What is a facelift?

A facelift, or rhytidectomy, is a surgical procedure that improves visible signs of aging in the face and neck, such as:

• Relaxation of the skin of the face causing sagging
• Deepening of the fold lines between the nose and corner of the mouth
• Fat that has fallen or has disappeared
• Jowls
• Loose skin and excess fat of the neck that can appear as a double chin or "turkey neck"

The loss of youthful contours in the face can be due to variety of factors, including thinning of the skin, loss of facial fat, gravity, sun damage, smoking, as well as heredity and stress.

Other procedures that might be performed in conjunction with a facelift are brow lift and eyelid surgery to rejuvenate aging eyes. Fat transfer or fillers may be suggested to replace the lost fatty volume. Skin treatments such as IPL, dermabrasion, peels or laser may be offered to improve the quality and texture of the skin.

What facelift surgery can't do

As a restorative surgery, a facelift does not change your fundamental appearance and cannot stop the aging process.

A facelift can only be performed surgically; nonsurgical rejuvenation treatments cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate and complement the results of surgery.

Some nonsurgical treatments, such as stem cell facelifts, are of unproven benefit.

Facelift candidates

In general, good candidates for a facelift include:

• Healthy individuals who do not have medical conditions that impair healing
• Nonsmokers
• Individuals with a positive outlook and realistic expectations

Facelift recovery

Following completion of a facelift, a bandage might be placed around your face to minimize swelling and bruising. Small tubes may be present to draw off any excess blood or fluid.

You will be given specific instructions on how to care for the surgical site and drains, medications to apply or take orally, specific concerns to look for at the surgical site or in your general health and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your recovery period.

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
• When will they be removed?
• When will the stitches be removed?
• When can I wash my face and wear make-up?
• When can I resume normal activity and exercise?
• When can I color my hair or get a haircut?

Facelift results

While most people are presentable to the public within 10-14 days, it will take 2-3 months for the face to feel "back to normal" in terms of texture, sensibility and loss of tightness.

Continuing daily sun protection and a healthy lifestyle will help extend the results of your facelift.

As swelling and bruising subside, the visible improvements of a facelift appear. Your final result should not only provide a more youthful and rested appearance, but also help you feel more confident about yourself.

Although good results are expected, there can be no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Follow your physician's instructions to ensure the success of your surgery.

Facelift procedure steps

A facelift procedure includes the following steps:

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

A variety of other procedures can further enhance the outcome of a facelift. They include:

• Facial implants or fat transfer to improve contour
• Resurfacing techniques to improve the tone and texture of facial skin
• Wrinkle reduction by injection of fat or fillers

Step 2 – The incision

Depending on the degree of change you'd like to see, your facelift choices include a traditional facelift, limited incision facelift or a neck lift.

A traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp. Fat may be sculpted or redistributed from the face, jowls and neck and underlying tissue is repositioned, commonly the deeper layers of the face and the muscles are also lifted. Skin is redraped over the uplifted contours and excess skin is trimmed away.

A second incision under the chin may be necessary to further improve an aging neck. Sutures or skin adhesives close the incisions.

Traditional Facelift

An alternative to a traditional facelift uses shorter incisions at the temples, continuing around the ear. "Mini-lifts" are usually reserved for patients with less skin relaxation, as the results are less rejuvenating than a full facelft.

Limited Incision

A necklift

 addresses the sagging jowls, loose neck skin and fat accumulation under the chin. The neck lift incision often begins in front of the ear lobe and wraps around behind the ear, and ends in the posterior hair behind the ear.

Neck Lift

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Step 3 – Closing the incisions

The incisions will be closed with sutures that may dissolve or may need to be removed after a few days. Some surgeons use skin glues to seal the incisions. Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear.

Step 4 – See the results

The visible improvements of a facelift appear once swelling and bruising subside. Your final result should not only restore a more youthful and rested appearance, but also help you feel more confident about yourself. Get more information about facelift results.

Facelift risks and safety

The decision to have plastic surgery is extremely personal and you will have to weigh the potential benefits in achieving your goals with the risks and potential complications of facelift surgery. Only you can make that decision for yourself.

You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

Facelift risks, while rare, include:

• Anesthesia risks
• Bleeding
• Infection
• Poor wound healing and skin loss
• Facial nerve injury with weakness
• Temporary or permanent hair loss at the incisions
• Fluid accumulation
• Numbness or other changes in skin sensation
• Persistent pain
• Unfavorable scarring
• Prolonged swelling
• Skin irregularities and discoloration
• Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
• Unsatisfactory results may include: asymmetry, unsatisfactory surgical scar location and unacceptable visible deformities at the ends of the incisions. (It may be necessary to perform an additional surgery to improve your results)
• Deep vein thrombosis, cardiac and pulmonary complications

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Your facelift consultation

During your facelift consultation be prepared to discuss:

• Your surgical goals
• Medical conditions, drug allergies and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
• Previous surgeries

Your surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Discuss your facelift options
• Examine and measure your face
• Take photographs
• Recommend a course of treatment
• Discuss likely outcomes of a facelift and any risks or potential complications
• Discuss the type of anesthesia that will be used

The consultation is the time to ask your plastic surgeon questions. To help, we have prepared a checklist of questions to ask your facelift surgeon that you can take with you to your consultation.

It's important to understand all aspects of your facelift surgery. It's natural to be nervous about it, whether it's excitement for your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with your plastic surgeon.

Preparing for facelift surgery

In preparing for a facelift, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Apply certain products to the facial skin preoperatively
• Stop smoking
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding and bruising

A facelift may be performed in an accredited office-based surgical facility, licensed ambulatory surgical center, or a hospital. You must arrange for a friend or family member to drive you to and from surgery and to stay with you the first night following surgery.