Introduction: What is a Facelift?
A face lift/ neck lift is a surgical procedure that helps to improve signs of aging in the face and neck. The procedure is meant to improve facial contours and lift the face and neck and replenish fat in the face to help with a more aesthetic and youthful appearance. A facelift can help improve sagging skin of the face and neck, deepening of the nasolabial fold between the nose and the corners of the mouth and jowls that develop in the cheeks and jaw line. The incisions can usually be placed in natural skin folds to help camouflage them.
Who is an Ideal Candidate for a Facelift?
Face lift/ neck lift surgery is suggested for people who have good overall health, but are worried about the signs of aging in the face and neck that don’t respond to more conservative treatments. Patients should be healthy without any significant comorbidites that would impair wound healing, non-smokers and patients should have a realistic expectation of what a face and neck lift can do for them.
Preoperative Assessment
Before your procedure, a detailed medical history is obtained, and a thorough physical examination is performed. During your consultation, your doctor will advise you to stop smoking, if you smoke, to avoid post-surgical complications and delayed healing. You should eat a healthy diet and avoid any restrictive dieting during this time. You should inform your doctor of all medications that you are taking and about significant medical conditions, allergies and previous surgeries if any.
Photographs will also be taken during pre-operative consultation, to be used in surgical planning and for before and after comparison. Your goals will be discussed, and realistic expectations will be set. After discussing surgical options, we will make an individualized surgical plan together that best suits your goals.
This is the best time to ask all your questions so that you can feel comfortable and confident going into surgery.
Procedure: Facelift
Face and neck lifts are performed under general anesthesia. There are multiple variations of this procedure that can be offered based on the individual patient anatomy and how much sagging skin they have and the patient’s goals.
A traditional facelift incision usually begins in the hairline at the temples and continues around the ear ending behind the ear at the hairline of the lower scalp. This incision helps to lift and redrape the skin over the face and neck and allows for lifting of deeper layers of the face as well for long lasting results.
Smaller incisions may be able to be made if patients either do not have a significant amount of sagging skin or if there sagging skin is limited to a specific area (i.e. the neck). The incisions can usually be placed in natural skin folds or the hair line to help camouflage them.
Fat transfer can be used as an adjunct in a facelift procedure to help improve facial contours and replenish depleted fat stores.
Fat transfer harvests fat from one part of your body with liposuction via very small incisions and transfers it to an area requiring augmentation. The source is usually the abdomen, buttocks or thighs. The most commonly grafted areas include the forehead/ temples, under the eyes, the lips, cheeks, chin and around the jaw.
Risks and Complications of a Facelift
Face lift/ neck lift is a relatively safe surgery. However, as in any surgery, there are chances of potential complications including:
- Anesthesia risks
- Bleeding
- Blood clots in the lungs or legs, cardiac and pulmonary complications
- Delayed healing
- Facial nerve injury with weakness
- Fluid collections (seroma)
- Numbness or changes in skin sensation
- Asymmetries or suboptimal aesthetic results
- Recurrence of loose skin
- Scarring
- Temporary or permanent hair loss at the incisions
- Infection
- Possibility of revision surgery
Recovery after a Facelift
After face lift/ neck lift there will be some temporary pain, discomfort, and swelling. Medications will be prescribed to relieve pain. You will be advised to rest after surgery and specific post-operative care instructions will be given. You will have a bandage around your face to help minimize swelling and bruising post operatively and may be advised to get a contoured elastic garment for extra support under the neck once the bandage is removed. Most patients can undergo a face lift/ neck lift as an outpatient procedure. Some patients may stay overnight for observation which will be discussed in your pre-operative appointment. Upon discharge, patients will be instructed about proper wound care and how to manage their drains at home. Stitches are usually dissolving and internal although in a facelift procedure there may be some external staples/ stitches that need to be removed. Specific post-operative care regimen to minimize scarring will be discussed with each patient. Strenuous physical activity and heavy lifting over five pounds is discouraged for at least the first 2-4 weeks or while you still have swelling post-operatively – details of this limitation will be discussed with you specific to the surgery that you will be having. You will likely be able to resume work in 1 to 2 weeks depending on what kind of job you have and how you are feeling. Full recovery may take a couple of months and you need to have follow-up appointments to ensure a positive surgical outcome.
Summary
A face lift / neck lift is a wonderful procedure to help give yourself a more youthful and rested appearance. You will likely have significant bruising and swelling in the first 10-14 days that will be noticeable to others, it will take a few months for you to be able to see your full results as swelling improves.
