Facelift

Alternate Names
plastic surgery of the face
rhytidectomy
rhytidoplasty

Definition of Facelift

A facelift is plastic surgery to repair sagging, drooping, and wrinkled skin on the face and neck. As people get older, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. There may be deep creases between the nose and mouth, the jaw line may have grown flabby, and there may be folds and fat deposits around the neck. A facelift will not stop the aging process. A facelift can be done to remove the excess fat, and tighten the muscles and skin. It is sometimes performed with other plastic surgery to reshape the nose, forehead, or eyelids.

Who is a candidate for the procedure?

The best candidate for a facelift is a man or woman whose face and neck have begun to sag. The individual's skin should still have some elasticity and their bone structure should be strong and well-defined. Another consideration is the cost. Most health insurances do not cover the expense of a facelift. A plastic surgeon may request full payment before the surgery is performed.

How is the procedure performed?

A facelift may be performed in a surgeon's office, a same day surgery center, or a hospital. Facelifts may be performed under local anesthesia, combined with a sedative to cause drowsiness. In this setting, the person will be awake, but relaxed. There should be no pain. Some surgeons prefer to use general anesthesia, meaning the person is put completely to sleep with medications.

Incisions are made above the hairline, at the temples, and behind the earlobe. The skin is separated from the fat and muscle underneath. Excess fat can be trimmed or suctioned from around the neck and chin to improve the contour. The muscle and skin are tightened. Tiny stitches are generally used to close the layers of tissue. Metal clips are sometimes used on the scalp.

What happens right after the procedure?

After the surgery, the person will be taken to the surgery recovery room to be watched closely for a short time. Vital signs, blood pressure, pulse, and breathing will be checked often.

A facelift is usually not associated with significant pain. A small drain may be placed under the skin behind the ear to drain any blood that might collect there. A dressing will be wrapped loosely around the person's head to minimize bruising and swelling.

What happens later at home?

A facelift is usually done on an outpatient basis, meaning that the person will go home the same day as surgery. Generally there is minimal pain following the surgery.

Some numbness of the skin is common, but it usually disappears in a few weeks. The person should keep his or her head elevated for a few days to keep the swelling down. If a drain was left in place, it will be removed 1 or 2 days after surgery.

Bandages are removed in a few days. The face will be pale, bruised, and puffy after the surgery. Swelling and discoloration generally disappear within 2 to 3 weeks. The person can return to normal activities within a few days if he or she feels ready. Final results will not be apparent right away because it takes several weeks for the face to heal.

What are the potential complications after the procedure?

There are possible complications with any surgery. These include bleeding, infection, and reactions to the drugs used to control pain.

Complications that can occur after a facelift include:

• A collection of blood can form under the skin. One must not take aspirin or most anti-inflammatory drugs for at least a week prior to surgery as these may hinder normal clotting and lead to excessive bleeding.
• The nerves that control the facial muscles can be injured.
• The skin can heal poorly, which is most likely to occur in people who smoke because smoking decreases the blood flow to the skin. This interferes with healing of the incisions. Smokers should stop smoking 2 weeks before surgery. By the time the incisions have healed, the person will have been off tobacco long enough that it is an excellent opportunity to benefit one's general health by quitting for good.

The risks of complications can be reduced by closely following the surgeon's advise after surgery.