The Future of Facelifts
Facelifts have recently been undergoing their own transformation.
by : Ingrie Williams- Sep 2nd, 2022
Collage by JENS WORTMANN
After years of using dermal fillers, Sabrina Rinaldi was left with a discoloured complexion and starting to resemble a stranger; going under the knife proved to be the only way for the 44-year-old to feel more like herself. The Toronto-based makeup artist has long found cosmetic surgery to be a confidence booster. She sees the procedures she has had—including rhinoplasty, liposuction and breast augmentation—as a sort of extension of makeup. “I can contour my face with makeup, and I can also contour my face with surgery,” says Rinaldi. “The two go hand in hand.” By sharing her experience, she hopes to help normalize and destigmatize the once taboo topic. “But it’s still something that people don’t openly discuss,” she says.
After attempts to dissolve the filler with injections of hyaluronidase (an enzyme that breaks down hyaluronic acid) failed, Rinaldi began researching alternative solutions. “I had so many years of compounded filler that I needed to surgically remove it,” she says. Her underlying motive was to reconnect with herself. “I realized that [these procedures]—mainly the fillers—were giving me a different face. And I wanted my face; [I wanted] to go back to what my face was—just a tighter version.”
Dr. Andrew Jacono, facial plastic surgeon and founder of New York Center for Facial Plastic Surgery, describes Rinaldi’s experience as “filler fatigue.” “When a skilled cosmetic dermatologist uses small amounts of filler in the right places, the results can be positive,” he says. “But when the face is overfilled—and unfortunately this can be seen almost everywhere we look—the skin can be stretched. There comes a point when fillers do not produce the same results they used to,” says Jacono. A facelift can address this issue as the surgeon can remove the filler and bring back natural proportions while evening out the patient’s complexion.
In 2019, Rinaldi decided that a facelift was the best way to course correct and achieve her long-term beauty goals, so she started saving up. “The mainstream idea around a facelift is that you wait until you’re in your 60s, when everything is fully sagged, and then you snatch it up,” she says. “But by getting it done in my early 40s, at the onset of [signs of] aging, I get to age with this face.” With results lasting for 10 to 15 years sometimes up to 20—it’s a strategy that’s part of a growing trend. The average age for a facelift at Jacono’s practice ranges from 47 to 53. “Now more than ever, I see patients in their 40s who want to ‘prejuvenate’ and restore a more youthful appearance before their faces age too much,” he says.
Facial surgery has also been on the rise at ICLS Dermatology & Plastic Surgery in Oakville, Ont. Cosmetic plastic surgeon and co-founder Dr. Julie Khanna identifies social media and Zoom as influences on this trend. “Everyone is looking at themselves, and we’re very critical [of] ourselves,” she says. She sees facial procedures as being on a spectrum and believes in tailoring options according to a person’s quality of skin, desired outcome, genetics and age, among other factors. “A facelift is a great operation for the right patient,” says Khanna. “But it shouldn’t be the only one. I want to make sure that people have choices.” Though she does perform volume-conserving facelifts, mini neck lifts (which sculpt and lift the jawline) have become her most popular procedure. As part of her approach, she recommends that patients have additional treatments like radiofrequency resurfacing or a laser peel. “Surgery is going to improve the quantity of skin,” she says. “But the technology improves the quality to give you back your glow.”
“Now more than ever, I see patients in their 40s who want to ‘prejuvenate’ and restore a more youthful appearance before their faces age too much. ”
Long gone is the telltale facelift of the 1970s and ’80s, which only relied on the traditional superficial-muscular-aponeurotic system technique to achieve a tighter surface. “Today’s plastic surgery isn’t your mother’s plastic surgery,” says Jacono. “Techniques are more advanced, and recovery is accelerated—today’s facelift doesn’t actually look like a facelift at all.” Jacono is a leading expert on the extended deep-plane facelift. Designed to lift the skin and muscle together, it repositions cheek fat pads and musculature. “Since the skin is not separated from the deep structure, the lift comes from underneath,” he says. “The surface appears smooth, not tight.” Jacono’s skills have been trusted by fellow plastic surgeons and celebrities most notably fashion designer Marc Jacobs. Last year, Jacobs shared a post-surgery selfie—his head wrapped in gauze and accessorized by drainage tubes—documenting his recovery, which included hyperbaric-oxygen therapy to speed healing.
As encouraging as before and after images can be, talking with multiple experts is a more critical part of the process. “Please see a few board-certified surgeons,” says Khanna. “Don’t just go with one opinion. Surgeons are like chefs. If you ask three chefs to make a delicious cheese soufflé, no two are going to be the same. You’ve got to pick the right flavour for you.”
After a $750 consultation with Dr. Chia Chi Kao, the L.A.-based originator of the Ponytail Facelift (an endoscopic technique with few incisions and minimal disruption to blood vessels), led to an estimate beyond Rinaldi’s budget, an industry friend suggested Jacono. She met him in early 2020 and felt he was the right fit for her ideal aesthetic and financial plan. “I knew I could tell him to go for it,” she says, “and his going for it would still be natural-[looking].”
For anyone considering plastic surgery, Rinaldi advises seeking out the best doctor they can afford. “It’s a big financial commitment, but after spending time and money to fix a botched nose job, I firmly believe in paying top dollar,” she says, noting that she wishes doctors were more transparent about pricing prior to a consult to help people avoid disappointment. She spent the start of last year recovering from a deep-plane facelift, lip lift and brow lift that cost almost $63,000. She went under the knife again five months later to revise part of her healed brow. “They treated me like a celeb,” she says. “The aftercare was great.” And she took that opportunity to also finally remove the filler under her eyes as well as get a lid lift and buccal-fat removal. “I wish I had done it all [to start with],” she says. In her experience, partnering with a pro whom you have absolute faith in is more reassuring, which takes the edge off the post-op journey. “It’s an emotional roller coaster,” warns Rinaldi, adding that cycling through uncertainty, anger and impatience is normal. “If it’s something you want to do and it makes you feel better about yourself, I think it shouldn’t be judged,” she says. “At the end, you get to experience [feelings of] joy and it’s like ‘What can I do next?’” The answer to that should always be up to you.
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