Facelift

A facelift is the most comprehensive approach to treating facial wrinkles and sagging caused by aging. The surgery varies in range from minimally invasive ‘lunchtime lifts’ to more extensive, sophisticated surgery. A facelift removes excess skin, tightens underlying tissues and muscle and
redrapes skin on the face and neck. It can correct midface sagging, marionette lines, jowls and a double chin, maintaining its reputation as the ‘gold standard’ for facial rejuvenation.

When to Consider a Facelift

– If you feel that your face does not reflect your youthful spirit and energy level
– If you determine that your facial sagging and excess skin is a social or career obstacle
– If you show signs of facial aging but still have some skin elasticity
– One day you look in the mirror and realize that time, gravity, sun exposure and heredity have taken a toll and you simply do not look like yourself any more.

Considerations

Pros
– A facelift can improve many areas of the face in one surgery
– Can last for ten years or more and can make you appear ten to fifteen years younger
– Can recontour the neck and jawline better than all other techniques

Cons
– A facelift will not create a ‘new’ you, just a younger version of yourself
– There will be some downtime associated with this procedure
– Depending on your age and skin type, you may want a secondary procedure later on Am I a good candidate for a facelift?
– Sagging skin in your midface and/or jawline
– Deep creases extending from your nose to the corners of your mouth (nasolabial folds)
– Lines extending from each corner of your mouth down your chin (marionette lines)
– Facial fat (volume) that has fallen or is displaced
– Sagging and loss of muscle tone in the lower face, resulting in jowls
– A double chin, resulting from loose skin and excess fatty deposits under the chin and jaw
– Creased and sagging skin in your neck.

About yout procedure

How is a facelift procedure performed?
Once the incisions are made, various degrees of ‘undermining’ of your skin is performed, and the deeper layers of your face are lifted. Undermining separates the overlying skin of the face and neck from the muscles and tissues deep to the skin. This frees or loosens facial and neck skin so it can be redraped at the end of the procedure, making sure skin is smooth.
Then, your surgeon will raise the skin from the temples, cheeks, and neck, and lift and reposition the underlying connective tissue, removing excess fat and skin. If this procedure is performed in conjunction with a neck lift, the surgeon will draw the neck muscles together, stitching them together at the midline to form a strong sling of muscles that supports the entire neck and jaw. Your surgeon may also include liposuction of the neck and jowls. Facial implants may be added to increase cheek or chin volume.
Finally, your surgeon redrapes the skin over the new underlying structure and closes the incisions with stitches and/or small metal clips. Where needed, drainage tubes may be inserted. A padded, supportive dressing is usually applied.
The goal of your aesthetic plastic surgeon and the entire staff is to help you achieve the most beautiful and natural-looking results, and to make your surgical experience as easy and comfortable as possible.

What will my facelift incisions and scars be like?
Facelift scars can be virtually invisible: narrow, flat, and well placed behind the ear so you can wear your hair close-cropped.

Preparing for Your Procedure

– Stop smoking six weeks before your surgery to promote good wound healing and to reduce scarring.
Smoking also increases your risk of serious complications.
– Avoid taking aspirin, nonsteroidal anti-inflammatory medications (NSAIDs: Advil, Motrin, Aleve) and
vitamins/homeopathic regimens. These can increase bleeding.
– Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.

Aftercare and Recovery

Immediately after your facelift surgery
– You may be placed in a compression garment or wrap immediately after surgery. Wear this exactly as directed. Remove it only as directed for cleansing incisions or showering.
– To minimize swelling, recline rather than lie down. This will be more comfortable for you, and can
reduce swelling. Always keep your head elevated. Do not bend forward or over.
– You will have a mild to moderate amount of pain and discomfort. This should be easily controlled with oral medications. If it is not, call your surgeon.
– The discomfort and pain should begin to decrease within forty-eight hours after surgery. If you have a significant increase in pain after this period, call your plastic surgeon. Severe pain is rare; if you experience this, call the doctor immediately.
– Expect bruising and swelling. These symptoms will peak within the first thirty-six to forty-eight hours after surgery and will gradually subside over the next ten to fourteen days. To minimize swelling, sleep with your head elevated for a couple of weeks after the surgery.
– It is not unusual to have some slight drainage for the first forty-eight hours. A bulky cotton compression dressing with drains will cover your scalp and face for one to two days to help prevent blood collections under the skin.

Recovery time frame after a facelift

Follow all postoperative instructions, including information about bandages, drains, taking an antibiotic (if prescribed), and the level of activity that is safe. Your doctor will let you know the signs of problems to watch for, such as signs of infection. Recovery time will vary by patient and in relation to the extent of your surgery.

The first week

– You may not drive for at least a week after surgery.
– A feeling of tightness in your neck is not unusual after surgery. This sensation is most pronounced in the first one to two days after surgery while the bulky dressing is in place.
– During your first postoperative visit, the bulky dressing and usually the drains will be removed. You may be placed in a supportive elastic face garment that is to be worn according to your doctor’s instructions.
– Do not take any aspirin or any anti-inflammatory compounds for two weeks before and two weeks after your surgery unless you first discuss it with your surgeon.
– It is recommended to sleep with your head elevated forty degrees for two weeks; an additional pillow or two under your mattress may help, if necessary.
– Apply cool (not cold) compresses to your eyes. Do not apply ice or anything frozen directly on the skin. Soak soft, white washcloths or gauze squares in ice water and wring out well. Apply directly to the eyes, but not to the cheeks or neck. Do not apply any pressure. Apply cool compresses for no longer than twenty-minute intervals. Do not apply heat.
– Stay up (sitting, standing, walking around) as much as possible after you return home. This helps to decrease facial swelling.
– Avoid bending or lifting heavy things for one week. Besides aggravating swelling, this may raise your blood pressure and encourage bleeding.
– You may wash your hair gently twenty-four hours after your surgery. Do not use the usual heat-type hair dryer; use the cap type or use the cool setting on the blow dryer.

– You may shower or bathe the day after surgery, but do not let the spray directly strike your face. It is permissible to get your suture lines wet, however.
– Report any excessive bleeding that persists after applying pressure for fifteen to twenty minutes.
Two to six weeks
– Don’t go swimming, diving, water skiing, or participate in strenuous athletic activity for at least one month after surgery.
– You can expect to experience some numbness around your ear lobes, face, and neck for several weeks after surgery.
– Refrain from any strenuous exercise and from bending or lifting.
– You may begin sleeping in a modified reclining position, but do not sleep lying flat or on your stomach. If you are a side sleeper, two pillows under your head and a soft pillow under your mid- back and shoulders may offer more comfort.
– Do not wear makeup until you have been told to do so.
– During the first four to six weeks your scars may appear red and be slightly firm and raised then the redness fades and the scar softens. It takes a minimum of one year for the scar to achieve its final appearance.
– Refrain from direct sun exposure. Wear sunglasses and a wide-brimmed hat. If you are outdoors,apply at least an SPF thirty at least thirty minutes before sun exposure. Your face will be highly susceptible to sunburn or the formation of irregular, darkened pigmentation.
Long term You may ease into your regular fitness routine. However, wear protective eyewear and a hat. Discomfort or tightness and tingling in your face will resolve. Be prepared to wait at least six months for your facelift to completely heal inside and out. It is important to see your doctor as scheduled.

How Long Will the Results Last?

– Minimal facelift techniques with fast recoveries will last the least amount of time
– Mini-facelift, or ‘S-Lift,’ refers to a facelift with a small amount of skin undermining with limited SMAS (muscle/fascia) mobilization. With this technique, recovery is fast and results can last up to five years.
– Full or standard classic facelift: There are many versions of the operation that fall into this class,and can be called SMAS platysma, SMAS-ectomy, SMAS imbrication, deep plane, composite lift, or subperiosteal. These all require extensive rearrangement of the underlying facial tissues in addition to significant skin undermining. They are technically demanding procedures that are undertaken by trained, board-certified aesthetic plastic surgeons. The recovery is longer (two to four weeks), but the results generally can last over ten years.
– The more extensive the procedure, the longer the recovery period will be, and the longer you will enjoy the results.

Limitations and Risks

– Adverse reaction to anesthesia
– Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
– Infection
– Changes in sensation
– Scarring
– Allergic reactions
– Damage to underlying structures
– Unsatisfactory results that may necessitate additional procedures.