FaceLift

Dr. Putterman does a simplified facelift to decrease jowls. It is done by releasing skin from around the ears and face and tightening the fibrotic tissue underneath skin. He commonly combines this with a cheek-midface lift done through a lower eyelid approach, which pulls the midface almost straight upward. The facelift then pulls the lower face obliquely toward the ears, which decreases the jowls.

Fig A: Pre-op photo of patient with lower face sagging and jowls.

Fig B: Post-op photo after patient had facelift with improvement in lower face and jowl sagging.  Patient also had eyelid and mid-face surgery. 

Before and After Photos

Before Photo		After Photo

Click any photo above to enlarge

Face Lift Surgical Techniques

A. The dotted lines indicate the area of the skin incision in front and behind the ear.  Part of this incision goes behind the tragus (the protruding area in the mid ear).  This helps hide the incision.
B. The incision extends behind the ear either along line A or B, depending on how much skin has to be removed.
C. After the skin is incised and released, sutures are placed that plicate and tuck the firm tissue beneath the skin known as the SMAS.  This lifts the sagging facial tissues.
D. & E. The excessive skin that drapes over the incision sites is then excised.  The remaining skin is then united with sutures.
Illustrations are from Dr. Putterman's textbook "Cosmetic Oculoplastic Surgery".