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THE SEATTLE FACIAL PLASTIC SURGERY CENTER
WILLIAM PORTUESE, M.D. | 1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
THE SEATTLE FACIAL PLASTIC SURGERY CENTER
Surgical Staff
Dr William Portuese - board certified facial plastic surgeon
Dr. William Portuese is one of the top-rated facial plastic surgeons in America
Surgical Facility
Our state-of-the-art facility will make your experience comfortable and safe.

Facial Plastic Surgery Descriptions

MID FACELIFT: The mid facelift is a common surgical procedure where the goal is to give a lift only to the cheek areas. This procedure is usually performed under a general anesthesia. The incisions are made in the temporal area and underneath the upper gum line, and a pulling and tightening effect is performed on the muscle and fascia layers of only the cheeks. An excellent alternative to this technique is to place cheek implants in the cheek area overlying the maxillary bone. As the face ages there is a volumetric reduction in the amount of fat and an overall volume loss of tissues in the cheek; therefore, sagging cheeks occur. Re-suspending the cheeks with a mid facelift helps. In addition, volumetric augmentation with cheek implantation works well. Cheek implants are placed through a gingival incision on the upper lip above the teeth, and they are placed on the natural cheekbone. They are undetectable both by look and feel, and they feel just like the patient’s own normal cheekbone. The mid facelift or cheek implants are usually performed on patients in their 40s and 50s who have limited aging only to the cheeks and do not require a facelift, a neck lift, or any other facial rejuvenation procedure. The cheek implants can also be performed in combination with a facelift if there is facial laxity and a flat cheek area. The surgery is performed at the Seattle Facial Plastic Surgery Center, which is a Medicare-certified surgery center, under the direction of Dr. William Portuese. Board-certified physicians/anesthesiologists come from Swedish Medical Center to perform the anesthesia. Out-of-town patients can stay at one of the area’s three hotels within one block of the office.

NECK LIFT: A neck lift is performed on someone in their 30s, 40s, or early 50s, when there is no excess neck skin. The goal is to remove fat and tighten muscles of the neck without removing any skin in the neck. If there is a laxity of skin in the neck, the neck lift is not the correct operation to perform. In the neck there is fat above and below the platysma muscle, and both need to be addressed. A 1-inch incision is placed underneath the chin area hidden in the submental crease, and there are two 1/2-inch incisions placed behind the ear in the retroauricular sulcus. Indirect liposuction is performed from the postauricular area to define the posterior jawline. Direct liposuction and manual sculpting and removal of fat in the entire submental area are performed after lifting up the submental skin area. Once the fat is removed above the platysmal muscle, the area is manually sculpted and additional fat is removed from underneath the muscle. This creates a better definition of the jaw line both from the side and front profile. A sharp delineation of the jawline is then created by sewing the anterior platysma muscles together. This is all achieved using the submental approach. The incisions are closed meticulously with fine sutures. In addition, Jackson-Pratt drains are placed underneath the skin in the neck to remove blood and fluid in the near-term postoperative recovery. These drains help to alleviate blood accumulating underneath the skin and are removed in a few days after the surgery. The neck lift is the correct operation for someone who has excess fat in the neck and desires a better neckline definition, however, has good skin tone and does not need any skin removal. This is usually done under a general anesthesia but can be performed under intravenous sedation or twilight anesthesia. The necklift is a much better alternative than traditional submental liposuction, which does not address subplatysmal fat or neck muscle tightening. The necklift surgery is performed at the Seattle Facial Plastic Surgery Center, which is a Medicare-certified surgery center, under the direction of Dr. William Portuese. Board-certified physicians/anesthesiologists from Swedish Medical Center perform the anesthesia. Out-of-town patients can stay at one of the area’s three hotels within one block of the office.

MINI LIFT: The mini lift or tuck facelift has many description terms such as an S-lift, which is a minor variant of the mini lift. A mini lift involves tightening the facial cheek and jowls however, it does not address the neck, which is only addressed through a face/neck lift or just the neck lift. A mini lift is a procedure where the incisions are placed in the anterior temporal hairline along the sideburn and behind the tragal portion of the ear in a small portion behind the ear. The undermining that is performed is only in the high cheekbone area, and the muscles are tightened in the facial area (also known as the superficial muscular aponeurotic system or “SMAS”). The primary goal of a mini lift, tuck facelift or S-lift is to remove the jowls. This operation is usually performed under a general anesthesia but can be performed under twilight intravenous sedation. No drains are required for this operation and patients tend to get back to regular activites sooner with less bruising and swelling than a traditional face/neck lift. If there are preexisting neck conditions such as submental fat, skin laxity, and anterior platysmal muscle bands, this is not the correct operation for the patient. The surgery is performed at the Seattle Facial Plastic Surgery Center, which is a Medicare-certified surgery center, under the direction of Dr. William Portuese. Board-certified physicians/anesthesiologists from Swedish Medical Center perform the anesthesia. Out-of-town patients can stay at one of the area’s three hotels within one block of the office.

FACE/NECK LIFT: A face/neck lift is a comprehensive facial rejuvenation procedure. This procedure encompasses rejuvenation for the face, the jowls and the neck. Removal of any fat underneath the neck including tightening of the anterior muscle platysmal bands and the muscles in the face is also included in the face/neck lift. This operation is a combination of a neck lift and a mini lift or a tuck facelift. The incisions are placed at the anterior temporal hairline and behind the ears and up into the retroauricular incision. They are placed in such a fashion that patients are still able to wear their hair up off their shoulders after the incisions have healed. There is also a 1-inch incision underneath the chin to allow sculpting of the neck structures. The facial muscles, including the superficial muscular aponeurotic system (SMAS) are tightened along the cheekbone area and the jowls are lifted. Any excess facial and neck skin is tightened and the fat above and below the platysmal muscle in the neck is removed. In addition, the neck muscles in the center front of the neck underneath the chin area are tightened, as well as the neck muscles in the posterior portion of the neck to accentuate and create a new defining jawline. Two Jackson-Pratt drains are placed underneath the neck area and left in place for a few days in the immediate postoperative period to remove blood and fluid from underneath the skin. The face / neck lift is performed under a general anesthesia and post operative pain is usually minimal. The surgery is performed at the Seattle Facial Plastic Surgery Center, which is a Medicare-certified surgery center under the direction of Dr. William Portuese. Board-certified physicians/anesthesiologists from Swedish Medical Center perform the anesthesia. Out-of-town patients can stay at one of the area’s three hotels within one block of the office.