By Dr Jonathan Toogood
My staff tell me they receive many enquires about “mini facelifts”. It has taken a while for us to understand what the caller is actually requesting because, clinically, there is no such thing as a “mini facelift”. And what each person imagines a mini facelift might entail, differs from individual to individual.
The essence of the enquiry is that the patient has come to realise she needs help to reverse the signs of ageing – trips to the skincare clinic are simply not enough anymore. However, a full facelift – á la Joan Rivers – is not what she feels she needs at this stage of her life. Perhaps the caller should rather ask for “fairly dramatic facial rejuvenation” and then the reception staff could reply: “Sure, Doctor can help with that.” You see, when it comes to facial rejuvenation, we have many more arrows in our quiver than just a selection of scalpels.
Upon consultation with a patient requesting a “mini lift”, it usually comes down to altering the visible sagging of the lower third of the face (see graphics below). By way of demonstration, the patient will put both her hands flat on either side of her face (placing her forefinger just in front of her ears) and move her hands backwards and upwards. The result? The jaw line soothes out and the naso-labial lines – that run from the nose to the corner of the mouth – are also eliminated.
You are probably trying it out this very moment, so have a closer look and see what happens when you do this manoeuvre. All the excess skin bunches up around your eyes. So, if one addresses sagging of the jawline and neck without addressing the excess skin around the eyes, the result is unbalanced and it would be obvious to the casual observer that something is “just not right with her face”. There would be disharmony between the upper and lower parts of the face.
So, what are your options?
For the 45-year old face, I would recommend Botox for the frown lines on the forehead and filling the naso-labial lines. I would use filler to smooth out the jawline. Both these options are temporary. Botox lasts about three months and filler from six months to a year. If you are happy with the results, you can continue with the treatments. If you would like the results to be more permanent, then I would consider fat filling the naso-labial lines and jaw line with your own fat harvested from somewhere else on your body you are happy to donate from.
For the 55-year old face, I would suggest a facelift procedure combined with filler or fat filling. Why fat filling? Apart from sagging skin, another telltale sign of ageing is atrophy (thinning) of the fat deposits of the face. Just compare the fullness and roundness of the 35-year old face with the 55-year old face. The great thing about having a facelift at the relatively young age of 55 is that the ageing process is interrupted at this stage. You will notice your peers may continue to age at the same pace, but the visible signs of your ageing will appear to take place at a slower rate.
There is no one-size-fits-all approach for facial rejuvenation. I have achieved excellent results for patients requesting “mini lifts” with a combination of eyelift surgery, fat filling and laser resurfacing. Amazing rejuvenative results can be achieved by brow lifting alone.
As always, a thorough consultation with a plastic surgeon, who understands your facial-ageing concerns, should result in an agreement of the goals that need to be achieved. Whether with surgery or other methods to address your specific concerns.
There are many options available to you. I am reminded of a quote from Calvin Klein:
“The best make-up is natural and for that you need a lot of make-up.”
I realise it is hard to come to terms with the fact that you may need a full facelift to achieve the desired outcome, but sometimes, for the most natural, harmonious result, pretty extensive surgery is required.