Facelift

With age, the skin and soft tissues of the face and neck lose their elasticity. This loss of skin elasticity results in the formation of wrinkles and the development of sagging, loose skin. A plastic surgery procedure known as a facelift or rhytidectomy can help lift and tighten facial tissues to restore a more youthful appearance. Keep reading to learn everything there is to know about a facelift surgery, one of the most common cosmetic procedures performed worldwide, including how to prepare, what to expect, recovery, costs, and more.

What is facelift surgery?

During a facelift procedure, a plastic surgeon removes excess skin, smooths out wrinkles, creases, and folds, and tightens loose facial tissue. The focus of a facelift cosmetic surgery is on the lower two-thirds of the face and neck. Signs of aging in the upper third of the face can be addressed with procedures such as a forehead lift, brow lift, or eyelid lift.

Why have a facelift?

The main reason for undergoing a facelift cosmetic surgery is to improve some of the signs of aging and restore a more youthful appearance to the face and neck.

Anyone who is in good general health, does not smoke or abuse illicit substances, and has realistic expectations from the surgery is considered a good candidate for a facelift.

How does facelift surgery work?

A facelift cosmetic surgery helps smoothen out creases and wrinkles, remove excess skin and sagging skin, such as that causing jowls, and lift and tighten facial tissues. The result is a tighter, smoother, more refreshed appearance with correction of some of the common signs of aging. The results of a facelift are more dramatic and longer-lasting than less invasive treatments like a chemical peel.

Facelift vs brow lift: Can a facelift improve my eyelids too?

A facelift does not involve a brow lift or eyelid lift. However, the two procedures can be done at the same time if the plastic surgeons consider you a good candidate for both. A neck lift can be done with an incision near the chin to improve sagging skin in this area.

What is the best age for a facelift?

The best age to get a facelift depends on your individual circumstances, meaning the degree of aging that is evident as well as your aesthetic goals. In general, people in their mid 40s get some of the best results from a facelift. However, the surgery is commonly performed on patients in their 50s and 60s as well with excellent results.

Preparing for a facelift 

Consultation

During the initial consultation, your plastic surgeon will perform a careful examination and obtain a detailed health history from you. At this time, it is important to tell your doctor about any medical conditions you have. Some people with bleeding or blood clotting disorders may not be candidates for a facelift. Other medical conditions such as high blood pressure or poorly-controlled diabetes may preclude a patient from getting a facelift because these conditions can lead to wound healing problems, hematomas, and other complications. Smoking is associated with a significantly higher risk of hematomas, skin loss, and poor wound healing, so your surgeon may recommend stopping smoking for a few weeks before and after a facelift.

Preparation for a facelift involves the following:

• Health information and examination
• Medications and allergies review
• Photographs and thorough facial examination
• Discussion about expectations

If you are scheduled to undergo a facelift, you should follow all the instructions from your plastic surgeon carefully, such as discontinuing certain medications before the procedure that can increase the risk of bleeding.

Day of surgery

On the day of your surgery, wash your face and hair. You may be instructed to avoid eating or drinking anything for 6-8 hours before the surgical procedure if you're getting general anesthesia. You will be able to go home on the same day, but you will need to arrange for someone to drive you home from the surgical facility.

What are the steps of a facelift procedure?

Step 1

The surgical team will administer anesthesia to ensure your comfort during the surgical procedure. This can either be intravenous sedation or general anesthesia.

Step 2

The plastic surgeon will make the incisions based on the surgical plan. The number and size of the incisions will depend on the degree of change you want to achieve. Various surgical techniques are available. For a traditional facelift, the plastic surgeon usually makes an incision in the hairline at the temples and continues it around the front of the ear up to the lower scalp. A second incision near the chin may be needed to address signs of aging in the neck. The neck lift incision is made in addition to the incision near the hairline and earlobe. A mini facelift can be performed in patients with less loose skin and facial tissues and those requiring less rejuvenation than a traditional facelift. A mini facelift involves shorter incisions and an easier recovery.

Step 3

To perform the facelift, the surgeon will sculp or redistribute skin and fat in the face, jowls, and neck. Connective tissue and cheek fat will be repositioned and lifted. This will be followed by removing excess skin and re-draping the skin over the lifted contours.

Step 4

The surgeon will close the incisions with dissolvable stitches (in some cases, the stitches may need to be removed in the office a few days later). Skin glue can also be used to seal the incisions. Once healing is complete, the scars are well concealed in the hairline and natural contours.

How will facelift results look over the long term? How long will the results last?

The results of your facelift will be evident after the swelling and bruising have subsided. Your face will look more youthful and refreshed and you'll feel more confident about your appearance after the rejuvenation.

The average longevity of a facelift is 10 years. The results of the surgery are not permanent because with advancing age, the skin can begin to show signs of aging again.

To extend the results of your facelift, you should lead a healthy lifestyle by eating a balanced diet, exercising regularly, and not smoking. Daily sun protection is also important.

It is worth noting that people who have a history of weight fluctuation or repeated weight loss or gain may not get optimal results from a facelift. This is because the weight changes can affect the shape and contours of the face and the condition of the skin. The results may be less than satisfactory or short-lived in such patients.

What to expect after a facelift

Immediate post-operative period

After a facelift, you may have mild to moderate pain, swelling and bruising. There may also be numbness in the skin and some drainage from the incisions. Your doctor will give you pain medication to ease discomfort. Application of cold compresses can help reduce swelling and pain. It is recommended that you keep your head elevated as much as possible in the days following a facelift. Avoid picking on crusting scabs that develop on the wounds.

Aftercare

Follow all medical advice and instructions from your doctor about showering and shampooing your hair. Avoid makeup and excessive pressure on the face. Vigorous exercise should be avoided for a few weeks. The incisions should not be subjected to direct sun exposure for 2-3 weeks. Make sure you use a sunscreen when you're outdoors. It is recommended that you avoid bleaching, perming, or coloring your hair for several weeks.

Followup

After the surgery, the facial plastic surgeon will leave a bandage to protect the wounds and minimize bruising and swelling. Drains (small tubes) may be left in place to drain excess fluid and blood from the surgical site. Your surgeon will give you instructions on aftercare during the recovery period. You may be given some oral medications or creams to apply. You should return for followup as directed.

Signs to watch out for

Your doctor will tell you what signs to be vigilant for that could indicate problems. Make sure you contact your surgeon immediately if you have severe pain in the face or neck, chest pain, shortness of breath, or an irregular heartbeat.

Life after a facelift

Most patients can go out in public 10-14 days after surgery. Complete recovery time is 2-3 months, meaning it can take this much time to feel fully back to normal in terms of sensibility, texture, and tightness in the face. Life after a facelift plastic surgery will be normal with no special precautions except good skincare and sun protection.

Are there any risks or side effects? 

In the hands of an experienced plastic surgeon, a facelift is a safe procedure. However, like all surgeries, it carries some risks such as:

Hematoma

This is the most common complication of a facelift surgery. It is a collection of blood under the skin surface that can lead to swelling and pressure. If a hematoma develops, it needs to be treated surgically. This must be done promptly to prevent damage to surrounding tissues.

Scars

The incisions and scars from a facelift are usually well hidden in the contours of the face. Rarely, however, raised red scars can develop. If this occurs, the scars can be treated with steroid injections and other treatments.

Hair loss

Some patients experience temporary or permanent hair loss near the incisions. If the hair loss is permanent, it may require a hair transplant procedure to correct.

Nerve injury

Surgery on the face can injure the nerves and temporarily or permanently affect sensation and muscle control. A temporary muscle paralysis can lead to an asymmetrical face or unusual facial expression. Temporary loss of sensation after a facelift can last for a few months, even up to a year.

Skin sloughing

A rare complication of a facelift surgery is skin loss or sloughing due to an interruption in the blood supply. This can be treated with medications and wound care or a procedure to minimize scarring.

How much does a facelift cost? 

The cost of a facelift surgery will depend on your geographical location and the expertise of your cosmetic surgeon. The American Society of Plastic Surgeons reports the average cost of a face lift is $7,500 to $12,000. The total cost can vary depending on additional expenses such as anesthesia costs and surgical center or hospital costs. A mini facelift typically costs less than a traditional facelift and neck lift.

Choosing a facelift surgeon

After reading this facelift guide, are you still not sure if a facelift cosmetic surgery is right for you? The MeTime app makes it easy to find experienced board certified plastic surgeons and cosmetic surgeons in your area. You can click and upload pictures and have suggestions sent directly to you. Find out if a facelift plastic surgery could help you achieve your aesthetic goals. Try the MeTime app now!