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't stop this aging process. What it can do is "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. A facelift can make you look younger and fresher, and it may enhance your self confidence in the process. But it can’t give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

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Beauty for life:
Enhancing your appearance with a facelift

If you are bothered by the signs of aging in your face, a facelift may be right for you. Technically known as rhytidectomy, a facelift is a surgical procedure to improve visible signs of aging in the face and neck, such as:

  • Sagging in the mid-face
  • Deep creases below the lower eyelids
  • Deep creases along the nose extending to the corner of the mouth
  • Fat that has fallen or is displaced
  • Loss of muscle tone in the lower face may create jowls
  • Loose skin and excess fatty deposits under the chin and jaw can make even a person of normal weight appear to have a double chin

Rejuvenation procedures typically performed in conjunction with a facelift are brow lift, to correct a sagging or deeply furrowed brow, and eyelid surgery to rejuvenate aging eyes.

What it won’t do: As a restorative surgery, a facelift does not change your fundamental appearance and cannot stop the aging process. A facelift can only be performed surgically; non-surgical rejuvenation treatments cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate and complement the results of surgery.

Is it right for me?
A facelift is a highly individual procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. Facelift surgery is a good option for you if:

  • You are physically healthy
  • You don’t smoke
  • You have a positive outlook and specific, but realistic goals in mind for the improvement of your appearance.

What to expect during your consultation

The success and safety of your facelift depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Be prepared to discuss:

  • Why you want the surgery, your expectations and desired outcome
  • Medical conditions, drug allergies and medical treatments
  • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
  • Previous surgeries

Dr. Foley may also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Discuss the options available to you for facelift and facial rejuvenation
  • Examine and measure your face
  • Take photographs for your medical record
  • Discuss your options and recommend a course of treatment
  • Discuss likely outcomes of a facelift and any risks or potential complications
  • Discuss the type of anesthesia that will be used

Preparing for surgery

Prior to surgery, you may be asked to:

  • Get lab testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking well in advance of surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

  • What to do on the day of surgery
  • The use of anesthesia during your facelift
  • Post-operative care and follow-up

Dr. Foley will also discuss where your procedure will be performed. A facelift may be performed in our accredited office-based surgical center or a hospital.

You’ll need help
If your facelift is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Procedural Steps:
What happens during facelift surgery?

Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Dr. Foley will recommend the best choice for you.

A variety of other procedures can further enhance the outcome of a facelift. They include:

  • Facial implants
  • Soft tissue augmentation to recontour the facial structure
  • Resurfacing techniques to improve the tone and texture of facial skin
  • Wrinkle reduction by injection

Step 2 – The incision
Depending on the degree of change you’d like to see, your facelift choices include a traditional facelift, limited incision facelift or a neck lift. A traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp. Fat may be sculpted or redistributed from the face, jowls and neck, and underlying tissue is repositioned, commonly the deeper layers of the face and the muscles are also lifted. Skin is redraped over the uplifted contours and excess skin is trimmed away. A second incision under the chin may be necessary to further improve an aging neck. Sutures or skin adhesives close the incisions.

Traditional Facelift

An alternative to traditional facelift uses shorter incisions at the temples, continuing around the ear.

Limited Incision

Sagging jowls, loose neck skin and fat accumulation under the chin may be corrected with a neck lift. The neck lift incision often begins in front of the ear lobe and wraps around behind the ear ending in the lower scalp.

Neck Lift

Step 3 – Closing the incisions
Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear.

Step 4 – See the results
The visible improvements of a facelift appear as swelling and bruising subside. Your final result should not only restore a more youthful and rested appearance, but also help you feel more confident about yourself.

Important facts about the safety and risks of facelift surgery

The decision to have a facelift is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Dr. Foley will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks or potential complications.

The risks include:

  • Unfavorable scarring
  • Bleeding (hematoma)
  • Infection
  • Poor wound healing
  • Anesthesia risks
  • Correctable hair loss at the incisions
  • Facial nerve injury with weakness
  • Facial asymmetry
  • Skin loss
  • Numbness or other changes in the skin sensation
  • Fatty tissue found deep in the skin might die (fat necrosis)
  • Fluid accumulation
  • Pain, which may persist
  • Skin contour irregularities
  • Skin discoloration, sensitivity or swelling
  • Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
  • Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location, unacceptable visible deformities at the ends of the incisions )it may be necessary to perform additional surgery to improve your results)
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Possibility of revisional surgery

More facts about the safety and risks

Be sure to ask questions. It’s very important to ask Dr. Foley questions about your facelift procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with Dr. Foley.

A special note about the use of fibrin sealants (tissue glue)
Fibrin sealants (made from heat-treated human blood components to inactivate virus transmission) are used to hold tissue layers together at surgery and to diminish post-operative bruising following surgery. This product has been carefully produced from screened donor blood plasma for hepatitis, syphilis, and human immunodeficiency virus (HIV). These products have been used safely for many years as sealants in cardiovascular and general surgery. This product is thought to be of help in diminishing surgical bleeding and by adhering layers of tissue together.

When you go home
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedures and another surgery may be necessary.

Be careful
Following Dr. Foley’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Dr. Foley will give you specific instructions on how to care for yourself.

My recovery

When your procedure is completed, a bandage could gently be placed around your face to minimize swelling and bruising. A thin tube may be present to drain any excess blood or fluid that may collect under the skin.

You will be given specific instructions that may include: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with Dr. Foley.

Be sure to ask Dr. Foley specific questions about what you can expect during your individual recovery period.

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery?
    When will they be removed?
  • Are stitches removed? When?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?

The results will be long-lasting

It may take several months for swelling to fully dissipate and up to 6 months for incision lines to mature. Life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend the results of your rejuvenated, more youthful appearance.

How much will facelift surgery cost?

Cost is always a consideration in elective surgery. Prices can vary greatly depending on the extent of the procedure, the combination of multiple procedures, and the time involved. You will receive a detailed quote following your consultation. Talk with the Foley Plastic Surgery Center staff about your payment options.

Cost may include:

  • Surgeon’s fee
  • Hospital or surgical facility costs
  • Anesthesia fees

Your satisfaction involves more than a fee
When choosing a plastic surgeon for facelift surgery, remember that the surgeon’s experience with facelifts and your comfort with him or her are just as important as the final cost of the surgery.

Words to know

General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.

Hematoma: Blood pooling beneath the skin.

Intravenous sedation: Sedatives administered by injection into a vein to help you relax.

Tear trough: Deep creases below the lower eyelids.

Nasolabial fold: Deep creases between the nose and cheek.

Jowls: A jaw line that sags into the neck, usually caused by loss of muscle tone in the lower face.

Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.

Rhytidectomy: A surgical procedure also known as facelift, to reduce sagging of the mid-face, jowls and neck.