«The age of the first facelift has dropped a lot: if you want a real” time block “effect, you should even program the first at 40. It will stop the sagging and if you decide to do it again it will be just a soft recall “, says the plastic surgeon Paolo Santanchèwhich we interviewed.
But does facelift still make sense in the era of retouching like botulinum and fillers?
Each therapy has its own indication. Botox is a fantastic product: it serves to interrupt the impulse that causes the muscle to contract in a marked way, creating crow’s feet that I thus eliminate. The filler, on the other hand, that is hyaluronic acid, a ductile and safe substance, fills. But when I have a relaxation, I have to correct it: if an elastic or a rope loosens, I have to pull them, I cannot fill them. Over the years the facial tissues below the skin give way, dragging it behind and making the passage of time visible: then the surgeon must act on these areas, restoring the right tone to the floor on which the skin rests. And this cannot be achieved without correcting the sagging of the tissues. Therefore hyaluronic acid fillers and botulinum have other purposes and achieve different results, often temporary, i.e. we are talking about months, not years. Soft interventions? Lifting, for the patient, is a much less complex operation than others, such as breast augmentation for example.
You even say that the first should be done at the age of forty: isn’t it early?
We must distinguish between two philosophies: that of “rejuvenation” and that of “non-aging”. In my long surgical experience, in general but specifically with the facelift, I have seen that the earlier the surgery is, the more it slows down aging. And, therefore, in my opinion it is better to prevent aging than to correct it after it occurs. At forty you can look good but there are the first signs of letting up. The layers that support the entire scaffold are the Platysma muscle and the SMAS (Superficial Aponeurotic Muscle System), which is a fascia: if I put them back in tension, I recreate the conditions of when I was younger. A good example is Sharon Stone: when you admire her still beautiful and relaxed face at 64 it is not because she had a facelift yesterday, but because she did it long before her, when apparently there was none. need. As well as Sandra Bullock and Jennifer Aniston: they have always looked the same for decades. The public in fact has never seen them “aged” precisely because of the precocity of the interventions, made when the first failures began.
So, is it pointless to have a facelift at seventy?
It can certainly be done, and a good ten years takes them all away, but if I do it this far I will bring the age of the face down to 58-60, no more. If, on the other hand, I had done the same facelift at 40 and then do it again at 60, I will never have a really aged face, or it will be minimally.
Of course, as you explain it, it all seems easy … But you can see certain faces around, far from natural: did they pull them too hard?
They didn’t pull them, they inflated them. Those balloon faces with disproportionate cheeks are not facelifts, but attempts to avoid the facelift by filling up with fillers. If you want to fill something that has given way and needs to be put back in tension, you will have to fill it like a bagpipe, distorting the face with the improper and exaggerated use of fillers. You get these “results” just when you do not want to do the facelift (or whoever offers you these alternatives does not know how to do it, or does not feel confident in mastering the technique) and to obtain something similar you exaggerate with fillers, but also with the botulinum. I would say that the aesthetic result shows how wrong this approach is.
What results can you expect from a professional facelift?
The more the tissue yields, the less it opposes aging, the more toned it is, the more it resists and ages more slowly. Thus the facelift is longer lasting and the maximum results aesthetically. Whoever says “I resist a little longer and then I do it” is wrong. It is a mistake that I too made with my most affectionate patients, who insisted on having a facelift “soon”: those that I finally satisfied have shown me in fact and over the years how much the assumption of “first is better” is winning.
Is it very painful as an intervention? When can you show the face without marks?
It is precisely those who do not know how to do it who have spread the rumor that the facelift is a heavy operation for the patient: in reality it is for the surgeon, because it is delicate, difficult and demanding, since it lasts 3-4 hours. but we are home after only 24 hours. If the technique is done well on the face not even a bruise appears, just a little swelling that passes within two weeks.
But how do you see that a facelift has been done well?
Can not see it. Because no one has to understand that he has had a facelift. I have patients who told me: “My mom didn’t notice”. If your mother does not notice it, it means that it is the maximum of naturalness, because in reality we have not “pulled” a face, but reconstructed a face that the patient has already had in the past, that of his youth, a familiar face, not upset by the scalpel.
You can show it first to a patient what it will be the result?
When they ask me “how will I come?” I suggest going to see a photo of yourself from many years ago: that will be the result, because I am going to reconstruct a face that the patient has already had and that he knows well, but which dates back to a long time ago. This is the “miracle” of the facelift. I add that if I do the first one at 60, I will obviously see big differences with a photo of ten years ago, but if I do two facelifts, one “early” at 40 and then one at 50, the photos will be the same, and they will be even if I do a third at 60. Because non-aging surgery stops time.
The scars are invisible
Usually the lifting is done on the whole face, but it can also be limited to the lower sector, the one that goes from the cheeks to the neck. “The brow lift is practically no longer done because forehead wrinkles are resolved perfectly with Botox, such as crow’s feet and wrinkles between the eyebrows,” explains Dr. Santanchè. “In any case, even the most extensive surgery leaves no trace because the scars are all well hidden in the hair, behind the sideburn, inside and behind the ear. No visible signs on the face, therefore. The scar is not the problem of the facelift ».