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Our faces determine how we appear to the world; it’s even been said that our eyes are the “mirror of the soul.” Today there are many techniques, both surgical and non-surgical, to rejuvenate the face and enhance or modify individual features. Dr. O’Connell believes that the role of aesthetic procedures is not just to reverse the signs of aging but to help reflect how we feel — the beauty of youth combined with the appearance of health and well-being. Because each face is unique and is affected differently by the aging process, at Total Aesthetics ™each patient’s aesthetics and goals are carefully reviewed and an individualized treatment plan is formulated to help achieve a refreshed, natural, balanced facial appearance through safe and effective aesthetic procedures. Dr. O’Connell’s preference is toward less-invasive approaches and we’re pleased to offer the latest technology, procedures, and products to optimize your results with the shortest recovery time. Dr. O’Connell performs the majority of facial procedures under local anesthesia, sometimes with sedation, in the privacy of our accredited and state licensed outpatient surgical facility.


Short-incision Facelifts

There comes a time where non-surgical alternatives just aren’t able to reverse those troublesome signs of aging. With a mini facelift, the cheeks are gently lifted, the jawline and jowl areas are smoothed, and the facial shape conveys the appearance of youth. The procedure can often be performed in the privacy of our licensed surgical facility under local anesthesia. The incisions are shorter and the facelift recovery time is faster than a full-incision traditional facelift. Dr. O’Connell is a published authority on short-incision facelifts and his landmark article outlining the Bidirectional and Extended Bidirectional Lifts was published in the prestigious Aesthetic Surgery Journal in late 2015.

What is a short-incision facelift procedure?

For many patients, particularly those between ages 45-62, a mini-facelift, rather than a traditional facelift, is an excellent choice for facial rejuvenation. The scars are shorter and stop at the base of the ear. This technique works best for those with sagging of the mid-face, especially the jawline and jowl, without significant laxity of the neck. Dr. Joseph O’Connell utilizes his Bidirectional technique to gently and naturally elevate the cheeks and mid-face. This is a highly specialized, more advanced lift than other short-incision techniques that incorporates features of a MACS lift, offering long-lasting results.

Am I a candidate for a short-incision lift?

The best candidates for a short-incision lift have laxity in the mid-face, especially the lower mid-face along the jawline and jowl but without significant laxity in the neck. Fat below the chin can be removed during the procedure.

In addition, patients considering a short-incision facelift should be:

  • In good physical and mental health.
  • Accepting of the associated risks as well as the inevitable scarring and asymmetry that accompany the procedure.
  • Have realistic expectations about what a short-incision lift can and cannot accomplish.
  • Understand that only minimal improvement in neck contour will result.
  • Willing to use their hair to camouflage the incisions for several months and perhaps even permanently, especially in the area in front of the sideburn.

Facelift Surgery (Rhytidectomy), or Traditional Facelift

Our face and eyes show the natural changes of age more than any other area of our body. A traditional facelift can dramatically restore the face to a more youthful appearance with smoothing of creases, elevation of the cheek, and jowl with the restoration of a more defined jawline and neck. Dr. Joseph O’Connell believes that the goal is not to look unnaturally tight or over-pulled but rather to recreate a more youthful, relaxed, confident, and more beautiful version of yourself. Dr. O’Connell also believes that facelifts should be volumizing and tailored specifically for you. His techniques are designed to provide a natural, unoperated look with the shortest facelift recovery time possible.

What is a facelift?

A facelift, or rhytidectomy, is a procedure that is designed to achieve a more youthful appearance by addressing the changes caused by gravity and volume loss. While fat is often removed from the neck, Dr. O’Connell prefers to either add volume or simulate the appearance of added volume elsewhere in the face. Facelifts reposition sagging, lax tissues in the face and neck and also refine the jawline and sculpt the jowl area.

Am I a candidate for a facelift?

The best candidates for a traditional facelift have laxity in the face, especially the cheek and lower mid-face along the jawline and jowl and also laxity in the neck. Fat accumulation below the chin is commonly removed during the procedure.

In addition, patients considering a facelift should be:

  • In good physical and mental health.
  • Accepting of the associated risks as well as the inevitable scarring and asymmetry that accompany the procedure.
  • Have realistic expectations about what a facelift can and cannot accomplish.
  • Willing to use their hair to camouflage the scars for several months and perhaps even permanently, especially in the areas in front of the sideburn and behind the ear.

The Bidirectional (Quill) Facelift

Dr. O’Connell’s special interest within the field of plastic surgery is in less-invasive facial rejuvenation. His work on the “Baby-Boomer Facelift” was published in 1999 and in 2003 his article entitled “Refinements of minimal incision rhytidectomy” was published. In late 2015 his article entitled “Rhytidectomy Utilizing Bidirectional Self-Retaining Sutures: the Bidirectional Lift and the Extended Bidirectional Lift” was published as a lead article in Aesthetic Surgery Journal. In this article, he set forth his techniques for both short-incision facelift and traditional, full-incision facelift and he outlined the safety advantages provided by his technique. These procedures are also known as the Quill Facelift or Quill-Lift.

Because bi-directional, self-retaining “Quill” sutures are used to elevate the structures of the face and tighten the neck, no knots are required. This provides an important safety advantage because there’s no need to dissect into the deeper tissues of the face in order to anchor and bury the suture knots. The Quill sutures are slowly absorbed by the body so they can’t serve as a focus for infection down the road.

The Bidirectional Lift incorporates some of the key elements of a highly specialized technique, the MACS lift. Both techniques result in volumization of the cheek area, without the need for implants or injections. The result is a natural, refreshed, fuller, healthier, and more youthful appearing image of yourself.

What is a Quill-lift?

The Quill-lift is a facelift technique developed by Dr. O’Connell that utilizes self-retaining knotless sutures to elevate, tighten and re-suspend the tissues of the face and neck.

Who is a candidate for a Bidirectional Lift?

There are two versions of the Bidirectional Lift – the minimal incision Bidirectional Lift and Extended Bidirectional Lift. Because of this, the Bidirectional Lift can be performed on virtually anyone who is a candidate for a minimal-incision or traditional facelift. Candidates for the Extended Bidirectional Lift usually have more noticeable laxity in the neck.

What are the Advantages of a Bidirectional Lift?

Because no knots are necessary there’s no need to dissect deep into the face in the areas of important nerves and blood vessels. Without knots, there’s less inflammation, less swelling and less risk of infection.

Reoperative Facial Surgery

While the benefits of facial cosmetic surgery can be visible for many years, the aging process continues inexorably – we continue to lose volume over time, the sun still shines, and the law of gravity still applies. One of the greatest challenges in facial aesthetics is maintaining a youthful appearance without looking artificial or “operated upon” and this especially holds true for secondary or revisional facelift surgery. Today, many patients have also had non-surgical aesthetic procedures that need to be taken into consideration when planning aesthetic surgery.

Dr. O’Connell especially enjoys the challenges that accompany revisional or secondary surgical procedures. He will carefully help you navigate through such concerns as pre-existing scars, changes in ear shape, and the occasional functional issue, to find a safe and cost-effective approach to your aesthetic goals.

At the time of your consultation, complete copies of your medical records are usually not required; however, it is helpful to bring copies of prior surgical notes as well as any preoperative photographs that may be available.

Facelift FAQs

  • What is a MACS lift?

    A MACS lift is one type of short-incision facelift that utilizes specialized techniques of suturing the internal structures of the face. This type of facelift has achieved great popularity worldwide. A MACS lift is an acronym for the Minimal Access Cranial Suspension lift pioneered by Drs. Tonnard and Verpaele in Belgium.

  • What is the facelift recovery time?

    In general patients in our practice are able to return to sedentary occupations in about ten days.

  • Is anything removed from the face during a facelift?

    Because the natural aging process will result in volume loss over time Dr. O’Connell believes that nothing should be removed from the face, with the exception of fat in the neck and jowl area. Dr. O’Connell’s facelift techniques are volumizing in that they actually add or simulate the addition of volume to the face.

  • What type of anesthesia is used for a short-incision facelift?

    Dr. O’Connell prefers to perform facelift procedures under local anesthesia. Sometimes sedation is administered during the procedure. Many short-incision facelift procedures are performed without need for sedation in our office-based surgical facility.

  • What are the risks of a short-incision facelift?

    All surgery carries uncertainty and risk and a discussion of the alternatives and potential complications is an important part of your preoperative consultation(s) with Dr. O’Connell. The more common risks of a minimal incision facelift are bleeding, infection, unsatisfactory scars, hair loss and minor wound healing difficulties.

  • Can a facelift be done without scars?

    Unfortunately no. All surgery leaves scars although facelifts are designed to hide the scars in natural creases or camouflage them with hair.

  • How long does a facelift last?

    Facelifts don’t stop the aging process but merely “turn the clock back.” While a person’s lifestyle can greatly affect the aging process, most patients will look better than nature intended following a facelift for most of their life. Many patients never have a second facelift while others have additional procedures at a later time.

  • How long is the facelift recovery process?

    Most patients are able to return to work in about 10 days. You should allow more time prior to major social engagements. Mini-facelift recovery time is slightly shorter.

  • Are other facial procedures performed at the same time?

    Additional facial procedures such as eyelid surgery, brow lifting, liposuction of the neck, and fat transfers are often performed at the time of a facelift. Dr. O’Connell’s techniques are individualized for each patient, depending upon their aesthetic goals as well as the manifestations of facial aging that are present.

  • What type of anesthesia is used in facelift surgery?

    Dr. O’Connell performs most facelifts under local anesthesia with monitored anesthesia sedation. Many short-scar facelifts, or mini-lifts, are performed solely with local anesthesia.

  • What should I bring to my consultation with Dr. O'Connell?

    Please bring some facial photographs in both profile and frontal view from approximately 10 years ago to your consultation. This helps Dr. O’Connell evaluate the effects of the aging process upon your face.

  • Are there risks involved with facial rejuvenation surgery?

    As with any surgical procedure, there are risks and potential complications. A careful consideration of the risks, alternatives, and potential benefits of any surgical procedure is an important part of the pre-operative consultative process that you will have with Dr. O’Connell.

Our dedicated team of nurses and administrative personnel strive to make your visit an exceptional experience.

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Total Aesthetics

208 Post Rd. West, Westport, CT 06880

Tel: (203) 454-0044

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