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What is a Facelift?
A facelift in Dallas and Plano, TX, is a confusing term that has been used to describe various types of lifts. Dr. Lam’s facelift lifts and suspends the midface, lower face (jawline), and neck. The only area that Dr. Lam’s lift does not include is the brow, which is a separate lift, as he believes most people actually do not need a browlift. The lift should help mainly the sagging neck, specifically the platysmal bands, which are the two vertical bands that sag in the neck and are also known as a “turkey gobbler”. His facelift can also help with wrinkles in the neck but not primarily. Extra skin is removed during the procedure so wrinkles that are related to sagging should be improved but crepey skin and necklace lines (horizontal lines) are not truly treated with a lift. That would require other therapies like radiofrequency microneedle and mesoBotox. Of note, he also performs a very specialized procedure known as a deep neck lift that also addresses neck fullness whether you are young or old, born with it or not, as he believes conventional liposuction simply does not work. The deep neck lift is either part of his facelift or is not performed in someone that does not need that part of the procedure. He will let you know during a consultation. The sagging jawline, or jowls, are also improved with a facelift with some improvement in the downturns of the mouth but not complete elimination, which may require some fat grafting performed at the same time or some fillers afterwards for minor further corrections. The midface, which involves the cheek, should also be improved with Dr. Lam’s facelift, as he no longer believes fat grafting in the midcheek looks natural when smiling. However, he does strongly believe fat grafting around the eyes and the outer face (temples and outside near the ear) are still excellent areas to perform fat grafting.
What a facelift is not a skin pull since he does not pull the skin. He calls this the two-finger rule, which is pulling back on the skin in a way does simulate how a lift would look but also it stretches out wrinkles, pores and every minor flaw on the face, which is not accurate and is not part of a facelift result. He also adamantly believes that a threadlift is an absolute failure of a procedure that he used to perform a decade ago when it was initially popular and does not believe the technology has advanced over that time at all. His facelift technique, which will be explained below, requires a gentle release of ligaments, a so-called deep plane facelift, that certainly a threadlift does not accomplish even an iota. He highly encourages his patients not to even indulge in undergoing a threadlift because they simply do not work or last. Also, individuals will have heard about a “liquid facelift”, which he believes also is a false term since fillers do not lift the face despite what many dermatologists and other injectors claim. You may have heard a deep filling of the outer face will magically lift the jawline but this will never happen. He is a strong believer in fillers, as he performs artistic and conservatively tasteful fillers but fillers will not address gravitational problems unlike what a facelift can deliver.
He has also been asked “what kind of facelift do you perform? Do you perform a…. lift?” Unfortunately, there is so much marketing on the internet that really says very little. Dr. Lam tries to avoid this excessive jargon that has very little meaning except to sell a procedure. For example, does Dr. Lam perform a vertical facelift? In short, no. There’s no advantage to doing so in his opinion. You need to redrape the tissues in a way that maximizing skin removal with good elevation and release of deep ligaments, as he used to perform this procedure. How about a “ponytail facelift”? Again, no. Listen to his podcast on why.
Facelift Tutorial
How is a Facelift Performed?
Dr. Lam employs what is known as a deep-plane facelift. The key difference with this technique is that four ligaments (zygomatico-cutaneous, masseteric-cutaneous, mandibular, and posterior cervical retaining ligaments) must be released or there will not be significant lift or longevity with the result.
He believes that you cannot properly lift the neck without lifting the lower face at the same time. The key to a natural result is not to pull on the skin (the deeper structure called the SMAS is elevated) and not to distort the outer mouth or the outer eye (called the canthus). thatThe other method to lift the face is known simply as a SMAS lift. Even though Dr. Lam is lifting the SMAS during his deep plane facelift, the difference is that in his technique the SMAS is freely mobile after ligament release in the deep plane and does not need to be excessively pulled. In the past, Dr. Lam used to perform SMAS facelifts and found that they did not provide adequate lifting nor any longevity of results. Even though SMAS facelifts do appear natural, they suffer from these great setbacks; and interestingly, his deep plane facelift does not require longer incisions or a longer or worse recovery time.
As far as the incisions Dr. Lam uses, they are well-hidden inside the ear and follow the natural curvature of the ear to make the incisions virtually impossible to see even with your hair short or worn up. He has created what he calls the “M” incision where incisions can be most visible from the point of the tragus (middle part of the front of the ear) to the lobe. By visually breaking up this area and following a natural skin dimple he makes it very hard to see the incision, as shown in close-up photos and videos on this website. Further, he does not extend the incision up into the temporal hair where the incision can be very visible, or behind the hairline where it can shift the temporal hair back and cause hair loss (which can age someone further). He also does not extend the incision low in the hairline behind the ear where the incision can be unattractive for a woman who would like to wear her hair up or for a man with short hair. The incisions have to be long enough to access the tissues and to remove the extra skin that comes along with a facelift but short enough that they virtually disappear from sight even on close inspection.
Besides a deep plane facelift, he may also perform a deep neck lift as part of his facelift procedure. What is a deep neck lift? This procedure entails the deep neck contouring that is present from young to old but more common in older individuals as the necks become fuller. Some argue that all you need is some liposuction, Coolsculpting, or Kybella, but these methods truly fail in delivering any discernible outcome and can even advance neck aging by removing the precious outer fat that covers the platysma muscles so that these muscles become prematurely exposed leading to a faster turkey gobbler appearance in a younger patient. Instead, Dr. Lam performs a reduction of the submandibular glands, which by doing so should not cause any dry mouth along with some of the deep fat that needs reduction and that resides inside the platysma muscle rather than outside of it. His specialized technique is probably performed by less that 1% of facelift surgeons who practice facelifts. He explains his technique in detail in his podcast on the deep neck lift but only a consultation with Dr. Lam will determine whether you are a good candidate or not for this procedure.
What are the benefits of a Facelift?
Dr. Lam’s results are very natural because the skin is never pulled and he does not distort the outer eye (canthus) or the outer mouth (commissure) which are telltale signs of a poor facelift. He uses natural vectors of elevation so that there is no “windswept” appearance. Over-aggressive facelifts do not look natural. The benefits, mentioned in a prior section, include a natural elevation of the cheek, jawline, and neck along with reducing a bulky neck as part of his deep neck lift that may or may not be a part of your facelift procedure depending on your anatomy.
Beyond the physical changes, the real advantage is in your emotional response to the results. Most patients feel now that their facial appearance is more congruent or in alignment with how they feel about themselves. Most people over time cannot recognize how they look because their aging has taken that self-identity away. When that identity has been restored and you look more like you did 10-20 years ago, there is a profound reawakening of your own self-worth, confidence, and enjoyment in life. When people begin to compliment how good you look, you cannot help but feel better about yourself. In Jonathan Haidt’s book, The Happiness Hypothesis, he found that individuals who undergo cosmetic surgery improvements have sustainable happiness from that decision for many years. He found that winning the lottery, on the other hand, does not provide such durable and longlasting contentment
What are the Risks/Side effects of a Facelift?
Fortunately, today, there are few long-term risks with facelift surgery in the skilled hands of Dr. Lam. During a preoperative visit when you sign consents, you will be reviewed all of the details of the risks. Some of the risks and limitations include suboptimal results where you do not have a perfect outcome and there is some residual sagging. This is typically easily corrected with a small procedure in the office in a minority of Dr. Lam’s patients that he will perform at no charge with a limited recovery. Albeit uncommon, it is possible to need a small procedure to further tighten tissues for optimal outcomes. In terms of the major risks of long-term problems that include tissue compromise, major scarring, hair loss, facial nerve issues, fortunately Dr. Lam has not encountered any of these issues with his patients over the past 20 years of practice. He practices very safe surgery but all details of limitations and risks will be discussed during your preoperative visit with him and with his team.
How long is my Facelift recovery and what is the nature of the recovery?
The recovery is typically very quick and relatively pain-free. Most people can return to work within 10 to 14 days, sometimes earlier than that.
Most people think a facelift recovery should be 3 to 4 weeks with a lot of discomfort because they have seen their friends go through this kind of recovery. Dr. Lam’s recoveries are relatively quick with most individuals looking presentable by around the 10th day, i.e., a week plus two weekends or so. However, he has seen individuals look presentable as early as day 5 or last late as day 14 in some cases. It is important to be realistic about one’s recovery, as there will still be some swelling even a few weeks and even to a small degree for a month or two (which usually goes unnoticed by others) following the procedure. The goal is to define guidelines in terms of what would be socially and/or professionally acceptable. Dr. Lam uses drains for the first 3 to 7 days, depending on the procedure . These drains are not pretty but they have remarkably halved the recovery time by draining some of the blood and swelling from the face. They are painlessly removed a few days after the procedure. Also, by having drains for a few days, Dr. Lam no longer uses conforming dressings on the face after the first night.
What are the costs of a Facelift?
What Dr. Lam offers is very unique in terms of his approach and charges a proportionate degree for his skill and services. If you require a deep neck lift in addition to a standard deep plane facelift, then the cost will be higher. It is important to meet with Dr. Lam in person to see what strategy would be ideal for you and he will share with you the costs of the procedure along with any reduced prices for multiple procedures, for example, blepharoplasty (cosmetic eyelid surgery), fat grafting, etc. We do not publish prices online but would be happy to answer them via the phone or in person. That being said, the price quoted may not be relevant to you until Dr. Lam sees you to determine what exactly would best benefit you, and he can help guide you based on a budget to get you the ideal results based on any financial constraints or limitations you may have.
I want to thank Dr. Lam for the neck/facial procedure he did one year ago. The results are stunning. He went beyond the procedure to ensure that my ears aligned appropriately, fit me into his schedule within my flight constraints and was, as always, a delight to work with. My neck and chin line are exactly what I hoped them to be. This is a random note of gratitude for Dr. Sam Lam and his expertise. I couldn’t be more pleased.
FAQs
How long should I expect my facelift result to last?
In short, the results are permanent. However, you will continue to age, so Dr. Lam likes to say they are permanent minus further aging. The best way to think of it is that if you had an identical twin sister or brother who had the same stress, sun exposure, diet, and lifestyle as you, you should always look 10 to 20 years younger than your sibling. But in 10 years both of you will have aged 10 years, but you should most likely still look significantly younger than your sibling. Besides genetics, the best way to preserve your result is to avoid poor lifestyle choices like stress, lack of sleep, bad diet, excessive sun exposure, and maintain some small maintenance measures like Botox, fillers, light peels or lasers, that will help keep your results optimized until you would benefit from more rejuvenative surgical procedures.
I’m afraid of the incisions from a Facelift procedure. Please tell me about them.
The incisions should not be a great concern for you in Dr. Lam’s hands. There are several key points to making incisions virtually undetectable even at close inspection and even with your hair worn up. First, there should be no tension on the skin on closing the incision. A good lift has nothing to do with pulling the skin. In fact, the skin is never pulled but follows with elevation of the deeper tissues. Accordingly, the excess skin is easily trimmed away without tension on the incision leading to very favorable healing. Second, the incision follows the contour of the ear so that your eye will natural not see it since it is in an area where there already is a border or line, making the incision very well camouflaged. Third, there are no straight incisions so that every little curve of the incision makes your eye have a hard time seeing it. Fourth, the incision has the natural contours of the ear where the skin is defatted, fat removed, in the area in front of the ear to match exactly how skin should look there. Fifth, the incisions near the hairline, both in front and behind the ears, undergo what is known as a trichophytic incision meaning hairs grow through the scar making the scar very hard to detect.
It is important to discuss not only the kinds of incisions Dr. Lam makes but also the kinds that he does not. Too often the standard facelift incision travels way up along the front of the sideburn and very far down into the neck. These areas do not heal well and are avoided during Dr. Lam’s facelifts. In contrast, some surgeons try to hide their incisions inside the hair but this option is far worse. By doing so, the hairline is moved back, which makes an individual look older and less natural. In addition, sometimes these kinds of scars become visible within your hair-bearing scalp, which also looks bad. Unfortunately, Dr. Lam has had to perform a number of hair transplants to fix this problem.
I have wrinkles on my neck. Does a facelift fix that?
Yes and no. Some of the wrinkles should be improved in terms of elevating the excessive tissues that come along with tightening the neck since a lot of the sagging skin is removed during the procedure. However, a facelift or neck lift does not directly address crepey skin or sun damage on the skin surface. For these issues Dr. Lam uses a mixture of light lasers, fillers, Botox, and microneedle to make the necessary complementary interventions to achieve the ideal results. However, if you are contemplating a facelift sooner than later, he recommends not to bother with any of these minor therapies since the facelift may provide enough improvement that you do not need much else or you could do fewer therapies to get you to your ideal result. Also, repeated and excessive microneedle is less ideal before facelift as it may at times lead to more initial unwanted swelling during your facelift recovery.
Are there alternatives to a facelift?
This is a complicated answer since there really is almost nothing that compares to a facelift in terms of the power of rejuvenating the neck, jawline, and midface. That being said, there is a spectrum of therapies that can provide improvement, especially if your major complaint is mainly skin problems like wrinkles or you only have very early neck banding (the two vertical platysmal bands) that are only just showing up. For example, Botox into the plastymal muscle, if done every few months, can partially reverse these bands and help minimize their progressive worsening. However, Botox does not typically provide immediate results and only works decently well in very early neck banding. As mentioned, radiofrequency microneedle can also help with skin tightening. Photofacials and bleaching creams can help with the surface skin damage. Fillers along the jawline can mask the jowl if you are early in the process of visible jowling but does not do well in very advanced cases. As mentioned before, there really is no such thing as a liquid facelift or a deep fill filler that would somehow cause your face to be lifted. Fillers simply do not have the power to do that in any discernible capacity.
Are there special facelift considerations for me if I am a man?
Yes, there are a few considerations that are important that will be discussed more in detail during your consultation. First, incision placement will be important in the decision-making process. Dr. Lam performs three types of incisions in men depending on anatomy and lifestyle. The standard retrotragal incision (behind the tragus of the ear, that is, the thing you press on to close your ear when there is a loud noise) can be suitable for some men. If the beard does not get translocated onto the tragus or if the skin looks normal (not too thick and rough), then Dr. Lam will perform a retrotragal incision. If these criteria are not met, he will perform a pre-tragal incision. This incision is slightly more visible in the early phases of the healing but ultimately should heal as well as the retrotragal incision. The third type of incision Dr. Lam uses in men is along the back of the beard. He uses this incision only if you wear a beard all the time. A facelift in a man naturally moves the beard slightly more posteriorly, which usually looks ok for a man even if he is wearing a beard. However, the best position is exactly where it naturally is, but this incision is not placed in an area that would look good without a beard so Dr. Lam will only use this incision in men who exclusively wear beards.
The second major consideration is that you will not be allowed to shave for two weeks following the surgery. You should come clean shaven to the day of the procedure. After the first two weeks you must use an electric razor and still be careful around the incisions. After 30 days you can resume a normal shaving routine. One major benefit is that not shaving covers the incisions well and also masks any swelling. Interestingly, most men actually heal faster than women due to the richer blood supply in the beard area from the hair follicles. Finally, Dr. Lam recommends getting some light makeup camouflage to cover the incisions during the first month of healing if you wear shorter hairstyles.
I have heard of using glues instead of drains. Why does Dr. Lam not use these glues?
These glues use human blood products, which Dr. Lam does not find a need to use. In addition, they have not been shown to truly minimize risks or speed up healing. Even though drains are less sightly to look at for a few days, they provide the fastest route to minimal swelling and bruising by the second week, which is the main goal. The drains do not hurt while they are in and they do not hurt when they are removed.
Does Dr. Lam perform a mini lift?
In a way yes and in a way no. Yes, in the regard that Dr. Lam performs very safe procedures with relatively short incisions and with relatively quick recoveries. However, no, in the sense that just pulling the deep tissues with a standard SMAS technique (as discussed above) provides very limited results. He likes to call what he does a mini lift with max results.
Does Dr. Lam perform a ____ lift?
As mentioned earlier, Dr. Lam is careful to avoid overly hyped terminology that is meant mainly for marketing purposes. As an academic surgeon who has published numerous textbooks, book chapters, scientific articles and lectures on a routine basis, he believes that a proper description of what he does is much more helpful for a prospective patient. The easiest way to understand what he does is a deep-plane facelift with or without a deep neck lift, all of which have been thoroughly described in this section earlier on.
Is a browlift part of this procedure?
Not necessarily. A facelift really addresses the midface, jawline, and neck. He believes that the upper third of the face must be addressed through a different procedure that can be performed at the same time. His main methods to rejuvenate the eyes include an upper blepharoplasty (removing upper eyelid skin), a transconjunctival blepharoplasty (no-incision eyebag fat removal of the lower eyelid), fat grafting around the eyes, and at times a temporal browlift, lifting only the very corner of the brow to avoid a surprised look. During a consultation, Dr. Lam will explore with you the options that you may have to improve your upper face together with your facelift or as a separate procedure in the future.
Your Local Plano, TX Facelift Surgeon
Dr. Sam Lam graduated as Valedictorian from Cistercian Preparatory School and completed his undergraduate degree at Princeton University and his medical degree at Baylor College of Medicine, both with distinction. He trained for six years in head and neck surgery at Columbia University College of Physicians & Surgeons in New York City and then completed a prestigious fellowship in facial plastic and reconstructive surgery and hair restoration.
Learn more about Dr. Sam Lam.
Your Cosmetic Surgery Procedures will be performed by Dr. Lam's surgery center located in Dallas, Frisco and Plano, TX.
Interesting Blogs to Read
What is a MINI FACELIFT?
How is a Mini Facelift Performed?
A mini lift begins with the right facelift incisions, which are always curved. Dr. Lam never uses a straight line for his mini lift incisions, as the eye can detect any straight line. That is a basic principle of scar camouflage, which Dr. Lam uses for all of his incisions that end only half an inch in front of the ear under the sideburn. Using magnifying loupes and careful attention, Dr. Lam pays very close attention to how your incision closes so you should not see them nor should your friends or family.
What percentage of Dr. Lam‘s facelifts are mini lifts? Well, all of them are when it comes to facelift incisions. However, all of them are designed to provide maximal lifting and rejuvenation. Just remember small facelift incisions do not mean smaller results. Smaller incisions just mean smaller incisions.
All mini facelift procedures are performed by Dr Lam himself, at his Cosmetic Surgery center in Dallas Texas. To schedule a mini facelift consultation call 972.312.8105 or email us.
HOW MUCH DOES FACELIFT/MINI FACELIFT COST?
The cost of a Facelift/Mini Facelift in Dallas and Plano, TX will depend on several factors. The price can be affected by body type, type of technique performed, surgical complications, and even allergies. Find out more by scheduling a consultation.
Your Cosmetic Surgery Procedures will be performed by Dr. Lam's surgery center located in Dallas, Frisco and Plano, TX.
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I am 4.5 weeks out from a Face Lift and thanks to Dr. Lam and his staff, my confidence is through the roof! I healed quickly and painless. Dr. Lam is a perfectionist and is all about the natural look. I highly recommend Dr. Lam, if I could give him more than 5 stars I would. Thank you Dr. Lam.
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All facelift procedures are performed by Dr Lam personally, at his Cosmetic Surgery center in Dallas Texas. To schedule a facelift consultation call 972.312.8105 or email us. The details of your facelift (both the limitations and the benefits in your particular situation) will be explained to you during your facelift consultation with Dr. Lam and his team.