As we age, the tissues in the face begin to sag and loosen due to the effects of gravity. This results in the formation of jowls over the jawline, deep lines over the cheeks, and sagging under chin and neck. In addition, external factors such as sun exposure and smoking can contribute to the formation of finer wrinkles and skin damage. For those wishing to achieve a more refreshed and rejuvenated appearance, a facelift can address sagging and loose tissues over the lower half of the face and neck, as well as the deeper lines in the face. While we can’t turn back time, we can achieve a younger look, typically resulting in an appearance 10-15 years younger than your true age.
The original techniques for facelift involved removing only excess skin from the face and neck. However, it was soon discovered that the results from removing just excess skin were short-lived. The underlying soft tissue plays a large role in the formation of sagging and deep lines in our face, and also needs to be lifted and supported as well. The current techniques for facelift all involve varying degrees of skin and soft tissue removal and suspension to achieve a more youthful and rejuvenated look.
A typical facelift involves an incision that extends from the hairline at the temple, extending along the creases of the ear, and into the hairline at the back of the neck. The incision typically is placed at the hairline in order to prevent raising the hairline and creating a “surgical” look. An additional incision is placed below the chin to address the bands in the neck (“turkey neck”). The overall effect addresses the neck and lower half of the face.
As the tissues in the face are lifted, the nerves that control the muscles of the face are identified and avoided. This is a method of safely working around the nerves and preventing nerve damage.
All incisions are closed using dissolvable sutures. Drains are rarely used, and if used, are removed within the first 24 hours of surgery.
What to Expect After Surgery
A dressing is placed after surgery that wraps around the face and neck. This is typically the most uncomfortable part of the procedure, since the dressing places pressure on the face and neck, and feels tight. The dressing is removed 24 hours after surgery.
Swelling and bruising usually occurs to varying degrees after surgery. This can affect the eyes, cheeks, and neck. The appearance can be very striking at first, but this will resolve with time. It may take up to 3 months for the swelling to completely subside. Medications, such as Arnica cream and pills, can help speed up the resolution of bruising after surgery.
Activity is limited after surgery to assist with healing and to prevent complications. Light activity is permitted after surgery, but straining and heavy lifting are restricted for 6 weeks after surgery. Light activity can be resumed after 3 weeks, and normal activity can be resumed after 6 weeks. Some patients may be self-conscious about their appearance and will avoid going out in public immediately after surgery. On average, most patients will feel comfortable returning to their normal social activities 3-6 weeks after surgery but may want to wait 3 months before attending specific events such as weddings.
The effects of surgery may be readily seen even a few weeks after surgery, but complete healing may take up to 1 year after surgery. In addition, the two sides of the face may heal at different rates and may appear to be asymmetric or uneven, despite performing the same procedure on both sides. While this may be distressing, the appearance will even out with time.