FACELIFT SURGERY IN NEW ORLEANS
A facelift (also known as a rhytidectomy) is a facial rejuvenation procedure that typically includes a temporal lift (lateral brow lift), cheek lift (midface and jowl lift) and/or neck lift. In the same operation, the temporal lift may also be extended to a medial brow lift if the patient has more advanced brow drooping. Dr. Velargo frequently performs several procedures in the same operation for comprehensive facial rejuvenation and a shared recovery period.
While all lifts that he performs include addressing the deeper facial structures, he can perform “mini-lifts” where only one or two of the main facelift components are surgically addressed. Mini-lifts are a great option for patients who have moderate aging on the cheek and neck areas only.
Dr. Velargo also performs the Renaissance Lift™, which is an advanced technique that combines facelift surgery with nano-fat grafting and skin resurfacing to fully restore a youthful facial appearance.
WHAT CAN A FACELIFT ACCOMPLISH?
A facelift is a powerful surgical technique for facial rejuvenation. This procedure can accomplish the following:
- Correct drooping brows to create a youthful, refreshed appearance
- Lift “sunken” cheeks and sagging skin in the midface
- Eliminate jowls to create a tighter jawline
- Trim loose skin in the neck and “turkey neck” deformities to create a slim neck silhouette
Since facelifts do not address the eye area, many patients have a blepharoplasty (eyelid lift) performed at the same time. Dr. Velargo will assess your face during your consultation to determine the best treatment plan to meet your needs.
YOUR FACELIFT EXPERIENCE AT OUR NEW ORLEANS OFFICE
Your facelift is an outpatient procedure, and Dr. Velargo will discuss options regarding anesthesia with you during the consultation. Your sense of comfort and medical history are the most important factors in making this decision. The facelift surgery can be performed at our New Orleans office-based procedure room under oral sedation with laughing gas and local anesthesia only, or in an outpatient surgical facility with conscious sedation or general anesthesia.
Facelift surgery begins with incisions made either inside the hairline and/or behind the ear for optimal camouflage. Dr. Velargo takes great care to make the facelift incisions as short as possible and in areas that naturally conceal the resultant scars.
After the incisions have been made, Dr. Velargo tightens and secures the underlying SMAS (superficial musculoaponeurotic system) and facial muscles and then removes any remaining loose, sagging skin. Dr. Velargo prefers to perform a modified deep plane facelift (going deep to the SMAS and then lifting this layer) as well as a deep plane neck lift (going deep to the platysma muscle and then lifting the neck tissues) for most cases. This specific facelift technique produces long-lasting, natural-looking results that allow patients to look naturally refreshed rather than overcorrected.
Dr. Velargo can incorporate liposculpture (liposuction and direct fat excision) as needed into any facelift and necklift procedure.
In addition, Dr. Velargo can incorporate nano-fat grafting into any facelift procedure, particularly in cases where the skin quality, tone, and texture can be improved as well as in cases where there is moderate volume deficiency.
RENAISSANCE LIFT: A POWERFUL FACIAL REJUVENATION COMBINATION
When facelift surgery and skin resurfacing are performed in the same surgical setting, Dr. Velargo is able to address all aspects of facial aging at the same time – sags and bulges, volume loss, and wrinkles. He refers to this procedure as the Renaissance Lift™ because it provides dramatic results and is essentially “the rebirth of you.”
Combining the best aspects of facelifting and facial rejuvenation observed throughout his training, Dr. Velargo developed and trademarked this unique procedure. Particular attention is paid to the neckline, where long-lasting results are obtained utilizing the “SMMS technique” published by Dr. Velargo et. al. in the Aesthetic Surgery Journal in 2013 or other advanced techniques that specifically address the platymsa muscle such as platysmaplasty, platysma transection, or a lateral platysma sling.
The Renaissance Lift also usually incorporates placement of nano-fat to the face. This is often accomplished by harvesting fat from the body (usually the lateral thigh) and then serially emulsifying the fat down to stem cells, growth factors, and collagen scaffolding. This creates better skin quality as well as adds a conservative amount of volume to areas of placement.
Because the Renaissance Lift™ comprehensively addresses all aspects of facial aging during the same surgical setting, there are tremendous benefits – one healing period, more natural and balanced results, and economic advantages as well. No one Renaissance Lift™ is performed in the same manner from one patient to another because Dr. Velargo embraces the unique attributes of each patient.
Dr. Velargo encourages you to schedule a consultation to find out if the Renaissance Lift™ is right for you. View Dr. Velargo’s photo gallery for before-and-after photos of prior patients who’ve undergone this cutting-edge procedure.
YOUR COMPLETE FACELIFT RECOVERY GUIDE
You will feel some tightness when the anesthetic wears off after your facelift surgery. A head wrap will be placed following the procedure and is left in place until the next morning. Pain will be minimal, but the constrictive nature of the head wrap may be uncomfortable to some patients. However, most of our patients find this very tolerable.
Swelling, bruising, and soreness are to be expected after a rhytidectomy, but post-operative instructions and recommended medications will be given to ease any discomfort. It’s common to also experience temporary swelling, lumpiness, and discoloration. Though somewhat visually disconcerting, most people feel it is a negligible inconvenience to pay for the physical and psychological improvement they experience after a facelift.
The head wrap system that Dr. Velargo uses also has integrated ice packs specifically designed to contour to your face. Frequent application of these cool compresses for the first 72 hours helps to speed the healing process along. Dr. Velargo gives every facelift patient several days worth of Ocumend pads (contain 50 x the concentration of Arnica Montana than over the counter preparations as well as Ledum palustre), which drastically reduces the amount of bruising as well as the length of bruising following your procedure.
With some make-up, your hair worn down, a neck scarf (which Dr. Velargo will provide you with), and thick-rimmed sunglasses, you should be able to go out in public within a few days with minimal attention drawn to yourself. Most patients take 2 weeks off from work after a rhytidectomy.
Lumps and bumps may be present in the initial phases of healing. These usually go away with time, but we can often speed the healing process with local injections of steroids.
Incisions should be cared for around 4 times per day by cleansing the incision lines with hydrogen peroxide and applying bacitracin ointment. For dark-haired individuals, Dr. Velargo recommends cleansing the incisions with witch hazel to avoid bleaching the hair with hydrogen peroxide.
All sutures and staples are removed at one week except a tiny blue stitch at the corner of each earlobe. This stitch is kept in place for a total of 2 weeks to prevent accidental pulling of the earlobe in the initial healing phase.
You must avoid turning the head or stretching the neck for 2 weeks. When you turn, move the shoulders and head as one unit or as though you had a stiff neck. This is important to prevent stretching the healing incisions and causing the scars to widen, as well as to prevent putting tension on the deep sutures beneath the skin, which could cause them to loosen. Because of this risk, we advise patients to not drive for 2 weeks following surgery.
In order to minimize swelling, you are advised to sleep with the head of your bed elevated or in a recliner for 2-4 weeks post-op. The most common cause of post-op pain is not from the surgery itself, but from improper posture while sleeping on your back. The hips, back, and head should be in a straight line whenever you are lying down.
Parts of the face, neck, ears, and scalp might still feel weak or numb after the facelift operation. This is to be expected and is usually temporary. It may take several weeks or, and on rare occasions, months for this to subside. The top of the head may itch or exhibit numbness for 6-12 months.
The facial skin may feel tight for a while, and you may feel that it interferes with normal facial expressions. This should disappear within a few weeks when swelling subsides.
There may be thinning of the hair in areas adjacent to the suture lines at the temple or forehead/scalp and behind the ear. This usually occurs because the trauma of surgery “shocks” the hair follicles. It can sometimes be avoided by closely adhering to the instructions about shampooing and cleaning the suture lines, and the hair generally re-grows over time. The incisions are designed in such a manner that the hair in the temporal area and post-auricular area should grow right through the scars. Should a problem arise, we will advise you on any additional treatments.
After all stitches and/or clips have been removed, the scars will appear deep pink in color. There will be varying amounts of swelling in and around the scars themselves. With the passage of time, the pink should become white, the firmness of the scar should soften, and they should become less noticeable. It takes approximately one year for these changes to occur and for scars to fully mature.
As a rule, 80% of swelling is gone in 2 weeks, and 90% of swelling is generally gone by 2 months. So, do not evaluate the results of your surgery too soon. While you will look younger right away, facelifts continue to show subtle refinement for a significant period of time.
FREQUENTLY ASKED QUESTIONS
Most patients feel comfortable returning to work or social obligations 10-14 days following their facelift and neck lift surgery. At one week with appropriate camouflaging (hair down, scarf, sunglasses, etc…) you can easily go to the grocery store or small outing without much attention drawn to yourself. On average, at one week, about 50% of your swelling will be gone. At two weeks, about 80% of your swelling will be gone. At two months, about 90% of your swelling will be gone. Adjunctive procedures, like fat grafting, eyelid surgery, lip lift, brow lift, or CO2 laser, may slightly prolong this timeline.
Having facial plastic surgery is like buying a car. You need to put gas in it, change the oil, clean it, etc., or it will not last you very long. Similarly, there are maintenance procedures following surgery that will prolong your results. Botox or Dysport are excellent tools to keep wrinkles at bay. Occasionally, stimulating collagen injections (e.g., Sculptra) or filler may be beneficial for maintaining a youthful appearance. However, proper skincare and skin resurfacing procedures, which stimulate collagen, are most beneficial. Getting microneedling, a chemical peel, or even a laser genesis treatment every so often will keep your collagen and elastin production at peak and, in turn, keep your skin envelope as healthy and vibrant as possible.
In the majority of patients, Dr. Velargo uses an “extended deep plane facelift” approach for the face. If the patient has a heavy neck, Dr. Velargo will combine this with a “deep structural neck lift” approach, and if they have a thin neck, Dr. Velargo will usually perform a platysmaplasty with platysmal myotomy.
In younger patients where the neck has not aged extensively, but the face is showing signs of age, Dr. Velargo may utilize a “minimal access extended deep plane vertical vector facelift” technique where there is no neck incision or incision in the hairline behind the ears at all.
In younger patients where the face has not aged much, but the neck is full, Dr. Velargo can oftentimes perform an isolated “deep plane structural neck lift” using only an incision under the chin.
If you ask 5 different surgeons what a mini-facelift is, you’ll get 5 different answers. Rather than use this nomenclature, Dr. Velargo prefers to simply describe the areas of the face being lifted. A traditional facelift involves addressing laxity of the cheek, lower face, and neck. A mini-facelift addresses only one or two of these components. In both cases, the technique used is the same — a deep plane approach where ligaments are released for a natural and maximized lift. In some cases, a minimal access approach may be used to lift all of the areas that a traditional facelift does. Every facial surgery case is different and is customized to the patient’s needs.
In the great majority of cases, if the face is being lifted, so is the neck. The term facelift can be misleading because it almost always incorporates lifting of the neck tissue. Sometimes the neck can be lifted through an approach around the ears only, but in many cases this is accomplished through a small incision under the chin.
A facelift lifts the tissues of the face from the cheekbone down. While a brow lift can be performed simultaneously with a facelift, they are two distinct entities.
With the techniques that Dr. Velargo utilizes (extended deep plane facelift and deep plane neck lift), liposuction is rarely actually needed. Dr. Velargo prefers to sculpt the deeper structures of the neck by hand rather than suction out the fat on top of the platysma muscle, which can lead to irregularities. However, if the patient has substantial fat on top of the platysma muscle or fat that is obscuring the jawline, conservative liposuction may be performed.
Having a realistic set of goals in mind is the most important thing when entering the consultation. We ask that you do not wear heavy makeup so that Dr. Velargo can accurately assess your face and neck. Dr. Velargo will bring you to a mirror and physically demonstrate how lifting certain areas of your face and neck will mimic a surgical lift.
Before and after photos & videos similar to your age, condition, and surgical recommendations will be reviewed. Dr. Velargo is very thorough in the consultation and will review all portions of your proposed surgery in detail.
Whether you are undergoing plastic or reconstructive surgery, we try to make the preparatory process very simple for you. Prior to your facial cosmetic surgery date, we will meet for a pre-operative visit, during which we will give you a detailed list of medications to avoid, your post-operative instructions, a bag of all the supplies you’ll need to take care of yourself, as well as send in prescriptions to your pharmacy. It’s best to fill the prescriptions prior to your surgery date, so it’s one less thing you have to do after the fact. Be sure to share your post-op instructions with whoever is helping to take care of you so that you are both familiar with the instructions and restrictions before the surgery even takes place. Meal prepping is also beneficial.
As with any plastic surgery procedure, facelift and neck lift carries risks of bleeding, infection, scarring, and the potential need to re-operate. Of these risks, bleeding is most common (though still rare) and would likely present as a hematoma (collection of blood under the skin). Specific to face and neck lifting, other risks include nerve injury (usually temporary), sialocele (salivary collection under the skin), and skin sloughing (usually behind the ear). In the vast majority of cases, major complications do not arise. If complications were to occur, rest assured that you would not be abandoned. Dr. Velargo will get you to the finish line even if a detour is encountered.
Dr. Velargo uses sutures only to close his face and neck lift incisions. This extra level of detail allows for easier post-operative care and is simply a prettier closure.
The age of patients receiving a facelift and/ or neck lift greatly varies. Massive weight loss patients can present as young as their 20s or 30s needing a lift. Patients in their 40s are a very popular age for face and neck lifting now because the results aren’t as conspicuous to friends and family, and many of these patients are looking to avoid the alien look that can result from over-filling. Patients in their 50s and 60s are the most common age group to have aging face surgery as this group has typically maxed out on the benefits of non-surgical modalities. Dr. Velargo also performs facelifts on patients in their 70s and 80s. As long as you are a consenting adult in good health with a correctable condition, you are a surgical candidate.
There is no product, injectable, or device that can lift tissues in the same manner or with the same durability that a surgical lift can. Radiofrequency devices (e.g., Facetite or EmbraceRF) melt fat and contract the soft tissue envelope, essentially shrink-wrapping tissue around the deeper structures, so while this may provide some contour benefit, it does not lift the tissue. This is a good option for “thicker” patients in the lower face and neck looking for a little downtime non-surgical option. Similarly, dermal fillers do not lift tissue (in spite of everything you may have been told before). Filler simply adds volume and improves the contour and proportions of the face. This is easier to get away with when you are younger, but as you age and require more product to contour, overfilling is a risk and mistake made by many non-surgeon practitioners. Unfortunately, the alieniziation of the face by overfilling is what many patients assume is a surgical outcome. Surgery will make you appear more natural as it is simply repositioning and lifting your tissues to where they came from when you were younger.
A “liquid facelift” is a misnomer since dermal fillers do not lift tissue (in spite of everything you may have been told before). Filler simply adds volume and improves the contour and proportions of the face. This is easier to get away with when you are younger, but as you age and require more product to contour, overfilling is a risk and mistake made by many non-surgeon practitioners. Unfortunately, the alieniziation of the face by overfilling is what many patients assume is a surgical outcome. A traditional facelift or neck lift surgery will make you appear more natural as it is simply repositioning and lifting your tissues to where they came from when you were younger.
Any surgical change produced from facelift or neck lift surgery is permanent in the sense that you’ll always appear younger than having never done anything at all. The durability of facelift or neck lift surgery will depend on a variety of factors, including environmental exposures (e.g., sun, smoking, etc.) as well as your age, stress, and genetics. Certainly, having minor maintenance procedures with frequent intervals after your lift will enhance the longevity of your result. Dr. Velargo will set you up for the greatest success with the advanced techniques he uses to perform your surgery. Having said that, minor tuck-ups may be needed given enough time has elapsed.
When Dr. Velargo performs a facelift or neck lift, the goal is to make you a better version of yourself, not someone else. Natural results are paramount in our practice.
Patients are often concerned about looking stretched, pulled, or windblown after surgery. While you may appear tighter or pulled in the initial healing period, things will ultimately settle, and you will look “normal.” Dr. Velargo uses an extended deep plane approach that repositions the tissues more vertically (where they came from), which will ultimately appear very natural. In any event, the goal is to simply refresh your face and neck to where you were 10-15 years prior.
SMAS is an acronym for the “superficial musculoaponeurotic skeleton” of the face. This layer of tissue is found between the cheekbone and jawline and continues in the neck as the platysma muscle as well as into the forehead as the temporoparietal fascia. Most modern facelift surgery involves tightening this layer of tissue to allow for a durable lift of the tissues under the skin and to minimize skin tension once the skin excess is removed and tailored. A SMAS facelift, however, is distinct from a deep plane facelift because there is minimal dissection under this layer and little to no ligamentous release in the face. The results are not as profound as a deep plane lift.
Most modern facelift surgery involves tightening the layer of tissue known as the SMAS. During a deep plane facelift, Dr. Velargo elevates this layer of tissue in the face and releases the ligaments in the face to allow for maximal lifting power and durability as well as the most natural repositioning of the aging tissues. A deep plane facelift also eliminates skin tension once the skin excess is removed and tailored. The deep plane facelift is an advanced procedure, and most surgeons do not utilize this technique because of its complexity.
The traditional deep plane facelift involves elevating the SMAS in the face and releasing the ligaments in the face from the cheekbone to the jawline. Dr. Velargo performs an extended version of this lift by also addressing the lateral neck. Dr. Velargo continues the deep plane elevation under the platysma muscle into the neck with additional ligamentous release in this area as well. Dr. Velargo will then create a “platysmal window” whereby the angle of the jaw and jawline are further enhanced. This technique was popularized and described by Dr. Andrew Jacono.
A platysmaplasty is a technique whereby sutures are used to tighten the midline of the platysma muscles, which will help to correct the vertical banding often present in the aging neck. Dr. Velargo often combines this with a platysmal myotomy (muscle cut) at the level of the hyoid bone to further accentuate the ideal angle of the neck as well as to minimize muscle activity. In cases of fullness in the submentum (area under the chin), Dr. Velargo will perform a deep structural neck lift in conjunction with these maneuvers.
A deep plane neck lift or deep structural neck lift can be performed as an isolated procedure or in combination with an extended deep plane facelift.
A deep neck lift is a highly specialized approach to the full or aging neck, and Dr. Velargo is the only physician in New Orleans that performs this procedure. This technique was most recently popularized by Dr. Mike Nayak, who Dr. Velargo had the privilege of learning from on this topic.
Rather than addressing the superficial layer of fat between the skin and platysma muscle (e.g. liposuction, Facetite, etc.) and simply performing a platysmaplasty, the deep plane neck lift preserves this layer of fat and instead treats the deep fat under the platysma as well as allows access for Dr. Velargo to shave and contour bulky muscles (anterior belly of the digastric muscles) as well as bulky and ptotic submandibular glands. The hyoid bone can also be manipulated. After contouring the deeper structures, the platysma is then secured to the hyoid fascia and deep neck fascia to provide a chiseled and lasting neck contour. Because the layer of fat between the skin and platysma is preserved, there is less risk of contour deformities and less risk of banding after surgery.
In younger patients where the face has not aged much but the neck is full, Dr. Velargo can oftentimes perform an isolated “deep plane structural neck lift” using only a small incision hidden under the chin. The skin will simply re-drape without necessitating skin removal.
In older patients with skin laxity, the skin is usually removed via a traditional face and neck lift approach with the incisions placed around the ears and hairline.
A direct neck lift is where skin is removed from directly on the front part of the neck (between the chin and the Adam’s apple), which typically results in a “T” shaped scar down the front of the neck. The structural component of the lift is performed in the same manner as the deep plane neck lift, but in cases where skin removal is necessary, the direct neck lift affords one way to remove that skin. Dr. Velargo typically reserves this option for older men since the scar is more acceptable for a man and the recovery time is shorter than a traditional neck lift where the incisions are placed around the ears and hairline with skin removal performed laterally.
Depending on the type of facelift and neck lift that Dr. Velargo performs, surgery may be 3 hours (minimal access deep plane extended vertical vector facelift) to 5 hours (if a deep structural neck lift is also performed).
Facelift scars are very well camouflaged and nearly imperceptible with time. Incisions are hidden along the naturally occurring hairline in front of and behind the ear (if necessary) and in the natural creases around the ear. Dr. Velargo almost exclusively uses the “post-tragal” approach, where the incision is hidden behind the tragus in the ear. If the neck is addressed, that incision is hidden in the naturally occurring crease under the chin. Incisions along hairlines are beveled such that the hairs eventually grow through the scar for optimal camouflage. Dr. Velargo closes each incision meticulously in two layers and performs the closure himself (not an assistant). Scars are closely monitored post-operatively and treated as needed with laser or injections to facilitate healing. Protecting scars from the sun is the most important thing to do in the recovery period. The use of a silicone based scar cream, such as Biocorneum, may also be beneficial.
The ultimate goal of a facelift and neck lift is that you can wear any hairstyle with inconspicuous scarring. As the scars along the hairline heal, the incisions are designed to allow hair growth through them for optimal camouflage. The remaining incisions are placed in natural creases and transition zones in the face for optimal camouflage.
Regardless of the type of facelift that Dr. Velargo performs on you, you will want to limit intake of foods that require a lot of chewing or mouth opening. Your chewing muscles will be sore and the face and neck tight, which can make eating such foods difficult. Stick with soft foods and foods that are easy to chew in general.
If Dr. Velargo removed a portion of your submandibular glands (this will be verified after surgery), eat bland foods only. Do NOT eat sweet or sour foods or candies that will increase saliva production. NO chewing gum. Basically if it makes your mouth water excessively, avoid it. This is important to limit the amount of saliva leaking from your gland remnants into the neck.
If a minimal access deep plane extended vertical vector facelift is performed (without a submittal incision), then Dr. Velargo typically does not place drains. Dr. Velargo will typically place drains in the neck following a facelift and neck lift. While this may seem scary or painful, it’s actually not. Drains will decrease the amount of bruising and swelling that you have and also decrease the duration of swelling and bruising as well. They also minimize your risk of developing a hematoma or fluid collection. Drains typically only stay in place for around 3-5 days (depending on output), and are not painful to remove. If a deep structural neck lift was performed, you’ll have two neck drains (one under the platysma muscle and one on top of the platysma muscle). The superficial drain may be visible through the skin while the deep drain may be less visible. The drains may also put out different amounts of fluid, which is normal. You will receive detailed instructions on how to care for the drains and a link to a drain care tutorial video. It is a simple process that any adult can master.
After the bulky dressing from surgery comes off the morning after surgery, Dr. Velargo prefers that you wear a lighter and less constrictive “neck bra .”You will need to wear it more often than not during day for the first week taking 1-2 hour breaks following cleanings. And then wear it just at night for an additional week thereafter. This helps to prevent fluid accumulation and keeps swelling down.
Absolutely! Dr. Velargo routinely performs a series of procedures that is referred to more broadly as “aging face surgery.” Other common procedures to combine during a facelift or neck lift are fat grafting, upper blepharoplasty, lower blepharoplasty, brow lift, lip lift, SMAS grafting, and CO2 laser resurfacing.
Thread lifts, Kybella, previous liposuction, Facetite, Ultherapy, and any energy-based device will produce scar tissue in the tissue planes where surgical dissection occurs, which can make the procedure more of a challenge. Facetite, Ultherapy, and other energy-based devices also disrupt the blood supply to the skin, which makes you more prone to some complications in the post-operative period. It is important to let Dr. Velargo know if you have had any of these procedures (or any procedure for that matter) performed on the face or neck so that a proper individualized plan may be made for you to minimize the risks involved. Dr. Velargo has successfully performed facelifts and neck lifts on patients that have had these procedures in the past and is well versed in the nuances of subsequent surgery.
We do not operate on active smokers or users of nicotine products (this includes gum and vaping). Nicotine adversely affects the healing process and puts you at risk for significant complications such as skin loss and poor wound healing. We advise smoking cessation at least 2 weeks prior to your procedure through 2 weeks post-op. We may check your urine for nicotine prior to surgery to ensure your safety.
Most patients feel comfortable returning to work or social obligations 10-14 days following their facelift surgery. On average, in one week, about 50% of your swelling will be gone. At two weeks, about 80% of your swelling will be gone. At two months, about 90% of your swelling will be gone. Adjunctive procedures, like lip lift, blepharoplasty, fat grafting, or CO2 laser, may slightly prolong this timeline.
Dr. Velargo advises no strenuous exercise for two weeks post-op facelift. During this time, you may go on walks/ strolls — essentially activities that keep your heart rate and blood pressure low. After two weeks, you may start resuming your normal workout activities. For a period of time, working out may exacerbate swelling, so listening to your body is the best way to proceed.
While most patients feel comfortable returning to work around 10-14 days after a facelift, this timeline may depend on the type of work that you do. Patients with desk jobs or patients who work from home will easily be able to fit in this timeline. For patients with strenuous jobs, they should wait 14-21 days to return to work.
In spite of spite of what most people think, the majority of our patients have very little pain following their facelift and neck lift procedure. Many patients are able to get by with over-the-counter medications or non-narcotic prescriptions (e.g., Celebrex). However, you will receive a prescription narcotic just in case you need it. Typically the most uncomfortable part of the process is the compressive dressing worn on the first night of surgery (not painful but rather constrictive).
When Dr. Velargo performs a facelift and neck lift surgery, the goal is to make you a more youthful version of yourself, not someone else.
Dr. Velargo performs his facelift and neck lift procedures using general anesthesia in most cases. He feels that this affords patients the safest experience as their airway is protected for the duration of the procedure. In select cases, he will perform the procedure under deep conscious sedation or even with oral sedation and local anesthesia, depending on the level of complexity of the case and a patient’s overall tolerance.
Dr. Velargo performs his facelift and neck lift procedures at a fully accredited outpatient surgery center that has an anesthesiologist (MD) on staff. Patients desiring general anesthesia or deep conscious sedation should demand these criteria when selecting a surgeon as it affords the safest surgical experience. In rare cases, patients may be candidates to have their facelift surgery using oral sedation, laughing gas, and local anesthesia. Those cases are typically performed in our clinic procedure room.
You may shower starting the day after your facelift and neck lift surgery.
While rhytidectomy is an outpatient procedure, Dr. Velargo will discuss options regarding anesthesia with you. Your sense of comfort and medical history are the most important factors in making this decision. The facelift procedure can be performed in his office-based procedure room under oral sedation with local anesthesia only, or it can be performed in an outpatient surgical facility in the community with conscious sedation or general anesthesia.
Dr. Velargo’s training and experience includes a variety of facelifting methods that are customized for your needs, but he always tries to make the shortest possible incisions in hidden areas. Face lift incisions are often made inside the hairline and/or behind the ear for optimal camouflage.
In a facelift, Dr. Velargo tightens and secures the underlying SMAS (superficial musculoaponeurotic system) and facial muscles for strength and then removes any remaining loose, sagging skin. It is this technique that allows for face lift durability, as well as a natural-appearing result since it is not the skin that is being stretched for stability.
Additionally, the vector that Dr. Velargo secures the SMAS and re-drapes the skin and soft tissue of the face ensures that the patient will receive a natural-appearing face LIFT and not and a wind-blown-appearing face PULL.
Dr. Velargo incorporates liposculpture (liposuction and direct fat excision) into nearly every face and neck lift. He feels that a better jaw and neck line can be created by artistically sculpting these areas.
The duration of the results achieved with a face and neck lift cannot always be accurately predicted. If sagging was severe, it will obviously take years before the condition becomes as bad as it was before surgery. If the natural degenerative process in the skin is occurring rapidly, wrinkling and sagging will also accumulate more rapidly. This is precisely when “tuck-up” or “spot-welding” procedures are helpful.
A facelift generally helps turn back the clock about 10 years in most patients, but it does not stop the ticking. Nevertheless, most patients look forever younger than had they not had the procedure done at all. The excess skin and fat in the neck and lower jaw is removed at surgery. Any slack seen in the post-operative period is a result of continued aging and breaking down of the skin that remains.
Had the surgery not been performed, the patient would have the “new” sags on top of the “old” sags, which were removed at surgery. Tuck-ups help maintain a youthful appearance in the patient who chooses to have additional surgery. Tuck-ups are generally less extensive, less expensive, and quite effective. Dr. Velargo is also experienced in performing revision rhytidectomy.
Face lifts are cosmetic procedures, so insurance carriers do not cover these surgeries.