A facelift, or rhytidectomy, is one of the most commonly performed plastic surgery procedures each year with over 230,000 performed in 2020. The purpose of a facelift is to provide facial rejuvenation and improve signs of aging in the face and neck. Typically, patients seeking consultation for a facelift may wish to address changes such as loosening and sagging of the facial skin, jowl development in the cheeks or jawline, and displaced or fallen facial fat.
Finding the right surgeon to perform your facelift is critical. When searching for a surgeon, it is important to find a provider who has extensive training and experience in performing this procedure. Many providers may offer facelifts, and plastic surgeons who are certified by the American Board of Plastic Surgery (ABPS) are equipped to perform it given their extensive training in this procedure and extra certification.
During your facelift consultation, it is important to ask several questions. One of the most important questions to ask your surgeon is whether you are a good candidate for this surgery. Other questions you may consider asking include the following:
– Where will this procedure be performed?
– What type of anesthesia will be used for the procedure?
– What surgical technique is recommended for me?
– What are some common side effects or complications of this procedure?
– What is the typical recovery period and what is recommended for aftercare?
On the day of your facelift surgery, you may undergo general anesthesia, local anesthesia, or intravenous sedation depending on the type of facelift surgery your doctor recommends. The three main options for facelift surgery include traditional or standard facelift, mini or limited facelift, and neck or lower facelift. Each of these facelift variations addresses a different area and severity which will be addressed during your consultation with a plastic surgeon.
Among the various facelift techniques, the traditional facelift provides the most dramatic results. In this type of lift, the incision begins near the hairline at the temples and continues around the ear to the lower scalp. Following the incision, the underlying tissue is repositioned with lifting of the deeper layers of the face including the underlying musculature. The skin is repositioned over the uplifted facial contours with subsequent removal of excess skin.
In a mini facelift, there is only a scar in front of the ear which is in contrast to a traditional facelift where the scar extends around the bottom of the earlobe and behind the ear. Because the incision is shorter in a mini facelift, it is unable to address loose skin around the neck as well as a traditional facelift. Therefore, a mini facelift is best for patients who have minimal loose skin around the neck but desire improvement in the midface and jowls.
The neck lift incision often begins in front of the ear lobe and wraps around behind the ear, and ends in the posterior hair behind the ear. This type of lift is most equipped for addressing loose neck skin and fat accumulation under the chin.
Side effects and complications after facelift surgery are rare and may include facial nerve injury with weakness, infection of surgical site, numbness or sensation changes of the skin, scarring, and skin discoloration. Temporary or permanent hair loss at the incision sites it also rare and dependent on the type of facelift as well as the location of the incisions. Pain following surgery is usually mild and improves over the first few days. You make take over the counter pain medications including Tylenol as needed. It is important to avoid blood thinning medications such as NSAIDs (aspirin, Aleve, ibuprofen, etc).
Following your surgery, there are several steps you may take to ensure adequate healing and recovery. First, maintaining a position with your head elevated will help minimize post-operative swelling. You may also apply cool/ice packs to reduce swelling and help alleviate pain in the surgical area. Refraining from strenuous activity, using skin products on the face/ surgical site, and avoiding smoking are all critical to ensure proper recovery. Most patients typically recover from a facelift over the course of weeks. Immediately following surgery, you will likely go home with bandages on your face and may have drains. Drains may be removed within 24 hours after surgery and sutures are removed one to three weeks after surgery (depending on the type of surgery). For the first 4 weeks, lifting and bending are strictly limited, and strenuous exercise should be avoided for the first 3-4 weeks after surgery. Moat patients are able to return to work after 1-2 weeks.
Finally, there is no “best age” to have a facelift. Patients with signs of facial aging who are considering undergoing a facelift are encouraged to seek consultation with an ABPS board-certified plastic surgeon to gain a better understanding of the options available to them and assess whether they are an appropriate candidate for surgery.