Face-Lift

A cosmetic surgical procedure to improve the look of your neck and face is called facelift or rhytidectomy.

Excess skin is removed, facial soft tissues are lifted and skin is draped back over the newly repositioned contours during a face-lift. A neck-lift is often done as a part of a face-lift.

If your facial skin is beginning to droop you may choose to have a face-lift and it will also boost your self-confidence because this is a sign of aging but this will not affect the quality of your facial skin.

You may want to consider a skin-resurfacing procedure if you have sun damage and wrinkles. This procedure can be done along with other cosmetic procedures such as eyelid surgery or brow lift.

Here are the most common reasons to undergo a face-lift.

Your facial skin changes as you get older. A face-lift can give your face a more youthful heart-like shape because as your face sag and become loose it will look like a rectangular shape.

You may want to consider face-lift if:

• your cheeks are sagging
• your facial skin has become loose
• you have an excess skin hanging from your lower jaw line (jowls)
• the creases around your lower lip and chin and below your lower eyelids are becoming deeper
• vertical bands of skin in your neck (platysmal bands) have become visible
• you have lost definition and have excess fat in your neck

This procedure is not a treatment for sun damage, irregularities in skin color, creases around the upper lip and nose, and superficial wrinkles.

Some of the risks for facial lift include:

Scarring – you will have incision scars that can be seen permanently but can be concealed by natural contours of the ear and face and hairline. You may want to consider growing your hair before a face-lift if you have a short hair so that you can cover the incisions while healing.

Incisions can result in raised, red scars but very rare. To improve the appearance of the scars, your doctor will recommend injections of a corticosteroid medication such as Kenalog-10.

Bruising and swelling – there will be bruising and swelling for several weeks but this is part of the recovery that may go away after several weeks. Your facial movements may be stiffened and your facial features may be distorted because of swelling.

You should apply a cold compress and keep your head elevated to reduce the swelling. You should plan this procedure 6 weeks before going or attending any special events.

Hair loss – this may be temporary or permanent and will be near the incision sites but some may begin to recover in about three months. If you are bothered by the permanent hair loss you can have a transplant of skin with hair follicles from your scalp to the area or by removing the bay area of skin.

Changes in the skin sensation – such as affecting your sensory nerves meaning you may feel numb in your scalp, cheeks and neck for a few months up to two years.

Facial nerve injury – this is when there is a temporary or permanent weakness of facial muscle due to facial nerve paralysis and this can happen but is very rare.

Skin loss – such as skin sloughing because face-lift can interrupt the blood supply to our facial tissues but this is very rare, avoid smoking so you will not have this.

Your doctor may caution against a face-lift if you:

Take blood thinners – such as Coumadin and Plavix which can increase the risk of bleeding and can affect the blood’s ability to clot.

Have a medical condition – such as uncontrolled diabetes or high blood pressure because these may interfere with the ability to heal after the procedure. Talk to your doctor how you can manage your condition.

Smoke – you will have an increased risk of skin loss, your doctor will advise you to stop smoking before surgery and during recovery.

Have a history of repeated weight gain and loss – your skin will become loose again because of the repeated stretching of the facial skin.

In preparing for your face-lift procedure, you must follow your doctor’s orders. 

On your first visit, your surgeon will:

• review your medical history so be prepared to answer all his questions about your past and present medical conditions such as high blood pressure, make a list of all the medications, supplements and vitamins that you are taking and their doses especially those who can affect your blood’s ability to clot
• do a physical exam to examine your facial skin, neck, and facial bone structure and will determine what treatment options, he will also note if there are scars present or skin irregularities
• discuss your expectations including the benefits and risks of this procedure

Before the procedure you may need:

• to follow medications directions such as avoiding herbal supplements, aspirin, anti-inflammatory drugs that can increase your risk of bleeding
• wash your hair and face the night and the morning before your face-lift
• avoid eating anything after midnight before the surgery
• arrange for help in recovery such as driving you home by someone

Here’s what you can expect before, during, and after your face-lift.

This is an outpatient procedure and your doctor will give you sedative and anesthesia to numb parts of your body.

Depending on what you desire your doctor will use techniques to remove facial skin and reposition facial and neck tissues.

Some of the possible techniques:

• traditional face-lift by making incisions in your hairline that will start on your temples and ending behind your ears in your lower scalp
• limited incision facelift is when your doctor will make short incisions in your hairline starting at your temples and around the front of your ears, your doctor can also make incisions in the lower eyelids or under the upper lip
• neck lift by making incisions starting in front of your earlobes and then will continue behind the ears and ends in your lower scalp or under the chin

Your doctor will redistribute fat from your face, neck and jowls after the incisions and he may also use liposuction. Tape and stitches will be used to close the incisions.

This procedure usually takes two to four hours but in some case, it takes more than four hours if there are other cosmetic procedures that your doctor will do. You will be covered with bandages after the surgery.

To drain excess fluid or blood, your doctor will place a small tube under the skin behind both of your ears.

In the first few days:

• you need to rest your head in an elevated position and will have to take pain medicines
• avoid exposing your incisions to excessive motions or pressure
• do not wear clothing that needs to be placed over your head

Consult your doctor if you can return to your normal activities. He will remove the tube on your ears and will apply antibiotic ointment to your cuts the day after the surgery.

Two to three days after the procedure, you may be able to switch from wearing bandages to an elasticized facial sling.

Your doctor will be the one to remove the stitches and will check your incisions if there are ingrown hairs that need to be removed to avoid inflammation and infection.

As your incisions begin to heal, there will are crusts but you had to avoid picking it. To conceal and scars and redness in your face, you may be able to use makeup after a week of surgery.

Consult your doctor immediately if:

• you have shortness of breath
• if you have irregular heartbeats
• if you have pain on one side of your face or neck within 12 hours of surgery
• if you have chest pains

If you do not understand your face-lift results, consult with your doctor.

Your face and neck will be given more youthful appearance by smoothing loose skin.

The results of this procedure are not permanent because your facial skin will droop again as you age and sun damage can also age your facial skin.