Face lifting was performed firstly in the early years of the 19th century. Throughout the most of the 20th century a face lift mostly involved skin surgical excision and undermining. A revolution occurred in the 1970s when the public became exponentially more interested in the procedure and some surgeons started using surgical techniques that aided in dissection of the superficial fatty layer of the face in continuity with that of the neck. Since then, techniques have been described that involve every possible skin incision, extent of tissue manipulation, plane of dissection, type of instrumentation, and method of fixation. Many of these innovations provide little long-term benefit when compared to skin undermining that would expose the patient to more risk.

Placing tension on the skin is no more an effective way of lifting the face and leads to the “face-lifted” look and unpleasant scars in addition to distorting the facial landmarks such as the front hairline and the ears. The current new trend is toward redistributing, or augmenting, facial volume, rather than flattening it with excessive applied tension.

New face lift surgical trends are directed toward less invasive surgical procedures as it has been proved by researchers that the more “invasive” surgical techniques have not reproduced benefits in comparison with their risks. Moreover, the public outgrowing demand for rapid recovery has widely marketed the acceptance of simplified procedures. The ultimate goal of a face lift should be to help the patient look better, not awkward or operated on. Excessive tension, massive removal of facial fat, exaggerated changes, and focusing on one region while ignoring another may be translated into disharmony. The face is best manipulated and analyzed equally considering the entire face and the entire body, not the individual component of each, lest the “forest would be lost for the trees.”

Recognition of areas of facial atrophy is pivotal in determination of the right surgical approach for face lifts. The progression of aging not only involves sagging of the tissues and deterioration of the skin itself but also atrophy of underlying tissues, especially fat, in certain regions. Most patients are best treated with limited removal of fat from certain areas. However, other cases are best served by addition of fat to areas of marked skin atrophy.

Face lifts are perfect therapeutic options for only lid drop (ptosis) and atrophy of facial subcutaneous tissues. Face lifting can't improve the quality of the facial skin itself. Accordingly, face lifting is not a treatment for sun damages, wrinkles, creases, or irregular pigmentation. Fine wrinkles and irregular pigmentation are best treated with skin care and resurfacing procedures.

Dr Calvert is a certified Board Plastic Surgeon (Los Angeles) who specializes in face lifts. Dr Calvert abides by the novel trends in plastic face lifting. He will help you decide if you'd really benefit from a facelift. Dr Calvert now uses endoscopic face lift techniques which have proven efficacy by providing better assessment of the structural anatomy and the overall state of the facial tissues.