Facelift

Facelift surgery, or a rhytidectomy, is designed to restore a more youthful appearance by removing major wrinkles and sagging skin. It involves tightening of the facial and neck muscles as well as the removal of any excess skin.

The skin begins to wrinkle and sag as a result of age, sun exposure and genetics. Children and young adults have smooth, round faces due to evenly distributed fatty tissues in facial contours. Over time, the skin sags in the areas of the chin, jawline and neck that become prominent. Not only does a facelift improve facial appearance but also has a dramatic effect on the neck, enhancing its contour and profile.

A facelift done correctly is not giving you something new and different, it is restoring what you had, it usually makes a patient look like themself 5 to 10 years younger. Recovery as with any surgery depends on the amount of surgery needed, patients overall healing ability and post operative care.  Most patients can return to work in 1-2 weeks post operatively. By the end of the second week most swelling, bruising has resolved and incisions can be covered by hair or makeup.  Final results for a facelift can be expected around 4 months following surgery. 

BEFORE SURGERY

We will evaluate your medical history in order to determine your overall health.

woman receiving facial examination

Your facial cosmetic surgeon will discuss with you if you are a candidate as well as realistic expected results and the surgical and post surgical process.  Our objective is to create a natural appearance, and we pride ourselves on  helping patients look like they feel. Before and After photographs will reveal what the surgery has accomplished, these are typically taken at 4 months post op.

Preoperative Instructions:

Full pre-operative assessment and review of medications will be done and blood thinners will need to be held with the approval of your physician. Consultation with your primary care physician is sometimes indicated prior to proceeding with elective cosmetic surgery.

THE PROCEDURE

A facelift is frequently performed in conjunction with blepharoplasty (eyelid surgery), forehead lift, chin augmentation, liposuction, laser resurfacing or volume replacement to the midface to create an overall rejuvenation of the face. Patients often ask how long do the results last.  The goal of facial rejuvenation is to set back the clock but you will still age as time goes on.  Limiting sun exposure, not smoking and good skin care will help slow down the aging process.  The procedure can be repeated or touched up usually about 10 years after your initial procedure. Facelifts are performed in our facility or in an outpatient surgical center. We want our patients to be comfortable, so we prefer to perform our facelifts with deep IV sedation or general anesthesia.

Your surgeon will make incisions inside the hairline at the temple, in front of the ear, then around the earlobe and behind the ear, ending at the scalp area. Excess skin is removed and sagging muscles and connective tissues are tightened. In some cases, fatty deposits are removed from beneath the chin and neck, to help distinguish the jawline. Incisions are closed with small sutures  for the skin and surgical clips in the hair.

The procedure may take 3-5 hours depending on what the surgical plan is and the complexity of the different areas that will be addressed during the procedure.

POST OPERATIVE CARE

It is necessary to have someone drive you home and stay with you for the first 24 hours. Initially you will have a large dressing wrapped around your head. Typically surgical drains are not needed. If so they will be removed in approximately 24 hours. Stitches around the ears will be loosened or removed by the end of the first week. The sutures or surgical clips in the scalp will be removed in 7-10 days.

To minimize scarring, your surgeon may remove the sutures in stages. Incisions will initially appear as red as they heal and will fade with time. Swelling and discoloration decrease within two weeks. Tightness in your face is due to swelling and will be present for several weeks and there may be slight changes in your hair pattern around the incision.

We recommend that you avoid the sun for several weeks after surgery.

With a skilled facial cosmetic surgeon complications following facelift are rare but can occur. These include bleeding, infection, loss of skin behind the ears, facial nerve injury, discoloration of the skin, numbness, asymmetry and scarring. Infection is rare due to the large blood supply to the face. As mentioned, the risk of bleeding is greater if you take aspirin or blood thinners within 2 weeks of the surgery. The risk of wound complications increases in diabetics, persons with a history of radiation, autoimmune and collagen disease as well as in smokers. If these apply to you please mention it to your surgeon as it may affect surgical plan for obtaining the best outcome, and usually will have a delayed post operative healing. The most common and easily managed complication is a seroma or hematoma.  This is when fluid or blood collects in the tissue after surgery. This is usually easily managed with aspiration of the fluid and placement of a dressing and rarely effects final results.

By following pre- and post-operative instructions, you will minimize potential problems.

RECOVERY: WHAT TO EXPECT

In the weeks to months following surgery, the facial skin and your ears may be numb. There may also be some temporary discoloration as healing begins, which may take a few months to disappear. Occasionally, the facial nerve is bruised or irritated due to swelling during surgery, resulting in temporary loss of function or weakness. However, actual permanent changes to the facial nerve and facial movement is very rare.

The healing process is gradual, so you will not notice final results for up to 4-6 months. A single procedure often achieves the desired results. Most patients who have had facelifts are pleased with their more youthful appearance, helping them look how they feel.