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Facelift Procedures

A facelift, also called a rhytidectomy, cannot stop the aging process. However, it can “turn back the clock” by improving the most visible signs of aging. The goal is not to look as if you have had surgery on your face, or to look like a different person, but to look as you did eight to ten years ago. Dr. Delgado specializes in achieving a natural and well-balanced appearance, as seen in the before and after photographs of his patients.

There are few things to rival the compliment we get when a person trusts us with facial procedures. Dr. Delgado, and all of our staff, take seriously the responsibility we have for our patients. Whether you live in San Francisco or the Bay Area, or fly across the country to see us, we do everything possible to educate and make our patients as comfortable as possible.

Early signs of aging, such as frown lines and deep wrinkles, can be addressed with a variety of facial fillers and Botox or Dysport. These are very effective, especially when coupled with prescription strength skin care products, most notably Retin-A and physician supervised laser and esthetician services. These procedures are relatively non-invasive and have minimal to negligible down time. Benefits from these things are temporary and the procedures need to be repeated at regular intervals in order to maintain the improvement.

The majority of patients that we treat with these types of ongoing procedures are local Marin County and Bay Area residents. However, we often accommodate patients looking for a skilled surgeon, and some time away from home to recover.

At some point, the effects of gravity begin to appear, such as jowls, loose neck skin, excessive skin in the upper and lower eyelids, heaviness in the brow, elongated ear lobes, et cetera. The time frame for these anatomical changes varies from person to person. It is influenced by genetic predisposition, sun exposure, weight and simply the passage of time. When these more significant signs of aging become evident, a facelift procedure becomes the best choice for achieving your goals, as well as being the most cost-effective option over time than any other type of treatment.

Different parts of the face age at different rates. Many patients start facial rejuvenation surgery early in life as their facial changes appear. They may have their eyes done in their 30’s, an endoscopic brow lift in their late 30’s or early 40’s and a lower facelift in their late 40’s or early 50’s. By doing it in this fashion, facial rejuvenation can be achieved gradually. If, however, you start in your 60’s, the entire face will have significant gravitational changes and doing one surgical procedure without the others will not look natural and balanced. Therefore, a complete facelift is often required, i.e., brow lift, eyelid lift and lower facelift. Dr. Delgado will customize your treatment to your individual needs and concerns and propose an overall plan to achieve the most harmonious and natural-looking result possible.

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FACELIFT OPTIONS

Today, there are many types of facelifts. There are Mini-Facelifts, Short-Scar Facelifts and the Modern Facelift. Other options exist such as the Lunch Time Facelift, the Weekend Facelift and the Lifestyle Lift, although these latter ones are more marketing terms than anything else and actually fall into the categories of minor or short-scar facelifts. The Modern Facelift is the most extensive, but it holds up well, lasting longer.

Dr. Delgado will often suggest a Short-Scar facelift for a patient who has minimal to moderate laxity of his/her skin. For these patients, the Short-Scar Facelift is a good option because it corrects what is required without over-operation.

THE SHORT-SCAR LIFT

The Short-Scar Facelift is a relatively new procedure over the past five years or so. The demand is strong, because the lift is deep and the incision is limited to the front of the ears. The keystone of this facelift method is that it lifts the deep structure. This deep structure is called the SMAS or Superficial Musculoaponeurotic System. The SMAS is a firm and fibrous network that runs under the skin but over the facial muscles and forms the framework of the face. When the SMAS is tightened, it is significant and long-lasting. Since the SMAS connects to the neck region, that area can be improved with this approach as well. A Lifestyle Lift falls into this Short-Scar Lift category.

THE MINI-FACELIFT

The Mini-Facelift involves only the skin. This is not a deep lift and does little, if anything, to improve the neck. If you pull the skin back and upwards in front of the ears, this will mimic the effect of a Mini-Facelift. Since it pulls only skin, it does not hold up well for more than a few years. The skin is not a strong structure and will stretch easily. The degree to which this happens is determined by your genetic makeup and amount of sun exposure you have had. The Weekend Facelift and the Lunch Time Facelift are examples of the Mini-Facelift.

THE MODERN FACELIFT

The Modern Facelift has evolved over many years, starting with the discovery of the SMAS. Surgeons have dissected and pulled the SMAS every which way as they learned how to best utilize this tissue plane.

The Modern Facelift technique often includes an incision behind the ear and into the hairline. This is needed if a significant amount of redundant skin is present. This facelift is a gold standard and will typically last eight to ten years. The SMAS is more extensively supported in the Modern Facelift than in any of the other lifts.

The modern approach to facelifts has recognized the youthfulness of fat in the face. As we age, fat is lost in many areas of the face, such as the cheeks, the eyes and the lips. As this occurs, we look older. The skin loses its fullness and begins to appear deflated and saggy. In this situation, the facelift becomes a straight, slightly flat pull with less contour or curvature. This is the reason for fat conservation and fat injections. Dr. Delgado often incorporates fat injection into his facelifts. An additional technique Dr. Delgado may use to restore suppleness to the face is to overlap the SMAS, as opposed to removing a segment of this structure.

“Liquid Facelift” is a term used to describe injections of products to fill the facial areas and create more fullness. A patient’s own fat is commonly used, but products such as Sculptra and Radiesse can be used as well.

Every patient's needs, means, and desires are unique. For example, patients in San Francisco and Marin County often seek to work around their busy schedules, while patients who fly in for treatment from outside of the Bay Area often need a place to convalesce. We work with our patients to ensure that we meet their particular needs. Please don't hesitate to tell us about your particular situation. We work with all of our patients to ensure that your experience goes as smoothly as possible.

FAT INJECTION (STEM CELL FACELIFT)

Fat injection can be used to rebuild volume anywhere on the body and is a technique that has developed significantly since 2008. This process was developed by Dr. Sydney Coleman of New York City. In the Coleman Technique, fat is gently taken from areas such as the abdomen or the legs using a low-vacuum liposuction. The fat is then placed in a centrifuge to gravitationally separate it into three layers: a top layer of oil, a central layer of concentrated fat and a bottom layer of blood.

Research has determined that the bottom 20% of the fat layer has the most fat stem cells and growth factors. This stem cell rich fat layer is believed to produce fat cells with the best survival rate for transplantation into specific regions of the face.

The fluid and oil is discarded and the fat is transferred to small, 1cc syringes. The skill of the technique is in the injection process. Small amounts of fat are injected underneath the skin in fine tunnels. This creates beads of fat, which are crosshatched in the injection area. This slowly and effectively builds up the area and gives the fat cells an opportunity to establish blood supply. The technique yields better results than simply injecting boluses of fat into the injection areas. With the Coleman Technique, more than 50% of the fat can become permanent.

Therefore, a Stem Cell Facelift refers to the injection of fat into the face to increase volume. Facelifts can be done with or without including this process. Scientific research seems to support the stem cell concept, making the term, Stem Cell Facelift, more than purely a marketing term.

The most common question patients ask about the Stem Cell Facelift is, “How long does the fat last?” That depends on the injection area. For example, injections in a cheek location will have a better take than the augmentation of the lips, which are constantly in motion.

We are most concerned with keeping the people who trust us with their appearance happy with our results. If you don't live in the Bay Area, let us help you with accommodations. If you live in San Francisco or Marin County, and would like to keep your treatment private, we can also help you arrange a place to stay while you recover.

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