• Dr. Brent - Actual Patient

Facelift Details Beverly Hills

Facelift vs. Temporary Solutions
There are many minimally invasive treatments available, which indeed help, but they are not facelifts. Patients receiving these treatments should not expect facelift results, or they will be disappointed. Throughout the years, practitioners have applied the term facelift to anything they choose such as face creams, facelift in a bottle, etc. There are excellent fillers (Restylane, Juvederm, etc.) that give a nice temporary benefit in certain strategic areas of your face. Lasers, such as fractional lasers, offer slight tightening while CO2 lasers offer more tightening, but they have a longer down time. If you have high expectations for a facial makeover, you will be happiest with an expertly performed facelift and ancillary procedures more than you would be with temporary fillers.

The vast majority of patients who have undergone a skillfully performed facelift, not a mini or Lifestyle lift, are very happy with their procedure, as the reviews on RealSelf.com can attest to. A facelift rejuvenates your face through incisions located around your ears and usually below your chin. One important feature of the modern facelift is the ability to hide scars effectively. The incisions are very rarely, if ever, performed in front of the ear as they were in the past. Usually, the scars will go behind the little bump in front of your ear (called the tragus), underneath your earlobe, behind your ear, and approximately two-thirds of the way up, it will go back into your hairline. As an expert in plastic surgery, Dr. Moelleken will be able to keep your old hairline and not change it. Your ears will appear unaltered and not pulled down or changed in shape or their cant relative to the face. Typically, your scars are invisible even the day after surgery and this is a result of advancements in anchoring techniques. Dr. Moelleken will make your incisions minimally detectable, if at all, so no one will know that you have even had a facelift. He will restructure and elevate the deep layers, not just tighten them, which will give your face a more youthful, rather than just a tighter look.

A mini facelift generally uses the same incisions with more limited lifting and pulling. A mini-lift can also be performed through the front or back of your ear, depending on whether your upper or lower face is the target. Dr. Moelleken performs few mini lifts because patients are generally disappointed in the limited results when they could have had a real facelift through the same incisions obtaining better and longer lasting results.
A cheek lift addresses the area below your lower eyes into the cheeks not addressed with a facelift. Dr. Moelleken feels that cheek lifts are best viewed as a smart way of correcting your lower eyelid. It is often used (the subciliary version) to correct eye shape and restore an almond shaped eye when prior blepharoplasty has pulled down the eyelid. This is a highly technical operation best performed by a doctor who is knowledgeable with the mid-face, which is one of Dr. Moelleken’s specialties. A midface lift is another term for cheek lift and it is often performed through inside the mouth and temple incisions. This procedure does not address lower eyelid aging but it is especially effective if you want to increase the lateral projection of your cheeks. A midface lift is not recommended for patients who already have a large intermalar distance.

Signature Facelift Techniques
Dr. Brent Moelleken has pioneered and published many facelift techniques and has conducted seminars, which are attended by plastic surgeons around the world. The difference between an adequate facelift and a superb facelift is that Dr. Moelleken visualizes and creates youthful beauty. He takes the time to examine each of your features individually as well as your entire face as a whole. By doing this, he will define what needs to be corrected, how much needs to be corrected, and how to merge the factors together to create an outcome that will make you look younger without anyone thinking you had facelift surgery at all. The use of advanced techniques will ensure that your new appearance will remain in place a long time and additional laser treatments can help to maintain the results of your facelift.

Dr. Moelleken’s complete signature Rejuvenation Face and Neck lift procedures include:

Neck-Lace Procedure
For women who do not need or want a facelift yet, Dr. Moelleken recommends you consider a Neck-Lace procedure. The same incision that has been used for years is implemented underneath your chin but instead of just tying your muscles together in the center; Dr. Moelleken actually uses a wider technique compared to tying your shoe with an inner lacing stitch. He does this so he can better correct the deeper muscles below your neck. Since the result is more extensive tightening of the platysma muscle and the tissues above your glands, this procedure is exceptionally powerful at rejuvenating your neck without removing any volume. The platysma muscle is a broad sheet of facial muscle rising from the pectoral (chest) and deltoid (shoulder) muscles over the collarbone (clavicle) and proceeding upward in a slanting manner along the sides of your neck. This muscle draws your lower lip and the corners of your mouth sideways and down, partially opening your mouth sometimes in an expression of surprise, fright, or even a frown. Liposculpture of the submental, jowl region and the upper neck is performed before your Neck-Lace Procedure. Dr. Moelleken believes this will be the new “platinum standard” with superiority of corset platysmaplasty and face/neck lifting alone. Recovery is typically seven to ten days and this procedure is effective for patients with more fat and muscle looseness than can be handled with a corset platysmaplasty alone. The Neck-Lace involves extensive tightening of the muscle with no volume reduction and no cutting of the platysma. Liposculpture is performed on your submental and jowl regions as well and recovery is typically five to seven days.

Ultrashort Incision Cheek Lift (USIC)
Dr. Moelleken innovated the LUSIC, USI® and, USCI® procedures. The superficial cheek lift is a new technique, which involves raising the midface underneath your eye. No implants are used and the unique feature of this operation is that your cheek pad is tied with invisible stitches to very tough tissue beside your eye so it does not have to rely on your weak lower eyelid. The recovery time is approximately one week and this procedure uses an incision hidden just below your lower eyelashes. All the remaining stitches are buried underneath your skin.

LiveFill Grafts
-lift procedure with 100% volume retention, and cheek augmentation with superior vector SMAS as needed. Recovery is identical as for a conventional face and neck lift, which is seven to ten days. Dr. Moelleken’s most commonly performed procedure is the 360 Facelift.

Additional Facelift Options
Other options available to rejuvenate your face and neck include:

Revisional Face Lift Surgery
A great deal of Dr. Moelleken’s practice is devoted to revisional facelift surgery to minimize the appearance of prior surgeries. Some common problems that sometimes need to be corrected are “pixie ears” or ears that are pulled down, the “done look” which pulls in a non-atomic direction, a “hairline step-off” where your hairline shows scars from a previous facelift, a “lateral sweep look” resulting from a facelift without a mid-facelift, also called the “Nike swoop sign”, volume mal-distribution, or excessive volume in your jowl area, and facial fat atrophy that occurs normally with age exacerbated by some facelift techniques. Often, correction of these problems will involve elevating your mid-face, redoing your hairlines, redoing your earlobes, restoring reliable volume by redirecting the direction of pull from the previous facelift to a more anatomic direction, restoring lost hairlines and hair, and repairing the deep layers of the SMAS as needed. A primary facelift is completely different from a revisional facelift as the level of complexity and the skill needed for revisional surgery is extremely complex.

Depressor Anguli Oris (DAO) Release
Depressor Anguli Oris (DAO) Release is a procedure performed to lift the corners of your mouth. As you age, the corner of your mouth can turn down and patients often complain of constantly looking angry or sad. In order to have youthful, sensual lips, plastic surgeons now know that shape is far more important than volume. Rather than simply requesting their lips be made larger with fillers, increasing numbers of Dr. Moelleken’s patients are seeking beautification through reshaping. Lip reshaping is customized based on your facial structure, tissue characteristics, and aesthetic expectations. Lip reshaping can involve one or a combination of procedures performed either at the same time or in sequence and offers the distinct advantage of being a permanent solution. Corner Lip Lifts are designed to elevate an otherwise drooping outer corner of your mouth.

Radiofrequency Techniques
Minimally invasive devices such as radiofrequency (RF) devices are used to heat and tighten your skin while producing new collagen. No sedation is required for this procedure and you may immediately resume your normal routine.

Submental Liposculpture
When fat reduction is needed, liposuction or liposculpture of the area beneath your chin (submental region) or your jowls can be performed under local anesthesia. The incision is a small incision under your chin and healing time is approximately three days.

Wide Submental Liposculpture
Fat reduction and sculpting is performed through a small incision below your chin in the submental area, jowl, and neck region. Recovery is typically five days.

Corset Platysmaplasty with Liposculpture
This technique, often combined with liposuction or liposculpture, involves suturing together your plastysmal muscles. This technique will smooth your neck and is stronger than liposuction or liposculpture alone. Recovery time is approximately seven days.

Corset Platysmaplasty with Liposculpture Plus Face and Neck Lifting
This is a more powerful treatment for achieving smoothness in your neck and jaw line. Incisions are made behind your tragus (bump in front of your ear), below your earlobe, and behind your ear itself extending into your hairline. Recovery is typically seven to ten days and this procedure is currently the gold standard for rejuvenation of your face and neck.

Facelift Procedure and Recovery
The goal of a facelift surgery is to lift and reposition the sagging skin and underlying muscles of your face as well as to remove excess skin and fat which tends to sag with advancing years or premature aging. The facelift operation may be thought of in three parts: the forehead or eyebrow lift (the upper one third), the cheek lift (the middle one third), and the neck lift (lower one third). Some people require all three components but most can achieve improvement with attention to one or two of these areas. Dr. Moelleken will work with you to customize your rejuvenation procedure in order that you achieve the best possible result. Since each face has a unique shape and contour, the surgery will be slightly different for each patient. Before the procedure, Dr. Moelleken will evaluate your skin consistency and explain the surgery. If you smoke, you will be asked to stop at least two weeks prior to and two weeks after your surgery. The reason is that smoking inhibits blood flow to your skin and this will interfere with your healing. You will also be instructed to avoid aspirin and other medications that can increase bleeding.

The facelift procedure usually involves incisions behind your ear and they may extend into the scalp. Once the incisions are made, various degrees of undermining of the skin are performed, and the deeper layers of your face are lifted. Muscle tightening as well as liposuction of your neck and jowls may be performed while excess skin is either removed or repositioned. This tightening will lift your cheeks, giving your jaw line more definition while firming your neck. Finally, Dr. Moelleken will pull your skin back up over the area and remove any excess skin with a knife or laser. The incision is closed with stitches, sutures, or tissue glue and the typical facelift surgery will take approximately two to four hours. This will of course depend on the extent of the tissue and muscle work and the number of different procedures being performed. The incisions and techniques are varied to suit your individual needs, but in all cases the incisions are placed along natural skin creases and generally imperceptible once they heal. The deeper tissue and muscle layers are repositioned to their more youthful position. Long-term improvement is due to the deeper tissues healing in this repositioned location. Slowly dissolving sutures hold the deep tissues in place until your body can heal itself.

When surgery is completed, you will be taken into a recovery area where you will be closely monitored. A bandage will be wrapped around your face to minimize swelling. Your face and eyelids may be swollen and bruised. This will be most pronounced the first few days and lasts anywhere from one to six weeks after surgery although most bruising will disappear within two weeks. The speed of recovery depends upon your skin type, age, and healing ability. Most patients are able to resume everyday activities approximately two weeks after surgery. Your face may feel numb for a few weeks or even months but this is normal and will subside. Scars take longer to fade but because they are hidden in your hairlines, behind your ears and in natural folds, they should not be noticeable.

Your appearance will improve dramatically each day following your surgery. You will be able to shower by the second or third day but you must not pull on the drainage tubes or rub your incisions. All lifting, straining, and bending should be avoided until all bruises have faded. To minimize bleeding and swelling, refrain from vigorous activities for approximately three weeks and any pain can be controlled with medication. You will receive detailed guidelines regarding your pre and post surgery during your consultations and complications can be prevented if you follow them.

Some instructions include:

  • Keep your head elevated as much as possible to reduce swelling
  • Apply ice packs to minimize swelling
  • Do not take aspirin or anti-inflammatory medications (Dr. Moelleken will provide you a list to avoid)
  • Do not smoke or expose yourself to secondary smoke during your recovery
  • Avoid direct exposure to sunlight
  • Use a sun block with a minimum of 30 SPF to protect your skin everyday

At Neo Surgical Center, we will make your experience safe as well as comfortable and the results will be a tightening of soft tissues, which will restore a more youthful contour to your face.

Click Here to Return to Facelift