A male facelift (Rhytidectomy) & neck lift (Platysmaplasty) surgery involves tightening and lifting the skin and underlying tissues of the face and neck. Dr Turner performs this procedure to address concerns such as jowls, wrinkles, and fine lines on the face and neck while taking into consideration the unique masculine anatomy.
Differences Between a Facelift for Men and Women
The male face has a number of unique anatomical characteristics that must be taken into consideration when selecting the appropriate surgical strategy:
- Larger and more angular jaws and stronger midface
- Prominent facial muscle mass
- Stronger midface with angular cheekbones
- Low positioned brows
- Thick, dense, and heavy skin with hair follicles
As men age, we may see changes in the facial skeleton with decreased bone support in the midface and jawline. This can sometimes be combined with loss of soft tissue, laxity of the deep supporting fascia, and fat accumulation in the neck. The male skin is thicker than female skin, which generally puts men at a higher risk for bleeding during and after the face and neck lift procedure.
Suitable Candidates for a Male Facelift
Suitable candidates for this procedure are men who are:
- Medically and psychologically healthy
- Close to ideal body weight or BMI (<29)
- Non-smokers or those willing to quit smoking
- Willing to adhere to post-procedure instructions and have realistic goals
Male Face & Neck Lift Surgery
It’s important to keep in mind that a face and neck lift in men must be performed using specific techniques and requires a different aesthetic perspective than a traditional facelift.
Incision Placement
Dr Turner’s preference is to place the incisions along the hairline (pretrichial) using hair follicle preservation incisions (trichiophytic) to reduce scar visibility.
In men with minimal skin laxity in the neck, a ‘short scar’ facelift is recommended as the scar does not extend behind the ear into the posterior hairline.
In female facelift surgery, Dr Turner places the incision inside the ear canal behind the tragus (a small, pointed piece of cartilage that sticks out just in front of your ear canal) to minimise the visibility of the scar. In male patients, the beard makes this approach difficult. So, Dr Turner recommends a pre-tragal incision where the incision is in front of the ear and tragus, as it prevents hair-bearing skin from being pulled into the ear and distorting the natural tragal shape due to the thicker skin in men.
SMAS Modification
The foundation of any modern facelift procedure is the tightening of the underlying fascial layers of the face and neck. However, male patients have thicker skin, subcutaneous tissue, and beard. Thus, they require a more robust lift to the underlying SMAS.
While there are several approaches to modifying the underlying SMAS layer, the two techniques are recommended by Dr Turner:
- Deep Plane Facelift – This is the treatment of choice for the majority of men undergoing a facelift procedure. This technique allows Dr Turner to release the facial retaining ligaments and elevate and tighten the SMAS into its new position.
- SMAS Plication – The SMAS is often thinner and less durable than the younger male patient. In these cases, it is more reliable to perform an SMAS plication to tighten the underlying SMAS.
In both procedures, male face and neck lift patients require modification to the neck. This is performed by addressing the excess fat (lipectomy), tightening of the muscles (platysmaplasty), and removal of excess skin.
Addressing Facial Volume Loss
Men start noticing changes in the thickness of the facial soft tissue in the fourth and fifth decades of life. Thus, part of any male facelift surgery must include increasing the volume of the treated area.
Fat transfer can address the lost volume throughout the face, including the under-eye and cheek areas. The grafted fat may also be used to add volume to certain areas of the face such as the chin, jawline, and cheekbones.
If there is significant volume loss, fat grafting alone may not produce satisfactory results. In this case, Dr Turner recommends silicone facial implants for the cheek / malar regions or chin.
Complementary Procedures
First, it’s important to remember that any facelift procedure, whether for men or women, affects the lower two-thirds of the face only. If the upper face needs to be addressed, a blepharoplasty or brow lift may be included in the facelift procedure.
For men with excess skin and fat on both upper and lower eyelids, an upper blepharoplasty and transconjunctival lower blepharoplasty can help. Both procedures can remove excess skin, muscle, and fat from the eyelids.
Although a facelift can address fine lines and wrinkles on the jawline, it will not add projection to a receding chin or compensate for age-related bone reabsorption. A chin augmentation (genioplasty) can be performed to address this concern. This procedure involves using a fat graft or chin implant.
Recovery after a Male Facelift
Postoperative recovery may vary from patient to patient as a result of genetic, physical, and surgical factors. You can return to work after two weeks and sports activities after six weeks. Over the following weeks, swelling, bruising, and discomfort gradually subside. The final results may take several months to become noticeable as swelling resolves and tissues settle into place.
Risks and Complications of Male Facelift
Like any surgery, a male facelift has risks and complications, such as:
- Wound infection
- Bleeding or haematoma
- Poor scarring
- Allergies or reactions to medications, sutures, or topical treatments
- Delayed healing
- Skin flap necrosis
- Hair loss and changes in hairline or beard position
- Facial nerve injury and facial animation disturbance
- Salivary gland/duct injury
- Seroma formation
- Chronic pain and numbness
- Pigmentation changes
