What is a Face Lift?
A face lift is a surgical procedure performed to improve the effects of aging on the lower face and neck. The surgery is intended to counter the effects of aging and gravity on the skin of the face and create a more youthful appearance.
A face lift can be performed for one or more of the following reasons:
- to create a more youthful face and neck appearance
- to improve a double chin
- to create a more symmetric appearance in patients with longstanding facial paralysis
- as an accompanying procedure to other aesthetic surgeries
What is the most appropriate age for a face lift?
As long as you are healthy and are able to undergo anesthesia there is no age limit for a facelift.
Could I benefit from a face lift?
You may be an appropriate candidate for a facelift for one of the following reasons:
- you are unhappy with the effects of aging in your lower face and neck
- you wish for a more youthful appearance of your face
- you have long standing facial paralysis and sagging of one side of your face
- in conjunction with other facial plastic procedures
How is face lift surgery performed?
After anesthesia and sterilization of your face an incision is placed in the hair bearing portion of the temple region and continued in front of the ear. It is carried on to the back of the ear around the lobule and then is continued for several centimeters into the hair bearing portion of the scalp behind the ear.
In some cases where the temple tuft of hair is high the incision is placed just beneath the sideburns. In men the incision is placed to follow the natural beard lines. After the incision the skin is raised and a thin muscular layer that lies underneath the skin called the SMAS is prepared as a flap. Your surgeon will then pull the SMAS and skin to create the desired look. In most cases some skin is excised and some fat or SMAS may also be taken out. After these procedures are performed the skin is sutured.
Will I need to shave my hair?
No. The incisions that are placed in your hair are performed in a manner to preserve your hair follicles and closure is generally performed with either absorbable sutures which do not need to be taken out or staples which allow removal without damaging these follicle.
What can I expect after surgery?
You can typically get up and walk around the evening of the surgery or the following morning, initially with assistance. You should be prepared for moderate swelling and the ecchymosis of the skin. The degree of swelling and ecchymosis differs markedly from patient to patient. Most swelling will subside after 3-5 days and ecchymosis will barely be visible after 2-5 days. Complete healing will take 6-12 months but the major part of this process is most often completed 3 weeks after surgery.
Will I have a bandage or dressing after surgery?
Yes, you will have a bandage after surgery wrapped around your head to apply pressure over the forehead and to minimize the risk of a blood collection under the skin (hematoma). The bandage will be removed a day after the surgery. You will use an elastic bandage for the next few days. The drains placed behind the ear to prevent blood from collecting under the skin will be removed a day after the surgery as well. Removal of the bandage and the drains are typically also pain-free.
Do you need to remove the sutures?
The sutures are taken out between 5-7 days after surgery. The procedure of suture removal is almost always painless.
Will I be in pain after the surgery?
After surgery pain is minimal to moderate and is usually well managed with pain medications. Severe pain is not expected and if you are experiencing this then you should visit your doctor as soon as possible.
Will I have any visible scars?
There is no such thing as a scarless surgery and any type of incision on the skin will leave a scar. Most often these scars are barely discernible and all the incisions of face lift surgery are placed either inside of the hair or in natural creases of your face. This effectively camouflages the scars in these natural creases and leaves them barely perceptible.
What are possible risks and complications of face lift?
Hematoma formation: this is the collection of blood under the skin. This is easily recognized and will require intervention. This is a rare complication
Infection: infection of the surgical site is very rare. It is usually treatable with antibiotics.
Skin flap necrosis: skin and tissue death are extremely rare after face-lift surgery. The rate of occurrence for this complication greatly increases in smokers.
Nerve damage: during face-lift surgery some nerves may be damaged either temporarily of permanently:
- Ear nerve: the nerve that provide sensation to the ear area may be damaged and feeling around your ear may decrease. This is generally temporary and resolves after 6 months.
- Facial nerve: some branches of the facial nerve which innervates all of the facial muscles may be injured during surgery. This may lead to the inability to move some of the muscles on that side of the face. This type of complication is very rare. If there is temporary weakness this will subside in 3-6 months.
Scarring: all incisions during face-lift surgery are placed in the hairline and in natural creases of the face to hide the scars. Rarely while healing occurs these scars may heal leaving heavy scars.
Loss of hair/loss of sideburns: some hair follicles may be injured during surgery and this may lead to loss of hair. This is also a very rare complication.
Asymmetry/Pinched face: after surgery you may observe that one half of your face is asymmetric to the other side of your face. This is most often temporary and will correct itself in 3-6 months. You must be aware that no human face is completely symmetric and keep this in mind before and after surgery.
Is it possible that I will need revision surgery?
It is impossible to stop the effects of aging and after surgery this process continues. In time your face will age and the effects of surgery will decrease. The aging process is extremely variable among people so it is impossible to tell how long the effects of face lift surgery will last, but it is generally excepted that the results of surgery last 5-10 years.
How long will I be off from work?
Generally speaking the swelling and bruising will last from 1-3 weeks. Sutures if required are generally taken out 5-10 days after surgery. Your surgeon will ask you to refrain from strenuous exercise for 2-4 weeks but you may start working 7-10 days after surgery.
Can I wear make-up?
It is not advisable to wear make-up until after the third day of surgery but may be applied after this time.