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Should I get an upper facelift before a full facelift?

Oftentimes, there can be confusion in how people and doctors use the terms facelift.  In my experience, it’s not uncommon for patients to ask if they need a “full facelift” or just upper or lower.  There is no codified terminology for differentiating between the various facelifts.  Many times, I’ve found people to be thinking of the traditional facelift when they mention “full facelift.”  The most common conception of a facelift is when you want to fix your sagging jowls and restore a youthful jawline.  Many people are thinking of this when they mention “full facelift.”  However, in my practice, I like to categorize the various facelifts based on their anatomic regions.

An upper facelift is really addressing your brows, forehead and eyes.  You can say upper facelift, but I find it more helpful to offer browlift (or sometimes called forehead lift by some surgeons), upper blepharoplasty, and lower blepharoplasty.  So if you’re asking if you should get upper facelift only, the crucial issue is do you have signs of brow drooping, upper eyelid skin hooding or lower eye bags.  All these signs can make you look tired, angry or sad.  The eyes are a key feature to your beauty; you may have heard that phrase the “eyes are the windows into your soul.”  If you have very early signs of upper facial aging, then nonsurgical procedures can sometimes improve your signs. Botox injected strategically can achieve a subtle brow lift.  Fillers placed carefully in precise locations can support your brows too.  Fillers can also be used to smooth or reshape your forehead.  But if you’ve developed more advanced aging, then these techniques may not be as effective.  There may come a point when the most effective option is surgery.  Rather than say you’re a candidate for “upper facelift,” I like to examine your entire face, focusing on the upper portion.  If you have some brow droopiness, then a browlift may be the best option.  In my hands, I offer three options—endoscopic , trichophytic, and midforehead.   Which technique I offer depends on various factors.  Endoscopic browlift leaves the smallest scars, but can be suboptimal if you have a high hairline.  There is no removal of skin so the amount of lift will be limited.  To achieve more lift, or if you have a high forehead, then the trichophytic browlift is an excellent technique.  The main disadvantage is the scar runs across the entire forehead.  But with a properly designed incision the scar will be well hidden.  Finally, the midforehead lift is typically reserved for men and the incisions are made directly in existing forehead wrinkles to hide the scars.

It’s more common to complain of upper eyelid aging.  Patients tend to notice upper eyelid skin hooding before any brow droopiness.  If your eyelid skin is starting to hang over your eyelash and interfere with make up application or blocking your visual fields, then you benefit from the more common “upper facelift”—the upper blepharoplasty.  Upper blepharoplasty is a surgery that removes the excess upper eyelid skin.  The goal is to rejuvenate your eyes, make them look more open and more youthful.  This is a great procedure that can be performed in the office under local anesthesia.  Obviously, if you’re anxious about surgery, iv sedation can also be used to make this more comfortable.  The scar heals very heal and almost impossible to see once it’s completely healed.  I do feel the design of the incision should be different between men and women.  In women, I like to make the incision higher to create a “larger” eyelid.  In men, I think a more conservative incision creates a more natural look.  In my opinion, a higher incision in men will create a more feminine look.  Men typically seek upper blepharoplasty to help improve their visual fields.

So if you’re unhappy with signs of aging in your brows and eyes, then you are a candidate for browlifts and blepharoplasties for upper facelift.  But if you’re bothered by jowling and loose neck skin, then you are a candidate for a lower facelift.  Only if you want correction of both upper and lower face aging would you be a candidate for a full facelift.  A full facelift really means doing a browlift, upper blepharoplasty, facelift and necklift.    It’s important to see a board certified facial plastic surgeon or plastic surgeon for an exam to determine what procedures you should consider.

For more information about San Antonio facelift surgery, please visit our interactive website at Dr. Kenneth Yu Facial Plastic and Reconstructive Surgery is a qualified team of experts serving the San Antonio, Texas area. To schedule a consultation, please contact our Concierge Patient Coordinator at (866) 574-1719 or