Face-lift

As you get older, the appearance and shape of your face is altered because of normal age-related changes. A facelift, technically known as a rhytidectomy, is a surgical procedure used to give a more youthful facial appearance by improving these visible signs of aging, 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

• Excess skin (jowls) at your lower jawline

• Loose skin and excess fat of the neck that can appear as a double chin or "turkey neck"

Is a Face-lift right for me?

Patients with only mild sagging may only be recommended to undergo a mini or moderate facelift. This is a less-invasive procedure, which involves shorter incisions usually along the hairline and ears. On the other hand, standard facelifts are typically performed on patients that need more extensive or pronounced results. Aside from tightening and lifting the sagging facial tissues, your surgeon may also reposition and remove excess skin to give you a more youthful and tighter appearance.

Risks

Like any other surgeries, A face-lift surgery can also cause complications on your body. Some risks can be mitigated with appropriate care and medication while long term or permanent complications, while rare, can cause a significant change in your appearance permanently. The risks include:

• Hematoma. The most common complication after a face-lift surgery is a collection of blood (hematoma). This happens because of the incisions made in the face and it causes the swelling and pressure. It is treated accordingly with another surgery to prevent damage to skin and other tissues. 

• Scarring. Scars that came from the incisions are permanent but they are not so visible due to the coverage of the hairline and contours of the face. To improve the condition of scars, injections of a corticosteroid medication or other treatments might be used.

• Nerve injury. Injury to nerves, while rare, can temporarily or permanently affect nerves that control sensation or muscles. It can cause temporary paralysis in the muscle that can make your facial features or appearance uneven. Temporary paralysis can also lead to loss of sensation on the face that can last a few months to a year. Surgical interventions may offer some improvement.

• Hair loss. You might experience temporary or permanent hair loss near the incision sites. This can be mitigated by doing skin transplants with hair follicles.

• Skin loss. A face-lift procedure can rarely interrupt the blood supply of your facial tissues. If it happens, it can result in skin loss but the post-procedure effects can be treated with medications, wound care, a scar minimizing through procedure.

Preparation

Initially, you'll talk to a plastic surgeon about a face-lift. During the consultation you will cover:

• Medical history and exam

Your doctor will be asking you questions about past and current medical conditions, surgeries, plastic surgeries, drawbacks from previous plastic surgeries, smoking, alcohol or drug use. Your doctor will also conduct a physical exam to determine if you are qualified to undergo the surgery. 

• Current medications

Provide the list of your medications that you are currently taking: prescriptions, vitamins, dietary supplements, etc. 

• Facial exam

Photos of your face from different angles will be taken by your plastic surgeon for examination. The surgeon will also examine your fat distribution, bone structure, and quality of your skin to determine the best option and technique for the procedure.

• Expectation management

To manage expectations and the preferred outcome of your face-lift procedure, your surgeon will ask questions and help you understand what will be the effects of the face-lift such as change in appearance and what will the procedure address and won’t address in your face. 

Procedure

Before

In preparation for the procedure, doctors usually administer sedatives or local anesthesia, drugs that numb only parts of your body. However, it is recommended that general anesthesia is used for the purpose of rendering you unconscious for the entire procedure. 

During

In general, a face-lift procedure involves lifting the skin and making sure the tissues and muscles under the skin are tightened. Fat areas in the face and neck may be sculpted, removed or redistributed. Facial skin is then re-wrapped over the newly repositioned outlines of the face, excess skin is removed, and the wound is stitched or taped closed.

The incisions during the procedure will depend upon the technique that will be used and upon the preference of the patient. Options include:

• A traditional face-lift incision starts at your temples in the hairline, continues down and around the front of your ears and ends behind your ears in your lower scalp. An incision might be made under your chin to improve the appearance of your neck.

• A limited incision is a shorter incision that begins in your hairline just above your ear, wraps around the front of your ear, but does not extend all the way into the lower scalp.

• Neck lift incision starts in front of your earlobe and continues around your ear into your lower scalp. A small incision also is made under your chin.

Generally, face-lifts lasts for two to four hours but may be longer if other cosmetic procedures are applied simultaneously.

After

After going through a face-lift procedure, you may experience: 

• Mild to moderate pain

• Drainage from the incisions

• Swelling

• Bruising

• Numbness

Immediately contact your doctor if you are experiencing:

• Severe pain on one side of your face or neck within 24 hours of surgery

• Shortness of breath

• Chest pain

• Irregular heartbeats

Bandages will provide protection and cover for your incisions. They’ll be also providing gentle pressure to ensure that swellings and brusings are minimized. To drain excess blood and fluid from the incisions, a small tube might be placed under the skin. 

A few days after surgery, you should: 

• Rest with your head elevated

• Take pain medication as recommended by your doctor

• Apply cool packs to the face to ease pain and reduce swelling

Recovery

The recovery period for a facelift is fairly quick for most patients, healing time takes around 1-2 weeks.

Following completion of a face-lift, a bandage might be placed around your face to minimize swelling and bruising. Here are some self-care tips to follow during first three weeks of your recovery to minimize the risk of complications: 

• Do not pick at crusting scabs that develop on your wound.

• Avoid putting pressure around the incision area. 

• Avoid using makeup.

• Avoid vigorous activity or sports.

• Avoid direct sun exposure for three weeks. 

Depending on your desired outcome, you can be assured of our PAPRAS surgeons’ expertise and comprehensive knowledge of the facial anatomy. They can help offer sound advice on which type of face-lift is most suitable to help you achieve a realistic, yet long-lasting look.

Sources: 

Mayo Foundation for Medical Education and Research. “Face-lift.” 28 July 2020, https://www.mayoclinic.org/tests-procedures/face-lift/about/pac-20394059. Accessed 3 May 2021.