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On a Facelift, How Does the Skin Reattach to the Tissues when It's Redraped?

asked 6 months ago by Scorchj
Latest answer by Sam Naficy, MD
Question viewed 388 times
Tags: healing

I am worried about how the skin can be pulled up in a facelift (back to the cheek area), and then after the underlying work, it is redraped and tightened, so how does the skin "reattach", and what is the protection for not taking too much skin so the mouth doesn't close, etc.

21 answers to On a Facelift, How Does the Skin Reattach to the Tissues when It's Redraped?

Healing and Surgical Redraping after Facelift Surgery

During a "facelift" procdure the underlying tissues are "injured" in a controlled fashioned, as the platysma and deeper tissues are tightened. The overlying skin has been surgically lifted off these tissues also creating a "controlled injury". The body then heals these area by laying down sheets of collagen - which are the bodies own natural glue. The collagen is smooth, and provides the facial skin a new smooth not overly tight look. more

Rondi Kathleen Walker, MD
Washington Plastic Surgeon

Reattachment of skin after facelift

The skin on the face is elevated just enough to put sutures underneath the fascia so as to give the pole. The skin in the neck is also pulled back after sutures are placed in the front of the back part of the platysmal muscle. To allow the skin to reattach to the underlying structure as quickly as possible, we use drains to create a vacuum underneath the skin during the first 48 hours after the procedure to prevent any hematoma and seroma formation. It is important to have an... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Facelift draping

Your question cuts to the heart of a successful facelift. The operation is not at all about skin tightening or pulling. It is about the tightening and support of the underlying muscle and fascia (SMAS). Once this is done, the skin is allowed to lay done and there will immediately be seen an amount of redundancy or extra to be be trimmed or removed. Only an amount that will leave what is left to lay without pull or tension should be removed. That will promote better healing and natural... more

Michael L. Schwartz, MD
West Palm Beach Plastic Surgeon

www.palmbeachface.com

Facelift skin tightening and healing

As discussed by many of the other surgeons the formation of collagen begins at an early stage after the surgical procedure it is your bodies own form of glue you could say. As far as the mouth not being able to close or look unnatural go to a good surgeon and this should not be an issue. When consulting surgeons speak with their recent facelift patients, look at their pre and post operative photographs and decide if their results are similar to the aesthetic result you desire. It is... more

Michael Elam, MD
Orange County Facial Plastic Surgeon

Skin to tissue reattachment

Immediately after surgery, the body begins to produce new collagenous tissue which causes adherence of the skin to the subcutaneous tissue. This is an excellent question! The protection against excessive skin excision is in selecting a board certified plastic surgeon with years of experience and excellent clinical judgment.

Robert L. Kraft, MD
New York Plastic Surgeon

On a Facelift, How Does the Skin Reattach to the Tissues when It's Redraped?

I have performed Face Lifts for over 20 years and this is a very insightful question. The way to avoid pulling the corners, of the mouth and eyebrows, IMHO is to avoid the subperiosteal or Mid Face Lift (that pulls the entire forehead and face in that direction) and to be sure the Face Lift addresses the SMAS layer with imbrication and not plication or suspension. Impeccable aesthetic judgement as well as experience in performing Face Lifts, should be the main requirements... more

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Facelift skin tightening

Within 30 minutes or less of redraping the skin, the body begins to produce a sticky layer between the skin and the underlying tissues. The body will then begin to produce immature collagen as early as 24 hours, which will give the connection between the layers more strength. With respect to your second question, it is very difficult to tighten your skin to the point of being unable to close your mouth and not be noticeable on the operating table. The deformity would be... more

Ricardo Izquierdo, MD
Chicago Plastic Surgeon

The body is an amazing thing.

Within seconds of redraping the skin, the body begins the healing process. The same wound healing mechanisms that heal a small cut also go to work healing the skin lifted as part of the facelift. In fact these mechanisms are so effective that they are adapted as the basis for fibrin glue. In this case you heal using your bodies own fibrin glue. This matures into the new collagen that provides the long term strength for the facelift.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

How Does the Skin Reattach to the Tissues when It's Redraped?

Good question: The skin is only trimmed after the deep layers are tightened and it is trimmed under no tension so there is no risk of the mouth not closing from tension. The tissues will reattach using the body's natural glue - fibrin. This adhesion is aided by use of drains that suck the skin down as well as a compression dressing.

Sam Naficy, MD
Seattle Facial Plastic Surgeon

Tissue Redraping

Like any other elevated tissue in the body, the facial skin, within a few days after being elevated as with a facelift, will reattach to the deeper supportive tissue, some of which it obtains its blood and nerve supply, as well as its lymphatic drainage to provide a reduction in swelling. Experience guides the surgeon in determining just how much tissue to excise to achieve an aesthetic but not an unnatural result.

Jeffrey Epstein MD, FACS
Miami Facial Plastic Surgeon

Healing after a facelift

The skin after redraping as the result of face-lifting heals in the new position by forming of a collagen membrane, which is a subcutaneous sheath of scarring. A skilled surgeon is unlikely to produce any complications that may lead to a permanent disfigurement.

Kris Conrad, MD
Toronto Facial Plastic Surgeon

Facelift - How Does the Skin Reattach to the Tissues?

Great question. This surgery (and others) make use of the body's natural tendency to heal itself. In general, when there are open areas (even such as a laceration) the body will ultimately heal via contraction (basically, elastic-like fibers pulling things together) combined with the formation of new tissue (scar tissue, collagen, fibrous tissue, etc). Over time the skin, which is has been lifted up and pulled upwards before being sewn at the edges (for a facelift) heals... more

Alan Engler, MD
New York Plastic Surgeon

Healing after facelift

A facelift involves both tightening of the skin and also tightening of the underlying tissues. When the skin is redraped, it initially seals down with a natural substance called fibrin, the body's glue. Next, collagen, the body's rope and new blood vessels begin to grow and this tightens and establishes a permanent seal of the skin to the underlying tissues. I hope this helps without being medically technical.

J. Jason Wendel, MD
Nashville Plastic Surgeon

www.mc.vanderbilt.edu

Healing process of the body allows skin to be repositioned and then heal in new location

The wonderful healing process of the human body allows skin to be repositioned and then heal in its new location. This principle is used in rotation and advancement flaps throughout the body. Soon after the flap is repositioned, the microvasculature reestablishes itself so that tissue integration can take place. With the facelift, a rotation-advancement flap is used. Because the incisions are placed so far away from the mouth, the force is such that difficulty with... more

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon

www.drmmacdonald.com

Skin Heals Naturally!

When proper dissection is done the skin heals back down nicely and naturally. The key to having the right degree of lift to look great without the appearence of any pull is to choose a very experienced and artistically inclined surgeon. He will get you a fantastic result and leave your face looking completely normal and unoperated.

Richard Galitz, MD
Miami Facial Plastic Surgeon

Skin re attaches

Generally there is a limit to how much skin you can remove.The doctor wants to pull enough so that the end result will be natural.I have never seen,in 32 years,the skin pulled so tight that a person couldn't close their mouth.Experience does matter.

Robert Brueck, MD
Fort Myers Plastic Surgeon

The skin heals amazingly well after a facelift

After a facelift, the skin of the face heals to the underlying tissues much the same way as your skin heals when you cut your finger. The results can be very long-lasting, and the amount of pull is usually determined beforehand between the patient and the surgeon. see video

Jeffrey E. Schreiber, MD
Baltimore Plastic Surgeon

Healing of skin in a facelift

There are different typtill allow es` of lifs and they should ve adjusted to the needs of each patient, Less release of skin may satisfy many patients.. tightening the underlying smas or muscle layer will give lasting results. skin that is released reattaches to the underliying muscles older skin may need more release but they it is at higher risk for healing problems

Jed H. Horowitz, MD
Orange County Plastic Surgeon

www.pacificcenterplasticsurgery.com

Skin Healing after Facelift

This is exactly where much of the healing takes place. If the skin would not heal down afterwards, a facelift procedure would not be possible. In my opinion, the skin should not be tightened but rather allow to redrape without tension. Tight skin after a facelift adds only an unnatural appearance and poor scar healing.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon

www.drfechner.com

It is almost impossible to take so much skin in a facelift that the lips do not close.

Lips that may close poorly are due to injury to an underlying nerve. This is exceedingly rare with the facelifts as performed by experienced plastic surgeons. Skin becomes reattached in the normal healing process as explained by other responders. However reattachment can be delayed by fluid collection under the flaps. Once again this can be avoided by choosing an experience plastic surgeon who is gentle with the tissues. Dr Mayl Fort Lauderdale more

Nathan Mayl, MD
Fort Lauderdale Plastic Surgeon

How Does the Skin Reattach after a Facelift

Skin will reattach to the deep tissue as healing progresses. The best protection to avoid too much skin being removed is selecting an experienced well-trained surgeon.