A facelift (rhytidectomy) provides broad rejuvenation to the face and neck areas. As we age, the tissue and fat in our faces descend due to gravity. Fat deflation also occurs and the supporting fibrous ligaments begin to weaken and attenuate. Sun exposure and genetics may also take a toll. This leads to some of the changes we associate with aging like jowling, marionette lines, wrinkling, poorly defined jaw lines, sagging, loose neck skin and double chins. The facelift turns back the clock on these changes and allows you to look youthful, rested and natural. It is not meant to make you look like another person or be pulled too tight, resulting in a “windblown” effect. The facelift operation is often combined with other procedures.
Who is a candidate for a facelift?
If you have the changes of aging in your face like jowls, poorly defined jaw lines, creases extending from the corner of your mouth to your chin (marionette lines), sagging excess skin, deep creases, fat descent, loose neck skin, double chin, platysmal banding and you have good skin elasticity and are in generally good health with no history of smoking or high blood pressure, you would be a good candidate for a facelift.
How is a facelift performed?
The facelift typically addresses areas of the lower face and neck. Modified techniques can also be performed to address the midface. The incision is made at the hairline at the temple and continues down in front of the ear, over the tragus (anterior ear cartilage), around the earlobe and behind the ear in its natural crease towards the lower scalp. A small separate incision can be made underneath the chin to perform the neck lift or tightening of the anterior neck muscles.
After the incisions are made, the skin is separated and elevated. Then, the deeper tissue and muscle layer that is responsible for much of the support is tightened. The skin is then re-draped and the excess skin is removed. Closure is then performed with meticulous technique. Small drains may be placed and a supportive dressing is applied. The procedure takes about 2-3 hours but may be combined with other procedures like liposuction, chin or cheek implants, fat transfer, blepharoplasty or brow lift.
What to expect after surgery?
Dr. Farris and his staff at Farris Plastic Surgery will provide specific instructions regarding your surgery. You will be able to go home on the same day of surgery or stay at a nearby hotel. The office will gladly assist you with postop arrangements including a hotel if desired. On the following day, your head dressing and drains will be removed and you will be able to wash your hair. Do not use a heat-type hair dryer. Stitches in front of your ear are removed on the fifth day after surgery. Keep your head elevated while sleeping for 2 weeks. Most of the swelling and bruising should be gone by 2 weeks. At this point, you may use camouflage make-up when you go out in public. In preparation for major social events, allow 6 weeks to look your best.
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- What are the benefits of a facelift versus a neck lift?
This may be an issue of semantics as they both generally refer to the same area. A traditional facelift addresses the jowls, marionette lines, jawline and saggy neck. Through well-placed incisions around the ear, the skin and deeper tissue is pulled up, tightening the neck and lower face regions. Sometimes, an additional small incision under the chin is made to allow further tightening of the anterior neck muscles (platysmaplasty).
- Can a facelift fix my upper face / cheek area?
The facelift / necklift procedure addresses the lower face and neck regions. Rejuvenation of the mid-face or cheek would require a mid-face lift, typically performed through a lower eyelid incision in conjunction with lower eyelid surgery.
- Can a facelift fix the fine wrinkles around my mouth?
No. This area is best addressed with non-surgical methods like microneedling and injectables.
- How long does a facelift last?
The benefits of a facelift can last about 10 years. The procedure does not stop the aging process but can “reset the clock.”
- At what age is a facelift performed?
There is no usual age for a facelift to be performed – there is a wide range although most patients tend to be late 40s to 70s in age. Instead, I prefer to look at defined anatomical issues like jowling, poorly defined jawlines, marionette lines and a saggy neck. Sometimes, people in their 30s who experienced massive weight loss have a saggy neck that would benefit from a facelift.
- What is the downtime for a facelift?
You will experience bruising and swelling for the first two weeks. Swelling tends to peak on the third day after surgery, then begins to subside. Do not plan on going to any major function within 4 weeks after your facelift, just to be safe. If you have drain tubes placed, they are removed on the first day after surgery. Stitches are removed about 7 days after surgery. A compression garment is worn for the first 2 weeks. Do not engage in any exercise or strenuous activity for the first 4 weeks.
- Does a facelift affect the appearance of ears?
Although the facelift incisions are placed around the borders of the ears, the procedure does not affect the appearance of the ears. However, if the skin is pulled too aggressively and if there is tension with skin closure, that might lead to distortion of the lower ear.