Facelift

What to expect

Facelifts are very individualized procedures. In your initial consultation, your surgeon will discuss your goals for surgery and evaluate your face, including the skin, soft tissue volume, and underlying bone. Three-dimensional predictive imaging will be used to show what your plastic surgeon feels would be a realistic result in your situation.

You will be checked for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. Be sure to tell your surgeon if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.

Your surgeon will explain the techniques and anesthesia that will be used, the facility where the surgery will be performed, and the risks and costs involved. Do not hesitate to ask him or her any questions you may have, especially those regarding your expectations and concerns about the results.

Most facelifts are performed under general anesthesia. Occasionally, a facelift will be performed under IV sedation or twilight sleep. Your surgeon will recommend the best choice for you.

During surgery, an incision will be made in the hairline at the temples, continuing around the ear and lower scalp. An incision under the chin to access the neck may also be necessary. After separating the skin from connective tissue and muscles, your deep tissue layers will be repositioned in the face, jowls, and neck and your muscles will be lifted. Excess skin will be removed and the remaining skin will be laid back. The incisions are closed with sutures that may dissolve or need to be removed after a few days.

Because your facial changes will occur deep in the skin, your skin will not be under tension, preventing that “wind tunnel” appearance that many patients fear from a facelift.

There is generally little discomfort after surgery. In the event of greater discomfort, pain medication can be prescribed by your doctor. Some numbness of the skin is quite normal and should disappear in a few weeks or months. Your surgeon may tell you to keep your head elevated and as still as possible for a couple of days after surgery, to keep the swelling down. If you’ve had a drainage tube inserted, it will be removed one or two days after surgery. Bandages, when used, are usually removed after one to five days. Most of your stitches will be removed after about five days. Your scalp may take longer to heal, and the sutures in your hairline could be left in a few days longer.

You should be up and about in a day or two but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first. Your doctor will give more specific guidelines for gradually resuming your normal activities and may include avoiding strenuous activity for at least two weeks and avoiding alcohol and saunas for several months.

At the beginning, your face may be pale, bruised, and puffy. Some bruising may persist for two or possibly three weeks, and you may tire easily. By the third week, you will look and feel much better. Most patients are back at work about 10 days to two weeks after surgery. If you need it, special camouflage makeup can mask any bruising that remains.