Facelift Surgery


As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck.

A facelift (technically known as rhytidectomy) can "set back the clock," improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.

About the Procedure

A facelift usually takes several hours-or somewhat longer if you're having more than one procedure done. Most facelifts are performed under local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and your face will be insensitive to pain. (However, you may feel some tugging or occasional discomfort.)

Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin.

After the Procedure

There isn't usually significant discomfort after surgery; if there is, it can be lessened with the pain medication prescribed by your surgeon. Some numbness of the skin is quite normal; it will disappear in a few weeks or months.

Am I a Candidate?

The best candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well.

A facelift can make you look younger and fresher, and it may enhance your self-confidence.

After Surgery Details for Facelift and Mini-Facelift

Normal Things: You will have a loose netting around your face which is used to hold gauze in place. The gauze is to collect any oozing from the incisions. You may change the gauze as needed. If the netting feels too tight you can cut it with scissors to loosen the fit. Once the incisions have sealed, usually the next day, you may remove the netting. Keeping hydrated is important so take plenty of fluids. A small amount of oozing is normal from the incisions the first couple of days. The face and neck will swell from the surgery and is usually the most the first morning after the procedure. The swelling should be soft, however. If the swelling in the face or neck is firm and painful call me. Do not be alarmed if one side of your face is slightly more swollen or numb than the other. This is common and usually disappears within a few weeks after a facelift.

Medications: Take the Vicodin for pain every 4 hours if you need it for discomfort. Take it less often if your discomfort is controlled. If you get nausea from the Vicodin try taking a half a pill at a time. Take the antibiotics (Cipro) and Arnica as directed. The Medrol is to help with swelling. Take it as directed in the package.

Activity: Keeping your head and shoulders elevated helps with reducing the swelling. Sit with your back and feet elevated on the couch. Sleeping in a recliner chair for the first 2 nights will help decrease swelling. Walking is important to keep from getting blood clots in the legs so try to get up and walk every couple of hours while awake. Light activity can be performed as tolerated but strenuous activity must be avoided for 3 weeks or bleeding may occur.

Ice and Heat: Ice may be applied to the face and eyes the first night and off and on the next day. After that, ice will not make much difference. Never put heat on your face after a facelift. Heat will make you swell and you might possibly burn your skin where it is numb.

Showering and Washing Your Face and Hair: You may wash your face the night of surgery if you desire. Bland soap and water is acceptable. Remember your face will be numb in places so be careful with the water temperature. You can shower the day after your surgery and wash your hair. I suggest to not use a washcloth but to just use your fingers so that you will not break the delicate sutures around our ears. You may shower with the drains in place – just be careful. You can clip the bulbs to something placed around your neck while you shower.

Makeup and Skin Care: You can wear makeup 2 days after your surgery but avoid getting the makeup near the incisions. If you are using Obagi: the cleanser, toner and sunscreen can be used after the first week but wait for 4 weeks for the Retin – A and Clear.

Drains: You may have one or two drains from the surgery. If you do, empty the drains in the toilet when the bulbs become half full. Squeeze them to put them back on suction. If a drain comes loose and falls out, don't worry your body will resorb the fluid.

Sutures: I only use dissolving sutures in facelifts. However, sometimes even the dissolving sutures will create a small area of irritiation. I occasionally need to remove a suture in the office. It is best if you let me or one of my staff remove the suture.

The Healing Process: The first night and the following next day are the most difficult. After that, you should start feeling better. The swelling takes a good week or so to decrease with a minilift and longer with a full facelift. Bruising usually is more noticeable several days after the surgery and then subsides. You may notice it hurts to chew because a facelift works around the chewing muscles. Feeling "down" after a facelift is common. Just know the feeling will go away with time. Call me or my staff if you have any concerns at any time. The full healing process from a facelift takes many months for all of the swelling to resolve, the numb areas to return to normal and the smile and facial muscles to fully return to normal.