A facelift restores smoother, more pleasing contours to your face and neck. It can help you look as good as you feel, and perhaps feel younger than you are.

Am I a good candidate for a face lift?

Any one or combination of the following conditions may indicate that you are a good candidate for a forehead lift:

  • a deep line, or fold, running from the corner of your nose to the corner of your mouth.
  • jowls, or loss of a well-defined jawline associated with youthfulness.
  • deep wrinkles in the cheeks and sagging of the "highlight" areas of the cheekbones.
  • loose skin, wrinkles, vertical "cords" or excess fatty tissue in the neck.

A facelift can improve all of these problems. It cannot, however, correct conditions such as sagging eyebrows, excess skin and fatty deposits in the upper and lower eyelids, or wrinkles around the mouth.

Your Personal Consultation

During the initial consultation, your plastic surgeon may ask you to look in a mirror and point out exactly what you would like to see improved. Sometimes, patients may focus their attention on excess skin in the upper eyelids and not realize that sagging of their eyebrows contributes to this skin redundancy. You should be very frank in discussing anything about your appearance that bothers you, as well as what you hope to achieve with surgery. This will help your surgeon to understand your expectations and determine whether they can realistically be achieved. 

How will I be evaluated face lift surgery?

In evaluating you for facelift surgery, your plastic surgeon will assess the thickness, texture and elasticity of your skin, and the severity of wrinkles and folds. Your hairline will be examined to determine where incisions can be discreetly placed. All of these factors, as well as your bone structure and underlying tissues, will be considered in developing an individual surgical plan. 

Your plastic surgeon may discuss with you additional procedures that can be performed along with a facelift in order to address all the concerns you have identified. For example, a facelift is frequently combined with or followed by a forehead lift, eyelid surgery, nose reshaping or skin treatments such as a chemical peel, dermabrasion or laser resurfacing.

How a face lift is performed

Although there are many variations to the facelift procedure, generally an incision is hidden in the natural contour of your ear, then extends around the earlobe and back into the hairline. Following surgery, incisions can be easily concealed by your hair or with makeup. There may also be a small incision hidden underneath your chin.

Most facelift incisions are placed within the hairline and within natural contours in front of and behind (shown in lighter black) the ear.

Sometimes the deeper tissues (grey shaded area) may also need to be repositioned in order to restore a more youthful contour to the face.

After the skin has been pulled up and back, the excess (grey shaded area) is removed.

Because of individual factors, not everyone will achieve the same results from a facelift. Your plastic surgeon will select the surgical technique that he or she feels will obtain the best outcome for you.

How is this surgery able to restore a firmer, fresher look to my face? 

Through the discrete facelift incisions, your plastic surgeon is able to free the skin from the underlying tissues to the extent necessary for the particular surgical technique selected. After the skin has been pulled up and back, the excess is removed. In some instances, the deeper tissues may also need to be repositioned in order to restore a more youthful contour to your face. If necessary, a small incision beneath the chin permits the removal of fatty tissue in that area and smoothing of the cord-like structures of the underlying muscle in the neck.

Understanding Risks

Fortunately, significant complications from facelifts are infrequent. Every year, many thousands of people undergo successful facelift surgery, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and risks.

Potential Complications

Some of the potential complications that may be discussed with you include

  1. hematoma (an accumulation of blood under the skin that may require removal).
  2. infection.
  3. reactions to anesthesia.
  4. injury to underlying structures is possible. The structure at risk is the facial nerve or it’s branches. This may lead to an appearance of asymmetry. The weakness is usually temporary and usually recovers in ten to twelve weeks.
  5. Mild asymmetry in the early phase as a result of unequal swelling.
  6. Sensory alteration of the facial skin.
  7. Scarring can be unpredicable due to individual variations in healing. Facelift incisions are most often inconspicuous.

You can help minimize certain risks by following the advice and instructions of your plastic surgeon, both before and after surgery.

How should I prepare for surgery?

If you are a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. Your surgeon will advise you and provide additional preoperative instructions. If your hair if very short, you may want to let it grow enough to cover your incisions while they heal. If you are overweight you have a realistic desire to lose more that 15 pounds, you should discuss this with your surgeon.

What will the day of surgery be like?

Your facelift will be performed in a hospital under a general anaesthetic. 

Medications are administered for your comfort during the surgical procedure. For your safety during the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulation in your blood. 

When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. A bandage may have been wrapped around your face to be closely monitored. A bandage may have minimize swelling. Sometimes small tubes will have been inserted beneath the skin to drain away fluids that might otherwise accumulate, but you will not feel these at all. It fact, there is surprisingly little discomfort from the surgery. 

You probably will be permitted to go home after a hospital stay of one or two days.

How will I look and feel initially?

It is important to realize that the amount of time it takes for recovery varies greatly among individuals. 

After surgery, you will be asked to restrict your activities and simply relax for a few days. Elevating your head when you sleep will help to minimize swelling and bruising. Remember, you must not take aspirin or certain anti-inflammatory medications, and you should not smoke or be exposed to heavy secondary smoke for a while. 

Any bandages and drain tubes will usually be removed in one or two days. At that time, you will notice puffiness and discoloration that may be more pronounced in some portions of your face than others. Do not be alarmed by any unevenness or temporary asymmetry caused by this variance in swelling and bruising, which is perfectly normal. Generally, the greatest amount of swelling occurs 24 to 72 hours after surgery, but it may take several weeks before all puffiness is resolved. Most bruising will disappear within two weeks. After a few days, you will be permitted to wear makeup that will help conceal and discoloration. You will also experience some numbness in the facial area, which may be present for several weeks or longer. Your stitches will be removed from four to seven days after surgery.

When can I resume my normal activities? 

Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you will be able to resume most of your normal activities within two to three weeks and begin to exercise four weeks after surgery. You will be instructed to temporarily avoid exposure to direct sunlight and, for the long-term, to be conscientious about the use of a sunblock to protect your skin.

Results of your face lift

The results of your facelift may be dramatic or subtle, depending on how you look before surgery as well as the specific goals that you and your plastic surgeon have established. Since the healing process is gradual, you should expect to wait at least several weeks for an accurate picture of your "new look." Additional minor changes, or settling, may occur over several months.