Board certified plastic surgeon, Op. Dr. Ali Murat AKKUS, is one of Manhattan, Istanbul’s most sought after facelift surgeons. His nuanced, skillful approach creates unrivaled results that appear spontaneously beautiful and natural.
The best candidate for a facelift is a woman or man whose face and neck demonstrate skin laxity (sagginess), especially of the lower face/jowl area, and neck. Most patients who seek the Istanbul plastic surgeon’s expertise are in their forties to sixties, but facelifts can be performed successfully on people in their seventies or eighties as well, as long as they are in good health. In very selected cases, Op. Dr. Ali Murat AKKUS will perform a facelift on women below the age of forty, if they have experienced significant facial aging, particularly as a result of sun exposure.
About facelifts
Unlike many plastic surgeons who perform their facelifts under general anesthesia with the patient completely unconscious, Op. Dr. Ali Murat AKKUS strongly prefers "twilight" anesthesia, also known as IV sedation.
With this form of anesthesia, the patient is breathing on his or her own, responds to verbal commands (such as a request to take a deep breath), but typically has no memory whatsoever of the procedure. Not only does Op. Dr. Ali Murat AKKUS consider this form of anesthesia to be safer than general anesthesia, but also recovery is much smoother and more rapid.
From a technical point of view, a facelift is the operation that addresses the core problems which have resulted from significant facial aging. While injectables can provide dramatic solutions for volume loss of the midface (areas around the cheeks and eyes), injectable fillers have a fairly limited role in addressing the jowls and neck.
When the neck demonstrates significant crepe-like skin, as well as vertical bands or folds of skin (we call these platysmal bands, as they consist of edges of the platysmal muscle), there is very little that fillers or Botox can do. Patients with these problems are ideally treated by a facelift. Liposuction as well as direct reduction and contouring of neck fat is an intrinsic part of the facelift procedure and helps create a natural and rejuvenated appearing neck.
Facelifts, Mini Lifts, Lifestyle Lifts
With regard to terminology, Op. Dr. Ali Murat AKKUS feels that there has been a veritable explosion of names for types of facelifts, and he regards these names to be more marketing and sales maneuvers than meaningful descriptions. Dr. Ali Murat Akkus considers the terms facelift, lower facelift, and neck lift all refer to the same operation.
The term "mini facelift" can be very misleading. According to Op. Dr. Ali Murat AKKUS, there really should be no such thing as a true mini facelift. Once the surgeon is opening the face in order to rejuvenate it, he should, of course, perform every maneuver which is safe and reasonable to achieve optimal results. Some patients like to think of their facelifts as mini facelifts simply because they do not want to admit to themselves that they have had a facelift.
A short scar facelift is a specific type of facelift, which refers to the facelift scar not extending far behind the ear and into the hairline or scalp. As noted above, however, the exact same type of operation is performed internally, and therefore a short scar facelift is truly not a mini facelift.
Lifestyle Lift is a specific term used by a company for marketing, which does deserve some attention. Although the name Lifestyle Lift seems to denote a specific surgical technique, according to Op. Dr. Ali Murat AKKUS, what it really denotes is a facelift performed under local anesthesia, which is marketed by a specific company.
Op. Dr. Ali Murat AKKUS feels strongly that, while he prefers IV sedation to general anesthesia, some form of monitored sedation in the presence of an anesthesiologist is extremely important for the performance of a safe and optimal facelift procedure. When a facelift is performed solely under local anesthesia, the surgeon is under significant time pressure to work fast so that the patient does not become uncomfortable. Indeed, having a surgeon rush through the facelift procedure is not in the patient's best interest.
Furthermore, it stands to reason that the plastic surgeon performing a facelift is the key factor which determines the quality of the result. To the best of Op. Dr. Ali Murat AKKUS’s knowledge, when a facelift is performed by the Lifestyle Lift people, the surgeon’s remuneration is quite secondary to the profits of the company at large. This may motivate them to cut costs wherever possible in order to achieve maximum profitability.
Midface lifts
Midface lifts generally refer to facelifts that are performed via the lower eyelid and lift the soft tissues in an upward direction. These types of lifts are more commonly performed in the south than in the northeast, because they generally involve significantly more facial swelling and a prolonged recovery period. There also can be more issues with asymmetry using this technique. For these reasons, Dr. Ali Murat Akkus does not perform facelifts via the lower eyelid approach.
Facelift scars
Because facelifting involves removal of excess skin, they do require scars. These scars, however, can be very well hidden around the patient’s ears, and in women can be covered very well with a variety of hairstyles.
People sometimes talk about the facelift scar being either "in front of" or "behind" the ear. This is another example where terminology can be very misleading. In fact, all common facelift techniques involve a scar in front of the ear. The "in front of" or "behind" terminology refers to whether the scar is in front of or behind the tragus.
Op. Dr. Ali Murat AKKUS believes that selecting the scar location to be pre-tragal (in front of the tragus) or retro-tragal (behind the tragus), is a decision made on an individual basis. In many patients, there is a fine wrinkle immediately in front of the tragus, making the pre-tragal scar very appealing.
Perhaps more importantly is the fact that the tragus is truly a part of the ear; it contains cartilage like the ear, and has a color and texture that match the ear much more than the cheek. When a scar is placed retro-tragally (behind the tragus), one is draping skin from the cheek onto what is really a part of the ear, and this can result in an unnatural appearance.
Op. Dr. Ali Murat AKKUS’s facelift technique
The Park Avenue Plastic Surgery board-certified plastic surgeons perform multiple different types of facelift procedures depending on the anatomy of the patient and their desired outcome. These include a two-layer lift, generally referred to as a SMAS facelift, as well as a deep plane facelift.
The word SMAS refers to the Superficial Musculo-Aponeurotic System. This is essentially the connective tissue that surrounds the muscles of the face and which becomes lax over time. It is widely believed that addressing the SMAS at the time of the facelift produces both a more natural and longer-lasting result. The skin is re-draped over the restored SMAS and closed with utmost care in a tension free manner to produce the least visible scar possible.
A two-layer SMAS facelift is often the recommended procedure to address signs of aging in the midface, jowls, and neck area. During a consultation with an experienced plastic surgeon at Park Avenue Plastic Surgery, they will evaluate your areas of concern and create a surgical plan best suited to your needs.
Depending on the severity of your signs of aging (jowls, crepey skin, neck bands, and deep wrinkles around the mouth), our expert surgeons may recommend a technique called the deep plane facelift. The deep plane facelift and SMAS facelift techniques differ in how they lift the SMAS and rejuvenate the face.
The deep plane facelift involves lifting the SMAS from the underlying muscles and releasing the ligaments that anchor the SMAS near the folds around the mouth. Rather than elevate the skin as a separate layer, this technique involves lifting a major part of the SMAS while connected to the skin. The technique may allow for better preservation of blood supply to the skin, and some believe it creates a more comprehensive rejuvenation in appropriate candidates. A board-certified plastic surgeon at Park Avenue Plastic Surgery can recommend which type of facelift procedure is best for you.
Recovery
Op. Dr. Ali Murat AKKUS sends his facelift patients home accompanied by a nurse hand-picked by our practice, who remains with the patient at least overnight. The morning after surgery, the nurse removes all bandages and any drains (if used), and forwards detailed photographs for the doctor to review. The presence of a nurse following facelift surgery is highly desirable, both for comfort and well as for monitoring of blood pressure and to help allay any anxiety on the part of the patient and their family.
Complications:
- Hematoma
- Skin Loss
- Nerve Injury
- Motor Nerve Injury
- Unfavorable Scars
- Anesthesia Related Complications
- Unnatural Look
As with all surgery, there exists the possibility of complications. The most common complication following facelift surgery is hematoma. Hematoma refers to a collection of blood under the skin of the face and/or neck, which, depending on its size, may require intervention such as drainage, or re-operation. The literature reports the incidence of hematoma to be about 3% in female facelifts, higher in males because of the more vascular nature of men’s’ bearded skin.
The incidence of this complication in Op. Dr. Ali Murat AKKUS’s hands is significantly lower, likely a result of multiple factors, including careful technique and our insistence on nurse monitoring for the night after surgery. This keeps blood pressure under control. It is well established that increases in blood pressure lead to an increased risk of hematoma following facelift. It is therefore not surprising that having a trained nurse present for the highest risk period after surgery (90% of bleeding complications occur within 12 hours of surgery) will reduce the risk of this complication.
Where will my facelift surgery be performed?
Your facelift surgery will be performed by Board Certified Plastic Surgeon, Op. Dr. Ali Murat AKKUS at his fully accredited Manhattan, New York out-patient facility. In very selected cases, the surgery may be performed at Manhattan Eye, Ear, and Throat Hospital or at Lenox Hill hospital.
Can I have other facial plastic surgery procedures performed at the same time as my facelift?
Yes, in fact many of the Board Certified Plastic Surgeon’s facelift patients choose to have their facelifts performed in conjunction with other facial cosmetic surgery procedures, such as blepharoplasty (eyelid surgery), earlobe repair, or chin enhancement.
How long does a facelift procedure take?
The length of the facelift surgery will depend on the individual. Typically, a facelift can be completed in less than three hours. However, the amount of work you will require will directly affect the amount of time the operation will take.
After a facelift, are bandages used?
Yes, bandages may be applied to the head and neck with the purpose of providing mild compression to the area and preventing excessive motion. Your nurse will typically remove the bandages the day after surgery.
What should I expect after facelift surgery?
After a facelift, many patients are surprised by the lack of pain they experience after surgery. For several weeks, expect some swelling around the eyes; however, as the swelling goes away, you’ll begin to see the surgery’s progress. Bending or lifting can extend swelling and is not suggested for three weeks after surgery. Running, cycling, and aerobic exercise in general may resume after three weeks. Driving is permissible when the swelling goes down and does not get in the way of your vision. Flying is generally permitted approximately 10 days after surgery.
Is a facelift permanent?
Yes and no. Obviously, facelifts do not stop the aging process, so that as time goes by, the facelifted face will show signs of aging, such as jowls and loosening skin. On the other hand, the person who has facelift surgery will always appear more youthful than they would if they hadn’t had the facelift surgery, even years later. The Board Certified Plastic Surgeon, Op. Dr. Ali Murat AKKUS' s favorite analogy is to imagine two identical twins needing a facelift. Only one decides to have facelift surgery, and they both return every year to been seen by the plastic surgeon. The patient who had facelift surgery will always appear younger than her "identical" twin, even when she feels she is ready for another one, 7-10 years after the first facelift.
Before & After
Mid Facelift
