As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck.
A facelift (technically known as rhytidectomy) can’t stop this aging process. What it can do is improve the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or Rhinoplasty.
The Best Candidates
The best candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well.
A facelift can make you look younger and fresher, and it may enhance your self- confidence in the process. But it can’t give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
Considerations Before Having Surgery
When a facelift is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Still, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable. Poor healing of the skin is most likely to affect smokers. You can reduce your risks by closely following your surgeon’s advice both before and after surgery.
Planning Your Surgery
Facelifts are very individualized procedures. In your initial consultation the surgeon will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery.
Your surgeon should check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. Be sure to tell your surgeon if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting. If you decide to have a facelift, your surgeon will explain the techniques and anesthesia he or she will use. Don’t hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.
Preparing For Your Surgery
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it’s especially important to stop at least a week or two before and after surgery; smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas.
Where Your Surgery Will Be Performed
All cosmetic procedures are performed on an outpatient basis in our state of the art in-house operating suite. Minor procedures are also performed in our office’s minor surgery rooms.
Type Of Anesthesia
Facelifts are performed with a general anesthesia, so you’ll sleep through the entire operation.
A facelift usually takes several hours or somewhat longer if you’re having more than one procedure done. Every surgeon approaches the procedure in his or her own way. Some complete one side of the face at a time, and others move back and forth between the sides. The exact placement of incisions and the sequence of events depends on your facial structure and your surgeon’s technique.
Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin.
In general, the surgeon separates the skin from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The surgeon then tightens the underlying muscle and membrane, pulls the skin back, and removes the excess. Stitches secure the layers of tissue and close the incisions; metal clips may be used on the scalp.
Following surgery, a small, thin tube may be temporarily placed under the skin behind your ear to drain any blood that might collect there. The surgeon will wrap your head in bandages to minimize bruising and swelling.
After Your Surgery
There isn’t usually significant discomfort after surgery; if there is, it can be lessened with the pain medication prescribed by your surgeon. Some numbness of the skin is quite normal. It will disappear in a few weeks or months. Your doctor may tell you to keep your head elevated and as still as possible for a couple of days after surgery, to keep the swelling down.
If you’ve had a drainage tube inserted, it will be removed one or two days after surgery. Bandages, when used, are usually removed after one to five days. Don’t be surprised at the pale, bruised, and puffy face you see. Just keep in mind that in a few weeks it will diminish.
Most of your stitches will be removed after about five days. Your scalp may take longer to heal, and the stitches or metal staples in your hairline could be left in a few days longer.
Returning To Your Routine
You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb. Your surgeon will give more specific guidelines for gradually resuming your normal activities. Above all, get plenty of rest and allow your body to spend its energy on healing.
At the beginning, your face will be swollen; your facial movements may be slightly stiff. Some bruising may persist for two or three weeks, and you may tire easily. By the third week, you’ll look and feel much better. Most patients are back at work about ten days to two weeks after surgery. If you need it, special camouflage makeup can mask most bruising that remains.
Your New Look
You’ll have some scars from your facelift, but they’re usually hidden by your hair or in the natural creases of your face and ears. In any case, they’ll fade with time and should be scarcely visible.