FACELIFT - QUESTIONS AND ANSWERS
Because informed patients are so important to the success of any plastic surgery, Dr. Robert H. Stubbs, a Canadian and American Board Certified Plastic Surgeon has prepared this web info for you. The web info will give you a basic understanding of the procedure - when it can help, how it is performed and what results you can expect. It can not answer all your questions, since a lot depends on the individual patient and the surgeon. Please ask a certified Plastic Surgeon about anything you do not understand.
A: 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 a rhytidectomy) can not stop this aging process. What it can do is improve 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 chin augmentation, submental lipectomy and anterior platysmaplasty, browlift, blepharoplasty, etc.
A: A facelift can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations - they must be realistic.
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. You should be physically healthy, psychologically stable, and realistic in your expectations. Overweight or obese patients are not good candidates.
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 may make you look younger and fresher, and it may enhance your self-confidence in the process. But it can not give you a totally different look, nor can it restore the health and vitality of your youth.
A: All surgery carries some uncertainty and risk. Facelifts are normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is a certified Plastic Surgeon. Nevertheless, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable.
Complications that can occur include hematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles and/or sensation (this is usually temporary but may be permanent), infection and reactions to the anesthesia. Poor healing of the skin is most likely to affect smokers. You can reduce your risks by closely following your surgeon's advice both before and after surgery. See Special Consent to Facelift Surgery.
A: A facelift is a very individualized procedure. In your initial consultation, the surgeon will evaluate your face, including the skin and underlying bone, and discuss your goals for surgery. Be honest in discussing your expectations. We will be frank with you, describing the procedure in detail and explaining its risks and limitations. We will also explain the anesthesia used, the location where surgery will be performed and the total costs involved.
During this consultation, be sure to tell us about any medications (especially aspirin or other pills that affect clotting), vitamins or other drugs you are taking. Smokers should consider giving up the habit before and after surgery. Then, a complete physical along with blood and urine analysis is arranged.
A: The patient should not have had anything to eat or drink after midnight prior to surgery. Pre-op medications should have been taken. Also, transportation and post-op care arrangements should have been made.
Most facelift procedures are performed under deep sedation and local anesthesia. A facelift usually takes 3-4 hours, but the time required may vary considerably depending on the amount of work being done. During this time, the patient is carefully monitored.
Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may be also made under the chin. In general, the surgeon separates the skin from the fat and muscle below. Fat may be trimmed around the neck and chin to improve the contour. The surgeon then tightens the underlying muscle and membrane, pulls the skin back and removes the excess. Stitches secure the layers of tissue and close the incisions.
Following surgery, a small, thin tube is placed temporarily under the skin behind your ear to drain any blood that might collect there. The head is also wrapped in bandages to reduce bruising and swelling. The patient is then monitored in the recovery area for a few hours prior to discharge. It is mandatory for a patient who has had deep sedation to have someone stay with them the first night after surgery. The medications may affect judgment and co-ordination for 24 hours.
A: Follow-up visits vary according to the patient and the procedure. Most patients are seen again in 2 days for dressing and drain removal. Early post-op instructions usually include taking prescribed medications and keeping your head elevated to reduce swelling.
There isn't usually too much discomfort after surgery; if there is, it can be lessened with the pain medications prescribed. Severe or persistent pain or a sudden swelling of your face should be reported to your surgeon immediately. Some numbness of the skin is normal; it disappears in a few weeks or months
Do not expect to look or feel great right after surgery. At first, you are going to look much worse than before. The pale, bruised and puffy face you see initially will not last long and camouflage cosmetics can be applied shortly after the bandages are removed. Stitches are removed between 5 days and 2 weeks post-op. The fine sutures in front of the ear are the first to go. The ones hidden in the hair are the last to be removed.
Most patients are quite active a few days after surgery and many are back to work within a week. The healing process is gradual. While most of the swelling and discoloration will be gone in a couple of weeks, full healing takes many months. It is important in the early healing period to avoid strenuous activities, excessive heat (saunas, steam baths, hair dryers etc.) and sun exposure. Above all get plenty of rest and allow your body to spend its energy on healing.
A: The chances are excellent that you will be happy with your facelift - especially if you realize that the results may not be immediately apparent. Even after the swelling and bruising are gone, the hair around your temples may be thin and your skin may feel dry and rough for several months. Men may find they have to shave in new places - behind the neck and ears - where areas of beard-growing skin have been repositioned. You will have some scars from your facelift, but they're usually hidden by your hair or in the natural crease of your face and ears. In any case, they will fade with time and should be scarcely visible.
Having a facelift does not stop the clock! Your face will continue to
age with time, and you may want to repeat the procedure again - perhaps
5 or 10 years down the line. But in another sense, the effects of even
one facelift are lasting; years later, you will continue to look better
than if you had never had a lift at all. See the Surgical
Art Gallery for examples of this procedure.
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