The Principles of a Natural Facelift

By Ramsey J. Choucair, M.D., F.A.C.S

I am often asked why facelifts often appear so unnatural.

First of all, I mention that individuals that appear “distorted” or “pulled” are easily noticed BUT……..those persons who have undergone expertly performed, natural-appearing facelifts go unnoticed.  

So what is the difference between those with visible signs of a facelift versus the individual with a natural-appearing improvement after facelift surgery?

There are 3 basic principles that result in a natural-looking facelift.
1. The direction or vector of the skin pull must be in the proper direction. This means that the facial skin is lifted upwards in front of the ear and neck skin is pulled back toward the hairline behind the ear.  This allows the facial skin to be pulled in a “balanced” manner without an irregular, distorted appearance which is so easily visible.

2. The natural hairline should not be distorted or interrupted.  The temple sideburn and the distinct hairline contour behind the ear must be preserved.  Maintaining a normal hairline requires incisions that are precisely placed and thoughtfully closed.

3. The tension on the skin must be gentle. Wide scars, visible incisions, and distorted earlobes are avoidable.  Scars become noticeable and earlobes appear pulled downwards with excessive skin tension. An experienced surgeon intuitively measures the skin tightness so the incision heals with a hardly detectable, fine-line scar and without risking distortion of the earlobe.

Employing these three important facelift principles will result in a naturally rejuvenated facial appearance, avoiding the social stigma often associated with facelift surgery.