What is a Facelift?

Facelift Overview

Facelifts are one of the most popular forms of cosmetic surgery. Also known as a rhytidectomy, facelift surgery is designed to improve the overall appearance of the face and neck by addressing the visible signs of aging. A facelift tightens sagging skin and removes excess fat to leave patients with a more youthful and refreshed look.

Kinds of Facelift Surgeries

There are several approaches to facelift surgery that allow you to get the best results. Here are the most common facelift options:

1. Traditional or Full Facelift. This is the most comprehensive face lift procedure, addressing the entire face and neck. The surgeon makes incisions around the hairline, ears and sometimes under the chin to tighten and remove excess skin and facial fat.
2. Mini Facelift. A less intensive procedure than a full facelift, a mini facelift is designed to target specific areas of concern. Patients typically opt for a mini face lift to address concerns with the lower face and jawline. It utilizes smaller incisions, resulting in a shorter recovery time than a traditional facelift.
3. Mid-Facelift. The mid-facelift focuses on the center of the face, addressing sagging skin or loss of volume in the cheeks and under the eyes. The surgeon makes incisions around the lower eyelids or within the mouth to lift and reposition the mid-face muscles and tissues.
4. Deep Plane Facelift. This is an advanced, complex cosmetic surgery technique that repositions the deeper facial tissues and muscles. For patients with significant sagging, it can provide more dramatic and natural result.
5. Skin (cutaneous) Facelift. This plastic surgery procedure targets sagging facial skin. Unlike other facelift techniques, it does not address fat or underlying muscle. The results are not as long-lasting as other face lift techniques.
6. Lower Facelift. This procedure concentrates on the lower part of the face and neck, including the jowls. Patients often combine a lower face lift with a neck lift to further improve jawline definition and reduce the appearance of a double chin.
7. Nonsurgical Facelift. A nonsurgical facelift temporarily refreshes, firms or plumps the facial skin and tissues. It is performed without large incisions, general anesthesia or an overnight hospital stay. Nonsurgical facelifts typically use a combination of minimally invasive and nonsurgical techniques.
8. Neck Lift. While not strictly a facelift, neck lifts are often performed alongside facelifts to address sagging and excess skin under the chin and on the neck. It involves making incisions around the ears and under the chin to remove loose skin and tighten the underlying muscles of the neck.

How Facelift Surgery is Performed

Facelifts should always be performed by a board-certified plastic surgeon and can vary in complexity, depending on the patient’s specific needs and goals. However, a standard facelift typically follows these general steps:

1. Anesthesia. The procedure begins with the administration of anesthesia, which can be either local or general. The choice of anesthesia depends on the patient’s preferences and the surgeon’s recommendations.
2. Incisions. When the patient is under anesthesia, the surgeon will carefully make incisions in the appropriate areas, often around the hairline, behind the ears, under the chin or even in the mouth. These incisions are strategically placed to minimize visible scarring.
3. Skin Lifting. After making the incisions, the surgeon gently lifts the skin to access the underlying facial tissues and muscles.
4. Muscle and Tissue Adjustment. The underlying facial muscles and tissues are repositioned and tightened to the patient’s facial contours and bone structure.
5. Excess Fat Removal. If necessary, excess fat is removed to further enhance facial definition.
6. Skin Redraping. The skin is then draped over the newly repositioned muscles and tissues, and any excess skin is trimmed.
7. Incision Closure. The incisions are carefully closed with traditional stitches that will need to be removed, dissolvable stitches or skin glue.

How to Prepare for a Facelift

Like any surgical procedure, it’s important to be prepared for your facelift every step of the way.

Your Consultation

When you visit your board-certified plastic surgeon for your face lift consultation, you should be prepared to discuss your goals, along with any previous surgeries, medical conditions, or medications you are currently taking. This will help your surgeon determine whether you are a good candidate and if so, the best approach for your facelift surgery.

If it is determined that you are a good candidate, your surgeon will take “before” photos and provide you with a quote for the procedure. You may also be required to have a medical evaluation or lab testing to ensure you are cleared for surgery.

Surgery

In the days leading up to your surgery, you should follow the pre-op guidelines provided to you by your surgeon. These guidelines typically involve the following:

• Apply certain products to the facial skin, provided or recommended by your surgeon
• Avoid taking aspirin, anti-inflammatory drugs or herbal supplements to help prevent excess bleeding and bruising
• Avoid receiving any other facial treatments, including Botox and fillers, in the weeks before surgery
• Stop smoking
• Abstain from alcohol for at least 48 hours before surgery

On the day of your surgery, wear loose, comfortable clothes. Many patients opt to wear a button-up or zip up shirt to make changing easier after the procedure. Leave your jewelry at home and avoid wearing makeup, perfume or other facial skin care products.

Aftercare

Your surgeon will provide post-op care instructions—including follow up care appointments—to ensure you heal properly. You should arrange for someone to drive you home from your surgery and stay with you for the first few days of your recovery.

General facelift aftercare looks like the following:

• Plan to take 10-14 days off of work or other responsibilities.
• Sleep elevated and alone for 1-2 weeks following surgery.
• Avoid bending over and lifting heavy objects, including children, for at least 1 week.
• Avoid strenuous exercise for several weeks. Your surgeon will clear you for exercise when they determine you are healed enough, usually at the 6 week mark.
• Stay out of the sun for at least 1 week, and keep incision sites out of direct sun exposure for 1 year. This will help reduce scarring.
• For the first 72 hours, regularly apply ice packs to the surgical sites. Use a towel or cloth to prevent the ice from coming into contact with your skin. This will help minimize swelling and pain.
• Your surgeon may prescribe pain medication, but if not, take acetaminophen. Aspirin and anti-inflammatory medications may make bleeding worse.

If you experience concerning side effects like severe pain, chest pain or excessive bleeding during recovery, notify your surgeon immediately.

Risks of a Facelift

While facial rejuvenation surgery is typically a safe procedure, it does carry some risks and may result in possible complications. The most common risks include:

• Facial nerve injury, facial weakness, numbness or change in skin sensation. These may be temporary or permanent.
• Infection, as with any type of surgery. Proper aftercare helps to reduce the risk of infection.
• Reaction to anesthesia. If you have allergies or have ever had any type of reaction to anesthesia, make your doctor aware of this before the surgery.
• Hematoma, blood that collects under the skin, may occur. These are generally removed by the doctor and are not dangerous unless left untreated.
• Scarring. While your surgeon will take precautions to minimize scarring, it is always a possibility when incisions are made. Topical scar treatments or surgical intervention can help make them less noticeable.

Who is a Good Candidate for a Facelift?

The best candidates for facelift surgery are in good health and have at least one of the following:

• Wrinkles around the eyes, nose and mouth
• Sagging skin from the cheeks to the jawline
• Loose skin on the neck
• Jowls caused by sagging tissues along the jawline
• Volume loss in the cheeks

What Should I Look for when Choosing a Plastic Surgeon for a Facelift?

When choosing a cosmetic surgeon to perform your facelift, it’s important to do your research and ask plenty of questions during your consultation. Here are some of the questions we recommend asking:

• Do you hold American Board of Plastic Surgery certification?
• How many years of plastic surgery training have you had?
• Where and how will you perform my facelift?
• What will be expected of me to get the best results?
• How long of a recovery period can I expect, and what kind of help will I need during my recovery?
• What are the risks and complications associated with a facelift? How do you handle those complications?
• What if I am dissatisfied with results of my facelift?

In addition to these questions, ask to see before-and-after photos for other patients that have undergone a facelift and read reviews from previous patients. This will give you a better idea of what to expect.