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Facelift in San Francisco

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Facelifts and neck lifts are meticulous operations that require an eye for detail and careful planning. Board-certified San Francisco, CA plastic surgeon, Dr. Leonard Gray, has been perfecting his technique with these procedures for the past 20 years. Scars can be made shorter and less visible. SMAS (superficial musculo-aponeurotic system) tightening, under the skin layer, allows for deep tightening of the facial tissues without pulling too much on the skin itself. Also, release of tethering attachments up high on the cheek and down by the jaw allow for a more complete re-draping and tailoring. The result is a natural, refreshed look without an over-pulled appearance.

Sometimes the facelift can be combined with mild liposuction in the jowl area and fat injection in some of the deeper lines in the face. Conservative fat injection, with their associated stem cells, can be associated with skin quality improvement. Dr. Gray can also improve the neckbands with corset stitching of the platysma muscle. Scars are well hidden so women can wear their hair short or wear it up. At Bay Area Plastic Surgery, Dr. Gray and his team believe that the best result is a natural look that complements the patient’s active lifestyle. Good patient rapport and excellent surgical results are critical to Dr. Gray. He wants to make the entire patient experience the best possible.

Bay Area Facelift or Rhytidectomy

A facelift, also known as rhytidectomy, is a surgical procedure designed to address signs of aging in the face and neck. It involves the tightening of facial tissues and removal of excess skin. One of the key techniques often used during a facelift is the tightening of the SMAS (Superficial Musculoaponeurotic System).

Also referred to as the cutaneous facelift, this technique removes excess and loose skin to create a tightened look. The remaining skin is repositioned to lift sagging cheeks and jowls. It also improves the profile along the jaw line. With this facelift technique, the muscles or fat tissues are left untouched. As the treatment focuses on the skin only, recovery is quick. This is ideal for those who still have good tone muscle and distribution of fat, but find the skin losing elasticity in some areas.

SMAS is the superficial musculo-aponeurotic system, which is a muscle complex that is primarily active when it comes to facial expression. With normal wear-and-tear due to age, gravity and personal habits, muscle tissue loses its form and becomes displaced significantly for those over 50. This particular facelift is considered the standard when it comes to this cosmetic procedure. With lengthy incisions on the side of the face, from the temple to the lower hairline behind the ear, the skin will be peeled and lifted to reshape contours. If there is excess fat and skin, these will also be removed.

For those who have severe cases of drooping and skin folds that are normal with aging and extensive sun exposure, a deep plane lift may be the best approach. This is especially true for those whose facial profiles need extensive reshaping on areas that typically have the volume and tight contours. This involves a highly specialized skill set and the plastic surgeon must be carefully selected as the nature of procedure has a high chance of damage to the facial nerves.

Also called as a short-scar facelift because of the shorter incisions made, a mini lift is a quick treatment that corrects the middle and lower face. Many patients initially consider this technique, but this doesn’t correct any severe issues and usually renders short-term results. Patients who undergo this procedure are most likely to also stage a full facelift as a final step to fully rejuvenate and reshape the face to its youthful curves.

SMAS and Facelift

The SMAS is a layer of tissue that lies beneath the skin and covers the facial muscles. It extends from the forehead to the neck and plays a crucial role in facial structure and support. Over time, the SMAS, along with other facial tissues, can lose elasticity and contribute to sagging and wrinkles.

  • Incisions: Incisions are typically hidden within the hairline and around the ears.
  • SMAS Dissection: Once the incisions are made, the skin and underlying tissues are carefully lifted to access the SMAS layer.
  • Tightening: The SMAS layer is then lifted, repositioned, and tightened. This helps to address sagging and restore a more youthful facial contour.
  • Excess Skin Removal: After the SMAS tightening, any excess skin is trimmed, and the remaining skin is re-draped for a smoother appearance.
  • Closure: The incisions are closed with sutures, and the recovery process begins.

Tightening the SMAS layer offers several benefits:

  • Long-Lasting Results: By addressing the deeper layers of tissue, SMAS tightening can provide more comprehensive and longer-lasting results compared to procedures that only address superficial layers.
  • Natural-Looking Outcome: SMAS tightening allows for a more natural and subtle improvement, as the deeper tissues are adjusted to restore a youthful contour.
  • Improved Facial Structure: By lifting and tightening the underlying SMAS, the procedure can help reposition fat deposits and provide better support to the facial structures.
Dr. Leonard Gray

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Instilling Beauty
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Dr. Gray is a board-certified plastic surgeon with over 20 years of experience conducting surgical procedures of the breast, body, and face. His emphasis on patient education and attention to detail have made him the top choice for plastic surgery in the Bay Area. Dr. Gray invites you to meet with him for a friendly and informative consultation.

During & After Surgery

All facelift procedures are performed in an accredited surgical facility with general anesthesia. Even though this is considered an outpatient procedure, there are some cases where the patient stays overnight for monitoring. It is normal to experience bruising and swelling after the surgery, and patients will feel as if their face is being pulled tight. This subsides within a couple of weeks.  Optimal results will be evident after several months. It is important that activities are limited to help create a safe and quick healing.

San Francisco Facelift FAQ

Cosmetic surgery is constantly evolving and always finding ways to minimize the invasiveness of procedures. There are countless options that are considered less invasive than a facelift, including wrinkle relaxers such as BOTOX®, injectable fillers, and microdermabrasion. These alternatives aim to correct signs of aging such as wrinkles, as well flatten and soften folds and contours. The effects, while effective, are often short-term lasting about 6 months to a year. Although these procedures can be safely repeated, for some, a facelift may be a better, more permanent option.

Immediately following a facelift procedure, the patient will feel tightness and a pulling sensation. This is normal as the facial tissues, skin and muscle adjust to their new positions. It is important to choose a reputable plastic surgeon that has years of experience in facial cosmetic surgery. A doctor with experience in facial surgery will create natural, smooth results that will last for years to come.

A traditional facelift requires a long cut from the temple to the lower hairline, but the scars will be well concealed within the hairline and natural creases on the face. With the lesser invasive techniques, the scars heal pretty well and will almost be completely invisible to the naked eye.

Anyone can consider a facelift as soon as evidence of aging starts taking a toll on the skin. Generally, patients who are age 50 to 70 consider a facelift. Personal habits and environmental conditions can impact the skin and there are patients who are only 40 that are also good candidates for a facelift.