Facelift Surgery in The Woodlands, Texas, with Dr. W. Marshall Guy
When it comes to something as precious as your face, why would you trust it to anyone other than a facial plastic surgeon? One of our most common operations performed is the facelift, a procedure designed to help turn back time and restore you to a more rejuvenated appearance.
Dr. W. Marshall Guy is an expert facial plastic surgeon practicing in Shenandoah, located right in the heart of The Woodlands, Texas. Because he is a fellowship-trained and double board-certified facial plastic surgeon that practices only facial plastic & reconstructive surgery, Dr. Guy is in a unique position to offer high quality, specialized care for all of the faces of The Woodlands.
When Should I Consider a Facelift?
The goal of a facelift operation is to reduce the signs of aging. The aging process happens in a relatively straightforward process. First, the skin starts to lose some of its elasticity, which allows structures to begin to drop. This often shows up early on as lines around the mouth called the melolabial folds (also known as the nasolabial folds) and the marionette lines. As time goes on, jowling begins to develop as the cheek continues to descend.
An exaggerated hollowness below the eyes may emerge as the cheek falls. Bands start to form in the neck as the supporting structures weaken, leading to further hanging skin and even fatty deposits below the chin. As the cheek descends further, the jowls become more severe, and the cheek can become more hollow.
Facelifts are designed to counteract these findings by lifting the tissues and restoring them to their more youthful position. This includes not only lifting the skin but, more importantly, the underlying layer called the SMAS. The SMAS is a layer that connects the deeper muscles to the surface, and it has the strength to provide lasting results.
Some more signs of aging include:
• Cheeks droop
• Neck slackens
• Muscle in the neck (platysma) shows up as a band
• Brows fall
• Eyes develop lax skin and bags
• Deep lines form around the mouth
• Overall quality of the skin starts to worsen
Factors that may accelerate these conditions include:
• Sun damage
• Life experiences
There are less invasive options such as fillers and our Embrace RF that can help combat these signs, though facelifts remain the gold standard. However, not all facelifts are the same – nor should they be! The reason is that not all faces are the same. And, at different ages, the same person has different conditions of aging that develop. The facts are plastic surgery is an art form and can be tailored to meet your individual goals.
What Are the Different Types of Facelifts?
For marketing purposes, many surgeons will “claim” to create a distinct type of facelift. They will use catchy names such as the “lifestyle lift,” the “nano lift,” the “micro lift,” the “neck lift plus,” the “S lift,” the “afternoon lift,” the “mini-lift,” the “short scar lift,” the “twilight lift,” the “insert name of city” lift, the “insert name of surgeon” lift. Most commonly, these will involve either lifting the neck or the cheek or sometimes both. When it comes to a facelift, the name is the least important component.
The most important structure in the facelift is the “SMAS” or skin-muscle aponeurotic system. SMAS is the layer in the face that connects the muscles to the overlying skin. More importantly, it is a solid layer that helps to support the longevity of the lift. Any facelift must address this layer if it is going to last.
Procedures that address this include:
- deep plane lift
- composite lift
- sub-SMAS dissection
Each of these lifts appropriately addresses the SMAS, with nuances between each. The things that really matter are that your surgeon is skilled in the procedure, implements the right method on you for the right reason, and addresses the SMAS layer.
The operation itself may be divided into three parts:
- The forehead or eyebrow lift (the upper one-third)
- The cheek lift (the middle one-third)
- The neck lift (the lower one-third)
The most common isolated request is a “neck lift.” Most people seeking “neck lifts” require some lifting of the cheeks in order to avoid “puckering” of the skin around the ears. In select patients, it is possible that a neck lift is all that is required. Dr. Guy will recommend what would be of benefit during your consultation.
Dr. Guy has been trained extensively with years of experience in the various surgical approaches for rejuvenating the face to give you the best aesthetic outcome, which can be discussed in consultation.
What to Expect in Your Facelift Consultation with Dr. Guy
Dr. Guy takes pride in his ability to listen to his patients and put them at ease. During your consultation, Dr. Guy will give you plenty of time to discuss what your concerns are, answer any questions that you may have, and inform you of the details of the procedure. Because your face is unique, it is important that you and Dr. Guy work together to develop a customized plan.
All new patients get to spend an hour with Dr. Guy and his team. A member of Dr. Guy’s team will meet with you first to discuss the full scope of what he can offer you. Then, Dr. Guy will meet with you to focus on what you would like to improve.
Most patients will then have a second consultation where they will focus on what exact procedure they are having done and go into more detail about what to expect before, during, and after the procedure. Dr. Guy does this to not only make sure that he is giving his patients as much information on the procedure as possible but also to not put any pressure on them to commit in the first consultation.
At the end of your first meeting, Dr. Guy will also provide you with a book that will give you further reference information about the procedure in which you are interested.
It's Your Time to Look Your Best!
Dr. Guy is a specialist in all areas of rejuvenation and reconstruction for the face and neck. As a double board-certified and fellowship-trained facial plastic surgeon, Dr. Guy knows that everyone ages differently and that there is no one size fits all when it comes to restoring a youthful appearance. From surgical options like a facelift to non-surgical options like Botox® and dermal fillers, there’s never a better time to look your best.
Facelift Surgery and Recovery
Before Your Facelift Surgery
Dr. Guy likes to say that surgery begins the day before the actual operation starts. He recommends that you get your busy work done before so that you can relax during the healing period. Dr. Guy also suggests that you eat a high protein meal later in the evening before surgery, to make sure that you stay full for longer. He provides sleeping pills to patients to allow for a restful night’s sleep, both the night before and throughout the healing process, for those who would like one.
On the morning of the surgery, Dr. Guy will meet you at the surgery center. He will draw out the incisions for the surgery, have you verify the procedure, and then the anesthesiologist will give you a cocktail of medications that will make you feel like a million bucks.
After Your Facelift Surgery
After he finishes the procedure, Dr. Guy will be there to check on you. For procedures involving the neck, Dr. Guy will have you stay overnight in a hotel with one of his excellent sitters, who will help you have a smoother recovery. For procedures not involving the neck you have an option of staying overnight with the sitter. Dr. Guy will stop by the hotel to make sure that you are doing well and will even maintain an open line of communication on his personal phone which you can call or text at your convenience.
You will wear a snug facial garment for the night following the procedure. We will remove the garment the next morning and give you a looser fitting supportive garment that will help with cold compresses. Your face may be swollen and slightly discolored. Though discoloration usually fades away within about 10-14 days, it will likely increase for the first two to three days. You can return to most of your “normal routine” within two weeks, but your face and neck may feel “tight” and movement of the neck may be restricted to help with healing. You can expect this as long as your tissues are still swollen.
Follow Up Appointment
You will return to the clinic in about a week to have the sutures and clips removed. You may resume wearing makeup by ten (10) days. You should also be able to return to work and carefully drive an automobile in fourteen (14) days if work was done on your neck, or in seven (7) days if you did not have a neck lift. You must not pull against tightness, lay on your sides, or engage in heavy lifting during this time. Doing so can interfere with healing and lead to less than favorable results. Specifically, scars will defend themselves, and if you pull against them with the above activities, then the scar will likely widen. For best results and better scars, you should avoid these activities (other than driving) for at least two weeks following surgery and then ease back into your usual activity, listening to your body to makes sure you don’t overdo it.
Facelift FAQs with Dr. Guy
Realistic expectations are a vital part of any surgery. A facelift can remove what is present at the time of surgery. It does not prevent further aging from taking place, and it does not address the skin texture, although, by removing the slack in the skin, it can improve them to some extent. At the time of your consultation, we will discuss what we can reasonably achieve for you.
There are several locations where we can place incisions during a facelift, which we will base on your anatomy. We will look to camouflage scars in the hair and around the ear, within the adjacent hair, or by the natural creases and folds of the ears. We will bevel incisions that are next to hairlines to allow the hairs to grow through the scar and camouflage it even better. We will make incisions within the hairline in such a way as to minimize trauma to the surrounding hair.
If we perform a temporal or forehead lift, your hairline may be altered. If your hairline is high, the pretrichial incision (in front of the hairline) can help to lower the hairline. If your hairline is low, the coronal incision (behind the hairline) can help to raise it and create more of a forehead. For the temporal extension approach, we will tailor incisions to minimize hairline alterations and avoid the telltale sign of a facelift with a loss of hair above the sideburns. Essentially, the operation is “customized” to fit the needs and desires of each patient seeking surgery.
A facelift operation is designed to lift the soft tissues of the face and neck back to their more youthful appearance. This is in contrast to the windblown look that can be created with overly aggressive pulling instead of lifting. It also contrasts the very puffy and “done” or “unnatural” look that can be created by plumping up the face too much with treatments such as fat transfer at the time of the facelift. This does not mean fat transfer cannot be an excellent option, but when completed in tandem with a lifting procedure, it should be done conservatively to avoid unwanted results. A true lifting procedure may involve simply lifting the neck, the cheek, the temples, the brows, or a combination. We will determine which method is best for you based on your individual anatomy. The procedure should not be a once size fits all, which is why Dr. Guy customizes the treatment plan based on you and your goals.
You can expect some degree of tightness, numbness, or weakness of surrounding tissues following surgery. It is usually temporary, disappearing as healing progresses. The tightness will increase for the first few days as the swelling increases. This is not an “overdone” surgery but merely the body’s response to any operation. As the swelling dissipates, the tightness will improve. The numbness is most common in front of and below/behind the ears. If a brow lift was performed, depending on the technique, then the scalp may also be numb. As the nerves regenerate, it is common to feel little pings, zings, and itches. This is the body healing, and it is important not to itch these areas.
We may do the operation using only local anesthesia, “twilight” anesthesia, or general anesthesia. Dr. Guy is trained in all of these situations. Certain candidates are better for one type over the other. The final decision as to what type is used will rest with the anesthesia team, although we can provide our preferences to him or her. More than 99% of the face-lifts we complete are done in outpatient facilities, but even if the surgery is performed in the hospital, patients would be expected to be discharged the following day. If we do surgery in an outpatient facility instead of the hospital, the total cost is usually considerably less. We will discuss these arrangements during the consultation and depend on your overall health.
There is no set minimum or maximum age for a facelift. Assuming you show the signs of aging that are addressed by a facelift, then you are a candidate. The most common age for the first facelift is the mid-50s. For patients looking to maintain a youthful, “never aging” appearance, some may undergo a facelift at an earlier age. Those who wait until a later age, when the signs of aging are more advanced, can roll back the clock even more with a facelift.
You will want to be within about 15 pounds of your realistic weight. This does not mean within 15 pounds of your goal weight, but if you are losing weight and have a little more to go, it is best to have the weight off before the surgery. The reason is that a facelift addresses what is present on the day of surgery. If you continue to lose weight, then the skin that was being pushed out by the fat will begin to sag. Gaining excess weight after surgery won’t lead to sagging tissue, but it will push out the skin more so the definition achieved at surgery may not be as noticeable.
For most patients they can be out and about within two weeks, and most others would have no idea they had surgery performed.
With any procedure, maintenance can go a long way. This involves taking care of your skin, minimizing the damaging effects from the sun, and possibly doing some small treatments here and there, such as Morpheus8.
There are a lot of marketing names out there for different lifts. Historically speaking, a traditional lift will involve lifting the brows, the cheeks, and the neck. A mini facelift frequently involves just lifting the neck, cheeks, or sometimes both.
Guy has provided a lot of useful information on his website. We would recommend you begin by reading that information. Also, take a look at your face to see what areas bother you. That way, Dr. Guy can discuss all of the options, including non-surgical, to help achieve your goals.
Guy will go over all of the required preparation during your preoperative visit. In general, it is best to get your busy work taken care of prior to surgery to allow for a more relaxing healing period. You will need to pick up your prescriptions and bring them with you the day of surgery. You will also need to book your hotel room where you will stay the first night with a sitter as well.
With any surgery performed there are several generic risks. These include the risk of some discomfort, some bleeding, incisions, infection, need for repeat surgery, and asymmetry. Specific to the procedure, there is a risk of damage to a nerve that controls the muscles of the face, the risk of a saliva gland temporarily leaking under the skin, numbness around the incision lines, change in the shape of the tragus, for incisions completely in the hairline the risk of temporary hair loss, and even skin loss. For most, these risks are quite minimal and temporary if they occur.
Nicotine increases the risk of complications with any surgery. Smoking is not an absolute contraindication, but it does limit how much lift we can provide to minimize the risks.
There is a lot that goes into determining the price. This includes if you are lifting the neck, the cheek, the brow, or any combination. It varies if you would prefer to have surgery in the office vs. going to sleep in a surgical center. It also varies based on your individual anatomy. Prices will range from about 5k to 12k+, based on the above. Once you have had your consultation, you will know your exact cost.
It takes about 10-14 days to recover from a facelift.
We recommend to avoid exercise for about 2 weeks following surgery.
For those working from home, most can resume working about 2-3 days after surgery. For those being seen by colleagues we recommend waiting about 10-14 days.
Age is just a number, and there is no set age for a lift. The average age for a lift is around 55. However, we have lifted people in their early 40s and late 70s. For those with earlier lifts they will avoid any dramatic changes and simply look like they are aging very well. For those having a lift later in life they will have a more dramatic change.
A facelift is the gold standard for lifting. Less invasive options can provide some results but not nearly as much as a facelift. This may involve injecting filler to add volume and lift areas or an energy-based device like FaceTite or Morpheus8.
Yes, we do offer virtual consultations.
A liquid facelift is a misnomer. It involves injecting filler to various areas of the face. This can give a very slight lift but mainly it is for volume. A traditional facelift involves the use of incisions and tightening of the deeper structures of the face to truly give a lift.
A facelift will not stop the aging process, but the skin removed is always gone and the facial structures will always be tighter than if a lift hadn’t been done. Most lifts will last about 10-15 years.
You can except a more youthful and natural appearance.
A deep plane facelift involves extending the surgery below the SMAS and platysma muscle for a certain distance and then lifting and tightening.
The SMAS stands for the skin-muscle aponeurotic system. It is a layer above the muscles and below the skin that is a collagenous layer that can hold tension. It is the most important layer with any facelift. A SMAS facelift will address and tighten the SMAS in one way or another.
Every surgeon will take a different amount of time. For a cheek and neck lift, the most common type of facelift, the procedure takes about 2 to 2.5 hours.
As a double board certified and fellowship trained facial plastic surgeon, you can rest assured knowing you are in excellent hands with Dr. Guy. As he only operates on the face and stays up to date with the latest trends and techniques, you know you will be having a distinguished experience with a true specialist.