A facelift is a surgical procedure to improve the appearance of the lower face and the neck. There are a number of ways to perform a facelift but all involve some combination of techniques to tighten and move the skin and deeper tissues upwards and backwards. This reverses the gradual descent of these tissues that occurs as we age.
It's a good idea to minimize talking for 3-4 days after a facelift. The facial motion will occasionally lead to small blood clots under the skin (hematomas) at the corners of the mouth.
Women and men who have begun to notice the signs of facial sagging are candidates for a facelift. The typical signs include jowls along the jaw line and loose skin in the neck. The creases that run from the nostrils to the corners of the mouth (nasolabial folds) may deepen. More subtle is a gradual change in the shape of the face. This occurs as the tissue pads that cover the cheekbones slowly slip downward into the lower cheeks. The cheekbones appear bonier and less prominent while the lower face looks heavier and tired. Over time the face appears less angular and more squared and flattened.
The age at which these changes occur will vary depending on your skin type, bone structure, health, weight, and other factors. In most people they will start to show sometime in their forties. Facelifts are typically performed in men and women in their forties and fifties though we have treated patients from the early thirties to the late seventies.
Facelifts are cosmetic procedures. It would be very unusual for an insurer to cover this procedure.
The exact location of our facelift scars will vary somewhat from patient to patient depending on the individual anatomy and the specific techniques we use. Most commonly, the main scar hugs the front of the ear, curves underneath the earlobe, runs upward immediately behind the ear, and then crosses into the hairline where it travels for a variable distance. Scars in these locations tend to heal well in most patients and are often difficult to discern.
We frequently recontour the cheeks using a midface resuspension. The scars for this procedure are located inside the mouth and behind the hairline on the temples.
Most patients will show signs of aging in multiple areas of the face. It is not uncommon for us to perform a combination of procedures that may include:
- Midface lift
- Browlift or endoscopic browlift
- Eyelid surgery
- Fat injections
- Face and/or neck liposuction
- Skin resurfacing
Though everyone’s response to pain is different, most patients do not find facelifts particularly painful. The discomfort is usually short-lived and well-controlled with oral pain medications.
Most types of exercise can be restarted four weeks after a facelift. Performing physically strenuous activities earlier than this can impair healing.
Most patients can resume driving one week after a facelift.
When can I return to work after a facelift? Facelifts rarely produce much postoperative pain and most patients will feel well enough to return to work in several days. Appearance is usually the limiting factor governing return to work. All facelifts produce some degree of swelling and bruising. Depending on the techniques used, most patients will appear reasonably normal 2-3 weeks after surgery. When you feel comfortable returning to work will depend on the nature of your job and your personal comfort level.
Your facelift will be performed under general anesthesia (i.e. you will be asleep). We use only board-certified physician anesthesiologists.
We perform our facelifts at a JCAHO-certified ambulatory surgery center.
With most facelifts, the skin and/or deeper facial tissue are tightened by pulling them backward toward the ears. Though these techniques are effective, the required tension tends to flatten the cheeks and can produce an unnatural appearance if overdone.
Instead of tightening the cheeks, we internally lift them in a more vertical direction. This restores a more youthful volume and shape without creating a tight, stretched appearance.