramatic.
A deep facelift involves tightening the muscles deep beneath the skin. This is a more invasive procedure that will result in more discomfort and will require a longer recovery period. A deep plane facelift involves the skin and SMAS being lifted and tightened together, as one composite unit. This procedure is less used as there is little supporting evidence that it is more effective than a SMAS facelift, and it poses more risk to the patient.
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, muscle layers, and the facial skin.
High SMAS facelift, developed by Dr. Barton involves 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 than 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. The SixSurgery team 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 the SixSurgery team has elevated the facial skin. While most patients are candidates for the extended SMAS, others may not be. Some may not be good candidates for a prolonged anesthetic, in which case a skin-only technique may be selected, as it is the most simple and takes the least amount of time. In some patients, because of anatomic variations, SMAS undermining may be found to be unsafe and a SMASectomy or SMAS plication is performed. You can discuss these various techniques during your consultation.BOOK YOUR CONSULTATION TODAY
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 - 10 days.
Pain after surgery can generally be managed with prescribed pain medication, although in many cases, 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 - 3 weeks.
You will spend the first night following surgery in one of the beautifully appointed rooms in the Fairmont Royal York Hotel, and you will be seen the following morning by a SixSurgery team member before being released to go home. This allows for a safer recovery and more convenient post-surgical appointment. Having our staff visit you in your hotel room the next day as opposed to driving back to the clinic allows for a stress free and convenient recovery.
The SixSurgery team will see you at regularly scheduled intervals during the weeks following the surgery. This is done so that your surgeon can personally monitor your recovery process, and to ensure that you have the best results possible.
All surgical procedures, including a facelift, are associated with possible risks and complications that each patient should carefully consider prior to undergoing the procedure. You should consider the likelihood of each possible risk and whether or not the risks outweigh the benefits of a proposed surgical procedure.
Here are some of the more common and more relevant risks to be aware of when considering this surgery:
Bleeding is one of the more common facelift risks. With any surgery there will always be a little bit of oozing after the procedure, but sometimes the amount of bleeding is significant and can lead to a significant swelling which can cause abnormal facial appearance at best, and skin necrosis at worst. For that reason, if you have any suspicion that you may be bleeding, contact us immediately, or go to the ER if we are unreachable.
The management of bleeding can be as simple as applying pressure to the bleeding area, releasing the collected blood, or in extremely rare cases opening the stitches and finding the bleeding blood vessel to cauterize it.
Facelift surgery involves making incisions in the skin which are typically hidden in the natural creases around the ear, making them virtually invisible in most cases. However, in some cases, patients can develop abnormal scars such as hypertrophic scar or keloids, which can be visible.Treatment of abnormal scars can involve injections, laser treatments, radiation, or simply camouflage tattoos.
Injury to the facial nerve is a very rare risk but can potentially be a permanent injury and this is why all experienced facelift surgeons take exceptional care to ensure the facial nerve is not injured during the surgery. However, even the world’s greatest facelift expert cannot guarantee that the facial nerve will not be injured.
The most common facial nerve injury is ‘neuropraxia’, or bruising of the nerve. It is a temporary condition where the nerve stops functioning properly for some time but then resumes normal function. An even less common form of injury is when the nerve is actually cut during the surgery and this may lead to permanent facial paralysis. This type of injury has an increased risk in ‘deep plane’ facelifts where the surgeon dissects under the facial muscles, where the nerve runs.
The management of facial nerve injuries usually involves just waiting as neuropraxia (the most common injury) will resolve itself without any intervention. Sometimes Botox can be used to numb the other facial muscles to improve facial symmetry. Surgery may be necessary in some cases where there is a benefit to trying to repair the severed nerve.
Skin necrosis, or skin death, can sometimes occur as a result of poor blood supply to the skin, following a facelift where the skin was lifted off and thus blood vessels to the skin have been severed. Facial skin is very well vascularized and therefore this is not an issue for most patients. However, some patients, especially smokers and diabetics, have an increased risk of this happening. Treatment of skin necrosis is usually to do nothing and simply treat the wound, which will heal itself. Although it can take a few months of wound care, eventually most of these wounds heal. In rare cases, additional surgery may be necessary to help cover the open area, such as skin grafts of skin flaps.
A facelift is often combined with the following enhancement procedures for a full facial rejuvenation:
Eyelid surgery is the most common procedure to be combined 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.
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 may be considered in combination with a blepharoplasty is an eyebrow lift. The best way to determine if this procedure is appropriate in conjunction with a facelift is to discuss it during your consultation.
A neck lift is a procedure that helps address skin redundancy or deformity and involves an incision that is placed behind the ear and usually beneath the chin.
If you find that your brows are saggy, heavy looking, or that your forehead looks tired, a Browlift can provide an opportunity to not only reverse the wrinkling and loss of tone and shape in your brow, but can also change a heavy or asymmetrical brow. A Browlift, otherwise known as Forehead Lift or Browplasty, is also often combined with Upper Eyelid Surgery (Blepharoplasty), as descended eyebrows normally contribute to drooping eyelids.
As we age, we naturally lose facial fat that in our youth provides a supple and full appearance to the cheeks, under eyes, and around the lips. Facial fat grafting is an innovative facial rejuvenation technique that helps reverse the signs of aging by restoring youthful volume to the face.
Using liposuction the SixSurgery team 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 planes 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.
For patients in their 30s and 40s who do not have an extreme amount of excess skin around their jaw and neck line, a mini facelift, or short scar facelift, is a valuable alternative to having a full facelift. It will take years off of your appearance while providing you with a more youthful and energetic look.
The ideal candidates for a mini facelift are patients who show aging in the mid-face area. While no procedure can reverse or stop the aging process, a mini facelift can improve the most visible signs of aging that make a person look older than their years. The procedure can be done alone, or with other related cosmetic surgery procedures.
A mini facelift is a procedure that lifts the mid-face or the neck through several small incisions. It is less complicated than a traditional facelift and offers patients a shorter recovery time. Another difference is that it is less invasive than a traditional facelift and carries fewer risks to the patient.
A mini facelift offers many benefits that provide patients with a more youthful and revitalized appearance. The surgery restores and reshapes the facial contour, giving the face a more rested and youthful appeal. Benefits of the procedure include:
Because of limited incisions and dissection of the skin in a mini facelift, postoperative swelling and bruising will be reduced. Patients have less discomfort following surgery, and can usually return to work much faster as well.
The best candidates for a mini facelift procedure are patients who do not have significant sagging of the jowl and neck skin, and who want to be proactive to prevent sagging skin from becoming quite evident. Candidates for a mini facelift should have good skin elasticity. Patients who have excess facial aging will be better served with a full facelift, rather than with a mini facelift.
Because a mini facelift uses smaller incisions and is less invasive than a full facelift, it is limited in what it can do. You may consider a full facelift if you:
Overall, mini facelift candidates are younger, and require less dramatic correction. The mini facelift tightens up your lower face while maintaining your features. The SixSurgery team will determine the best procedure for your specific situation.
Because a mini facelift only addresses the mid to low-face or neck, eyelid surgery is used to address other issues that may affect your appearance. A forehead lift, or brow lift, is another option to consider, as it helps to minimize the visible effects of aging.
Most often the surgery is performed under local anesthesia with sedation. In some cases, general anesthesia may be used. The difference between a mini facelift and a traditional facelift is that the incision is much smaller, and there are no incisions behind the ears. The SixSurgery team will determine the placement of the incision based on your facial structure.
During the surgery, the SixSurgery team will separate the skin from the fat and muscle below. Fat may be trimmed or liposuctioned from the neck and chin area to improve the overall contour. The SixSurgery team will tighten the underlying muscle, pull the skin back and trim any excess. Sutures will be used to secure the layers of tissue and close the incision.
Once the mini facelift is completed, a loose fitting dressing is applied. There typically isn’t excessive discomfort after the surgery, but if there is, it is easily controlled with the pain medication prescribed by the SixSurgery team.
Following a mini facelift procedure, some swelling is to be expected. Some of the bruising may linger for 2 to 3 weeks. By the third week you will look and feel much better. Most patients return to work about 7 to 10 days after the surgery.
There will be some scars, but they are carefully placed within your hair or in the natural creases of your face and ears. In time they will heal and be barely visible. A mini facelift can’t stop the aging process. Some patients elect to repeat the procedure in five or ten years.
This depends on the particular areas of your face that you would like to change. If hollow cheeks and wrinkles beneath the eyes are a problem for you, a mid facelift could be a great solution. If you also have excess and sagging skin around the neck and jawline, you may want to consider a full facelift in combination with a mid facelift. In your consultation, The SixSurgery team will be able to assess your unique facial anatomy in order to determine which procedures would benefit you the most.
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 facelift surgery, S-lift, mini facelift, SMAS facelift(s), 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 – 3 hours; if additional procedures are added at the same time, such as eyelid surgery, the procedure will take anywhere from 3 – 4 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, the SixSurgery team’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 a blepharoplasty, more commonly known as 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, the SixSurgery team will review your medications with you during your initial consultation, and may recommend stopping certain medications before your surgery.
Incisions are carefully concealed in areas of the skin where creases naturally occur. Facelift incisions heal well and often go undetected after only a few months.
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, the SixSurgery team has various protocols in place to prevent complications from occurring.