Facelift Guide

What it is: A facelift is a plastic surgery procedure meant to address loose facial skin, deep lines, jowls and wrinkles. Facelift plastic surgery is also referred to as Rhytidectomy.

Search terms:  Facelift Surgery, Rhytidectomy, Plastic Surgery Facelift

 A Facelift usually involves:

• incisions in front of and behind the ear that may extend into the scalp
• various degrees of undermining of the skin to "lift" the deeper layers of the face
• excess skin is either removed or repositioned

A Facelift may involve:

• muscle tightening as well as liposuction of the neck and jowls

Who should consider a Facelift?

We typically associate a facelift with a woman of "a certain age," but it's less about age than about how a woman feels about her appearance. Gravity and diminished volume contribute to the major sign of aging—sagging or slack skin—that often results in a woman feeling she looks older than her years.

Facelift surgery can improve:

• Sagging in the midface
• Deep creases below the lower eyelids
• Deep creases between the nose and mouth
• Fat that has fallen or is displaced
• Loss of muscle tone in the lower face that may create jowls
• Loose skin and excess fatty deposits under the chin and jaw

A facelift helps smooth the skin of the face and neck, tighten the underlying tissues and muscle, and remove excess skin to ultimately restore a more youthful look and feel.

Doctor Consultation: what to ask

In addition to your surgeon performing a history and physical examination, your doctor consultation is the time to ask questions.

• See the Facelift consultation checklist
• Read about the experiences of others who've had a facelift.  See real Facelift reviews.

During your physical examination, your facial bone structure, underlying skin structure, skin thickness, texture, and elasticity as well as the extent of facial wrinkles and folds will be assessed. Based on this, a surgical plan will be made, and the goals of the procedure will be discussed. Your plastic surgeon will select the surgical technique that he or she feels will best achieve your desired results.

Getting ready for facelift surgery

If you are a smoker, you will be asked to stop smoking well in advance of the surgery. Certain medications that increase the risk of bleeding such as Aspirin, non-steroidal anti-inflammatory medications, and some vitamins/homeopathic regimens should be discontinued prior to surgery. If your hair is short, you may want it to grow out enough to cover your incisions while they heal. Any chemical processing of your hair should be performed prior to surgery since you cannot have any of these procedures for a month of more after surgery. If your facelift will be performed on an outpatient basis, be sure to arrange for someone to drive you home and stay with you for at least the first night following surgery.

During facelift surgery

Your facelift may be performed in an accredited hospital, free-standing ambulatory facility, or office-based surgical suite. Medications are administered for your comfort during the procedure. You and your plastic surgeon will have decided in advance what type of anesthesia is to be used—either intravenous sedation (twilight) or general anesthesia. For your safety during and after the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.

After facelift surgery

You will be taken into a recovery area and a bandage may be wrapped around your face. Sometimes small tubes will be inserted beneath the skin to drain away fluid that might otherwise accumulate. There is surprisingly very little discomfort experienced after facelift surgery. However, any discomfort you may experience will be controlled with pain medication as needed. You may be permitted to go home after a few hours, although some patients may stay overnight in a hospital or surgical facility.

Recovery from facelift

The amount of time it takes to recover from facelift surgery varies greatly between individuals.

First few days: Elevation of the head is extremely helpful in reducing the initial post-operative swelling. Your surgeon may also advise you to use ice packs intermittently.You should avoid Aspirin and non-steroidal anti-inflammatory medications. Smoking and exposure to second-hand smoke should be avoided to prevent delays in the healing process. Straining, bending, and lifting should be avoided during the early post-operative period as these activities may predispose you to bleeding.

Once the dressings and drains are removed, puffiness and discoloration may be more pronounced in some portions of the face than others. Do not be alarmed by any unevenness or temporary asymmetry—this is normal. Most swelling is usually noted in the first 24 to 48 hours.

Most stitches are removed within a week of the surgery.

Beyond the first week: Concealing makeup is usually permitted after the first week. You may experience numbness to the face post-operatively, which usually resolves within several months. Some patients find that mild swelling persists for many weeks. Most bruising resolves within 2 weeks.

Your surgeon will give you specific instructions that may include caring for the dressings and incisions, directions for your analgesics and other medications, specific concerns to look for, and when to follow up in the office to monitor your healing process. It may take several months for the swelling to fully resolve, and up to 6 months for the incision scars to fully fade.

Results: what to expect from facelift surgery

The results of your facelift may be subtle or dramatic, depending on your appearance prior to surgery and the planned goals set by you and your plastic surgeon. Since the healing process is gradual, you should expect to wait several weeks for an accurate picture of your “new look”. Additional minor changes or settling may occur over several months following your facelift surgery.

Facelift side effects

Significant complications from facelifts are infrequent. However, anyone considering surgery should be aware of both the benefits and risks. These are best discussed on a personal basis with your surgeon or one of their qualified staff members.
 
Potential complications may occur include:

• hematoma (an accumulation of blood under the skin)
• infection
• reactions to anesthesia

Injury to underlying structures is possible, though usually temporary. Facelift incisions are usually quite inconspicuous—however, this is not entirely predictable due to individual variations in healing. You can help minimize certain risks by following the advice and instructions given to you by your plastic surgeon both before and after surgery.

Facelift cost

Facelift cost can vary widely as reflected in the facelift cost data posted on RealSelf.com. A surgeon’s cost for a facelift may vary based on his or her experience, the type of procedure used, as well as geographic office location.

Costs may include:

• Surgeon’s professional fee
• Facility fee
• Anesthesia fee
• Medications
• Surgical garments
• Medical tests

Terminology to know

• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Hematoma: Blood pooling beneath the skin.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Tear trough: Deep creases below the lower eyelids.
• Nasolabial fold: Deep creases between the nose and cheek
• Jowls: A jaw line that sags into the neck, usually caused by loss of muscle tone in the lower face.
• Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
• Rhytidectomy: A surgical procedure also known as facelift, to reduce sagging of the mid-face, jowls and neck.