According to the National Institutes of Health, the first face lift can be attributed to a man named Eugene von Hollander, who performed the procedure on a Polish aristocrat in 1901. Since he cut those first S-shaped incisions over one hundred years ago, the cosmetic treatment has come a very long way in terms of technology. The latest techniques focus on creating a more natural look, so the skin doesn’t appear as pulled. Beyond alleviating the stigma around facial surgery, the precise cuts can go virtually undetected. To tell you more about these natural-looking facelifts, NewBeauty turned to Beverly Hills facial plastic surgeon, Natalie Attenello, MD to hear her expert take on the topic:
NewBeauty: Tell me about “natural” facelifts and how they work.
Dr. Attenello: Understanding facial harmony and the delicate aging process is paramount to achieving a ‘natural’ facelift. To avoid having the ‘pulled’ or ‘windswept’ look, you have to know the correct direction and degree to lifting the facial features. With these principles, you will achieve the longest lasting and most natural result possible. One can have several facelifts with this technique, yet never look ‘done’.
A ‘natural’ facelift is achieved by addressing the extra skin, the loose muscle, and the fat pockets that have descended with time. Jowls are created when all of these layers descend downwards and slightly medial (meaning towards the nose/midline). This creates a downturned mouth, fullness of the nasolabial folds, a wavy jawline, and loose skin underneath the skin. To perform a natural facelift, you need to address all the layers that have changed with aging. A natural facelift is achieved by precisely knowing which layers to address. I carefully lift and tighten the loose muscle layer, I then carefully lift and tighten and excise the loose skin layer. You always have to address the two vertical bands that run down the neck and these I do with a combination of excision, cautery, and suturing. I then perform delicate liposuction to remove any undesired fat pockets that are causing the more bottom-heavy, squarish face. Knowing the direction of lifting is paramount to this procedure: if you pull horizontally, you will look windswept. If you pull too vertically, then the skin will look bunched up and the natural vectors of your face will be off. The goal is to lift and pull in a direction that is the most natural—and this has both a vertical and horizontal component. The other techniques are meticulous incision placement to hide any signs or stigmata of surgery as well as meticulous suturing to have the scars heal as imperceptibly as possible.
NB: How is it different than a regular facelift?
Dr. Attenello: This approach is different from traditional facelifts because they address more than just the skin. As we age, our skin, muscle, fat, and even bone go through changes. To have the most comprehensive result, one has to address these multiple layers. Additionally, the direction of lifting has changed as well; in the past many surgeons pulled horizontally and this resulted in the ‘windswept’ look. Now, it is all about maintaining not only a natural appearance, but also maintaining your features unique to you.
NB: What results can you expect?
Dr. Attenello: One can expect a natural-appearing result that not only turns back the clock ten years, but also lasts longer than a traditional facelift.
NB: Who is an ideal candidate for a ‘natural’ facelift?
Dr. Attenello: An ideal candidate is one who is starting to notice the aging process in the forms of jowls and skin laxity underneath their chin.
NB: Is there any downtime required post-treatment?
Dr. Attenello: The typical downtime is about ten to fourteen days; with limited strenuous activity for about 4 weeks.
NB: Can the technique used in natural facelifts be applied to any other aesthetic treatments?
Dr. Attenello: Yes, the goal is to always take a moment to step back and assess the face as a whole, ensuring that facial harmony and balance is restored and not overly done.
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