Tuck-ups are small-incision procedures that target specific problems such as sagging of the neck, a jowl in the middle of the jawline, or sagging in the temple area near the outside corners of the eyes. Tuck-ups are generally performed for younger patients who have an area that seems to be aging more quickly than the rest of the face, or for patients who have had more extensive procedures such as facelifts and forehead lifts and require a “tune-up” of the original work. They have the advantage of being smaller surgeries so there is generally less swelling, bruising and downtime.

Patients can undergo tuck-ups and sometimes return to work in as little as four or five days. With strategic scheduling, this can lead to only two or three work days missed. Tuck-ups have become popular for our “on the go patients” and are recommended when appropriate. If a larger degree of improvement is needed to achieve the patient’s goals, then a more extensive procedure, such as a facelift or forehead lift is planned.

Sagging of the eyebrows and deep lines in the forehead can give one a tired, even angry appearance. The forehead/eyebrow lift is designed to restore the eyebrows to a higher, more youthful postion, and soften the wrinkles so often seen in the forehead. The surgeon is careful to strive for a natural-looking result which does not make the patient look permanently surprised.

The eyebrow lift may be performed through an incision at or behind the hairline, depending upon the patient’s specific hair pattern. A recently developed technique involves using much smaller incisions and lighted retractors to perform the procedure, and is applicable to some, but not all patients.

One point that patients sometimes find surprising is that lifting the brow can often dramatically improve the appearance of the upper eyelids and allow the surgeon to perform a more conservative upper eyelid blepharoplasty, while still realizing a beneficial effect.

Blepharoplasty is performed to correct deformities of the eyelids. Like other face and neck areas, the eyelids may develop wrinkles and bulges due to either heredity or aging. Pouches, both at the inner part of the upper lids and in the lower lids, are generally due to forward pressure caused by accumulations of fat above and below the eyes. Such excess fat and excess skin are removed in the eyelid procedure. Upper lid correction is done at the same time as the lower lid surgery. Dr. Godin frequently performs the transconjunctival type of lower eyelid blepharoplasty, in which fat can be removed from behind the eyelid without making an incision in the skin.

The operation takes about one to two hours and may be performed under local anesthesia or light sedation in our office surgical suite. Patients generally experience an early return to routine living.

There is usually little or no pain in the post-operative period. Each operation is followed by varying degrees of swelling and discoloration, which usually subside within 10 days. By this time, too, the thin scars can be camouflaged by make-up. These scars gradually blend in well with the surrounding skin and, after several months, are usually visible only on close scrutiny.

Corrective surgery of aging eyelids is frequently performed in combination with facelift or eyebrow surgery.

Otoplasty is the procedure used to reposition protruding ears closer to the head. Ear deformity can cause deeper emotional trauma than is generally realized, even by the parents of children who have the condition. Because the physical and psychological improvement following the operation is usually dramatic, it is most rewarding to the patient and gratifying to the doctor. Surgery is usually recommended before school age, approximately six years or younger, to avoid classroom teasing. Surgery for older children, teenagers, and adults may also be performed.Local anesthetic with sedation is usually used in the office operating room for adults and teenagers, while a general anesthetic given in the outpatient surgery center is preferred for youngsters. The Otoplasty procedure lasts approximately one hour per ear, and patients go home the same day, usually with very little post-operative pain.The dressing is removed the day after surgery, and a lighter dressing is placed to help maintain the new position and shape of the ears. Afterwards, a headband is worn, especially while sleeping at night, to help protect the surgical result

The array of available synthetic facial implants is continually changing. Dr. Godin is a nationally recognized researcher into the uses and safety of one of the most widely used implant materials: medical-grade Gore-Tex. Synthetic implants are most commonly used to build up the bridge of the nose in rhinoplasty, to improve a receding chin, and to give fullness to the cheekbone or malar area.

The smaller incisions of a Micro-Mini Lift® make it a minimally invasive facelift. Contact us today if you are interested in Micro-Mini Facelift in Richmond, Virginia.

Through years of work, I have developed a modification of the facelift, which I call the Micro-Mini Lift®. This is most appropriate for patients with a small amount of excess skin in the jaw line and/or minor looseness of the neck. The incisions are small and recovery time is usually a week or less. I perform this lift mainly for patients in their forties and early fifties who are beginning to see some loosening of the tissues but are not ready for a larger lift. I believe it is crucial to do the right procedure at the right time for my patients and so the Micro-Mini Lift® is a great addition to my face and neck lift line up.

A Conversation with Dr. Michael Godin about the Micro-Mini Lift® minimally invasive facelift

Q: What is the Micro-Mini Lift®?
A: A small-incision procedure to firm the jawline and improve drooping in the neck.

Q: Who can benefit from it?
A: Patients with early jowling and looseness in the neck. Generally, they are in their 40’s or early 50’s.

Q: Why is it called the Micro-Mini Lift®?
A: Because the incisions are smaller than a standard facelift or even a facial or neck tuck-up, it is a mini-lift. “Micro” describes the surgeon’s mindset – an almost microscopic attention to detail.

Q: Can the Micro-Mini Lift® be customized?
A: Yes, it is individualized in every case. For example, the deeper layer (SMAS) may simply be tightened or partially removed and repositioned, depending on tissue looseness and thickness.

Q: If I have a Micro-Mini Lift® now, can I have a more traditional lift when I’m older?
A: Yes, this procedure complements having a more extensive lift later in life. In fact, by creating a firm layer of healing, it can be used to enhance future results.

Are you interested in a Micro Mini Facelift?

Give us a call, 804.285.8578, or schedule your appointment online!

We also offer the Micro-Mini Lift® at our La Jolla and Beverly Hills offices.

Facelift Overview

The facelift procedure both improves wrinkling caused by loose skin, and also lifts and tightens the face and neck tissues, which tend to sag increasingly with advancing years.

As medical advances, better nutrition, and exercise increase the life span, many aging women and men find that they look older than they feel. The popularity of the facelift stems from its ability to turn back the clock on jowls and wrinkles.

The amount of improvement from surgery depends on the degree of wrinkling. If wrinkling is significant, results may be dramatic. If sagging is just starting and the operation is performed to keep the patient looking young, the improvement may be more subtle, causing friends to remark that the patient “just looks better.”

In some people, fat gradually develops below the chin to make a “double-chin.” The mound of fat obliterates the ideal chin-neck line and contributes to the appearance of aging. Other people have a “turkey-gobbler” deformity, consisting of several vertical bands which run from the chin to the base of the neck. Both problems can be addressed during the facelift procedure.

Lasting Results from a Facelift

A commonly asked question is: “how long will my facelift last?” The answer is that there will always be some positive effect: the patient should always look better than he or she would have at any given age. The facelift sets the clock back, but the clock continues to run. Another great benefit of the facelift — one that often justifies it being done as early as the patient’s 40s as part of a preventive maintenance program — is that the patient can maintain a youthful appearance for the rest of his or her life, simply by having periodic “tuck-ups” every few years. These relatively minor procedures are usually followed by very little swelling and discoloration, and downtime.

Facelift Surgery

The facelift operation is usually performed under sedation (not general anesthesia!) in our office Operating room. Patients usually go home on the same day with our nurse who has been extensively trained in taking care of Dr. Godin’s patients. It is a great comfort for the patient to have an experienced expert on hand to maintain comfort during the initial recovery.

The patient is able to wear makeup one week after the procedure and by two weeks is usually presentable enough to go to any occasion. Sutures are removed during the first week after surgery. In a short time, the scars, most of which are hidden in the hair and behind the ears, become inconspicuous except upon close scrutiny.

13 Most Commonly Asked Questions by Facelift Patients

1. Am I a candidate for a facelift?

There is no one facelift and most people from their mid-40s on can benefit from some degree of firming of the neck and/or jawline. This varies of course, by the patient’s individual appearance, their genetic history, and the amount of sun exposure they have had.

2. Are there different types of facelifts?

Absolutely. A facelift may involve improving the contour of the neckline, improving the jaw line and removing jowls, reducing the depth of facial folds such as the nasal labial fold and “marionette lines,” and improving the size, position and definition of the cheeks. The important thing is that the surgeon has the experience and aesthetic judgment to choose the correct type of lift for the patient.

3. How long does a facelift take to perform?

Approximately three hours, although this can vary depending upon the amount of work that needs to be done and whether it is a first-time lift or a revision procedure.

4. Speaking of revision procedures, how often are they necessary? In other words, how long does a facelift last?

A facelift lasts for a patient’s entire life in that the patient will always look more youthful for having done it. In the facelift procedure, the deeper tissues are tightened and excess facial and neck skin is actually removed so there is simply less tissue remaining to sag. Having said this, the facelift turns back the clock and does not stop time. Patient’s necks and jaw lines continue to change over time and it is not unusual for a patient later in life to want further improvement of these areas. The important consideration is that this should not be done too often or too soon and also in revision lifts there are some technical challenges that an experienced surgeon will know how to overcome.

5. Does the facelift procedure hurt?

The procedure does not hurt at all. The patient is under anesthesia. After the procedure, most patients say there is mild discomfort. This takes the form more of tightness than actual sharp pain. It is normally easily manageable with pain medication, which becomes less necessary after the first 24 to 48 hours.

6. Will I have bruising after a facelift?

Yes. Most patients do have some degree of bruising. It varies depending on the patient’s genetic makeup and any medications that they may be taking as well has how large an area required correction.

7. When am I presentable?

Patients are normally presentable 10 days to two weeks after a standard facelift and sooner after a smaller modified lift such as the Micro-Mini Lift®. I tell patients that they should easily be back to work and meeting clients within two weeks and can attend their daughter’s wedding in three weeks.

8. What is the cost?

The cost varies depending upon the amount of work to be done and is quoted individually for patients at the time of their consultation.

9. What type of anesthetic is used?

In my office, all of these procedures are done under intravenous sedation administered by a board certified anesthesiologist. This means that the patient does not have general anesthesia. There is no tube down the patient’s throat and none of the anesthetic gases are used. The patient is simply very relaxed by I.V. medications and then local anesthetic is added to keep the patient comfortable and sleepy during the procedure.

10. Do I have to go to the hospital for this procedure?

No! My office has an operating suite accredited by the American Association for Ambulatory Healthcare. The vast majority of our facelifts and other cosmetic procedures are performed there in a clean, safe, and efficient environment.

11. Are surgical drains used?

No. I have not used surgical drains in facelift surgery in over ten years. My facelift technique is a meticulous one in which all bleeding is stopped immediately by using electric cautery. This is the equivalent of “cleaning the kitchen as you go” rather than at the end. It takes a bit longer to do the surgery this way but the patients have less bruising and an easier recovery.

12. What do you like about a facelift?

I enjoy the facelifting procedure tremendously. In fact, it is my most common surgical procedure. It is always gratifying and sometimes amazing to see 10, 15, or even 20 years come off of a neck or jaw line on the table. I get to see the beauty of the patient’s underlying structure and show it off to the world.

13. I understand that you are a sculptor as well as a physician. Has this influenced your facelift procedures?

Yes. I do enjoy sculpture and work mainly in clay. In this endeavor, I am actually creating something that I hope will become beautiful out of a shapeless mass. It is a different kind of challenge than correcting existing aging or deformity. It trains the eye and the mind in a different way and I believe it gives me a better aesthetic sense that helps me deliver a beautiful result for my patients.