As we get older, sun exposure, stress and the impact of gravity have a negative impact on our skin and facial appearance. No matter how hard we try to maintain a healthy life and use skin care treatments, eventually we all develop signs of facial aging.
Aging can show on our faces in the form of presence of wrinkles, sagging cheeks, deep lines around the mouth, loose skin in the neck and heavy jowls, causing us to look older than what we feel inside and affect others how they are perceived as well as how others may interact with you. If these conditions describe you and you are willing to reverse some of these signs of aging, a facelift can help you refresh your appearance and potentially achieve your goals.
Facelift is the second most performed cosmetic surgery procedure among mature both men and women followed by an eyelid surgery. According to JAMA (The Journal of the American Medical Association) reports that patients believed that they look 9 years younger after undergoing the surgery. Most often results are so natural and good that patients refer this procedure to their families and friends.
WHAT IS FACELIFT?
Facelift is also known as ‘Rhytidectomy’, is a surgical procedure that involves removal of facial wrinkles with the goal of improving an overall appearance of the jaw and face. It is a form of aesthetic surgery performed to achieve a more youthful look.
WHAT CAN BE IMPROVED BY A FACELIFT?
Skin starts to lose its elasticity and facial tissues lose volume as we age. Although a facelift can not stop aging, it can set back the clock. The surgery can potentially improve one or more of the following issues:
- Sagging jowls or cheeks
- Deepened lines and wrinkles below lower eyelids and nasolabial fold (between nose and mouth).
- Banding in the neck
- Sagging, loose skin and excess fat below the chin and neck
- Overall face contour and appearance
- Confidence level
WHEN SHOULD I GET A FACELIFT?
There is no certain correct age to consider a facelift procedure. The right time may be defined as when what is seen in the mirror does not match with what is felt on the inside. It is an extremely personal decision to undergo the procedure, not to please others. The right time is when you are physically and emotionally ready for the procedure.
There are patients as young as their late 30’s as well as patient’s in their 70s and 80s who undergo the facelift procedure to attain a more youthful appearance.
WHO ARE THE IDEAL CANDIADATES FOR FACELIFT?
Ideal candidates for a facelift surgery are as follows:
- are in good overall health
- sagging in the facial area and neck, but elasticity in the skin
- have strong bone structure
- have minimal amount of fat tissue
- have realistic expectations about the procedure
- are looking to restore a more youthful appearance
CONSULTATION WITH YOUR SURGEON BEFORE THE SURGERY
MediExpert surgeon will discuss the following issues during your facelift consultation:
- Your surgical goals to be achieved
- Your general health status will be evaluated, allergies, previous medical treatments particularly related with the eyes will be checked
- Current prescribed medications and the usage of supplements and vitamins will be checked
- Smoking, alcohol and drug usage will be asked
- be used will be discussed
- Photos of the face will be taken
- Potential complications and the risks of facelift surgery will be discussed
WHAT DO I NEED TO DO PRIOR TO THE SURGERY?
Following should be done in terms of preparation prior to the facelift surgery:
- Blood testing will be required to evaluate general health status prior to the surgery and EKG may also be requested from your surgeon
- Avoid all sorts of blood thinners and certain anti-inflammatory drugs at least 10 days prior to the surgery as they might increase bleeding and bruising
- Stop smoking at least two weeks prior to the surgery as it can delay the healing process. If you are a heavy smoker, we will try to encourage you to avoid smoking as much as possible prior to the surgery
- Avoid alcohol 1 week prior to the surgery
- Avoid vitamin E supplements, ginseng, gingko biloba weeks before the surgery as these may prolong the bleeding
- Ensure to have cold compresses ready to use after the surgery
- Wear comfortable and loose clothes and not wear jewelry and necklaces at the day of the surgery
- Do not eat or drink anything 8 hours prior to the surgery except any prescribed medication
- Ensure that the bed in pre-arranged with plenty of pillows as elevation of the head will reduce swelling after the surgery
- Ensure that a family member or a friend is arranged to take care is available to stay with you for assistance the night after the surgery
- Do not wear any lotion, perfume, makeup and sort cosmetic products at the day of the surgery
- Do not apply any hair gel on the day of the surgery
TYPES OF FACELIFT SURGERY
MediExpert has a highly customized approach taking into consideration the patient’s specific aesthetic goals. Therefore, we will provide the optimum solution in order to meet with the desired goals of each patient. There are six different types of facelift surgery options which are outlined below.
A Mini-Facelift is an appropriate type of facelift for the individuals who exhibits a mild degree of jowling and sagging skin, but still have well-contoured neck. It is a minimally invasive technique that involves to tighten deep facial tissues through shorter incisions, typically from the hairline above the ear with the scars hidden in the natural creases of the skin. Cheeks are then lifted and tightened to reposition the jawline through these incisions. A mini face lift is generally preferred by younger individuals before reaching the signs of aging that allow them delaying the requirement of a more extensive surgery such as full facelift for many years.
A Standard Face Lift is also known as ‘Traditional Face Lift’ is appropriate for the individuals who have moderate to advanced aging around the mid-face and neck. Redundant skin of the face and neck, and often together with the excess fat of the neck is addressed. Incisions are located along the shape of the ear and extending behind the hairline which are hidden in the natural facial creases. The skin is lifted followed by tightening the underneath muscle and removal of excess fat. The remaining skin is then smoothed out and redraped. It is commonly combined with a neck lift platysmaplasty procedure as targeting only one area leave the other are not rejuvenated and less youthful than the other.
A mid-facelift targets the middle face area only to correct cheek sagging, whereas neck and forehead not targeted. The procedure involves several small incisions created in the hairline and inside the mouth for the fatty layer of the SMAS over the cheekbone to be repositioned. It is generally suitable for individuals between the ages of 40-50 having nasolabial folds due to cheekbones laxing. A mid-face lift flattens the mid-face region, improves the facial lines, eliminates the nasolabial folds and create an attractive cheek contour.
SMAS stands for ‘superficial muscular aponeurotic system” of the face which is a complex system of layer of facial muscles and connective tissue that separates the skin of the face from the underlying nerves and makes up the deeper soft tissue structure of the face. During this procedure, initially skin is separated from SMAS followed by the SMAS elevated off of the underlying facial muscles. The muscle is then trimmed and repositioned at a higher point on the face, while lifting both the face and skin. As soon as the underlying tissue layer tightened, the surgeon will redrape and trim the skin accordingly. The SMAS facelift technique can achieve significant cheek elevation and correct sagging in the lower face and neck.
DEEP PLANE FACELIFT
This technique is similar to the SMAS facelift and developed to achieve a superior correction of the deep nasolabial folds (nose to mouth lines) and a better elevation of the cheeks and the deep tissues of the face. It is the most invasive type of facelift that involve lifting and repositioning of mid-facial region and cheekbones. Lifted tissue and skin are thicker and require incisions along the hairline enabling the easy lifting of facial muscles and upper fatty tissue. The facial muscles along with the fatty layer above them are then lifted and repositioned in the mid face and cheek bone. This technique often deliver the most dramatic results lasting for 10-15 years and especially suitable for older individuals who suffer severe skin sagging and laxity. It is also considered to be a better technique for smokers.
A thread lift is the least invasive type of facelift surgery and can be performed without general anesthesia. It is generally popular among the individuals between the ages of early 30s and late 40s who need minimal improvements to treat laxity or sagging in the nasolabial folds, forehead and around the eye area. The procedure involves inserting a thin hollow needles that is attached to a barbed thread, then passes through fatty tissue below skin surface. Barbs in this technique act as a hook underneath the skin to gather skin layers in order to tighten the skin to an upward direction. Barbs eventually provide a lifting effect into the skin without any cutting required. A thread lift technique is proved to last up to 2-3 years.
STEPS IN A FACELIFT SURGERY
The following steps are taken in a common facelift surgery.
1. ADMINISTRATION OF ANESTHESIA
A typical facelift surgery is performed under an intravenous sedation or general anesthesia. MediExpert surgeon will choose the best option based on the type of facelift to be performed consulting with the patient.
2. OPENING INCISIONS
Depending on the specific aesthetic goals of the patient, facelift options include a mini facelift, traditional facelift, mid-face lift, SMAS face lift, deep plane facelift and thread facelift.
A typical facelift procedure begins with an incision in the hairline, just above and in front of the ear by using a laser or scalpel. Incision then continues under the earlobe and ending in the hairline behind the ear. Skin is then gently lifted, fat tissues may be removed followed by the tightening of underlying muscle and connective tissue. The skin is redraped over the uplifted contours and excess skin is removed.
A second incision may be required under the chin to improve neck contour. In all cases, the incision lines made during facelift procedure are performed with the intention to conceal scars within the natural crease of the skin.
3. CLOSING THE INCISIONS
After the excess skin is trimmed, incisions are then precisely closed with extremely fine sutures and/or metal clips to minimize scarring.
BENEFITS OF FACELIFT SURGERY
Some of the potential benefits you may be experiencing from a facelift surgery include:
- More youthful appearance as overall
- Tired and sad look in the face will be converted to a more sharp look
- Smoother neck
- Well defined jaw line
- Diminished smile lines
- Smooth cheeks
- Boost in self-confidence
- High patient satisfaction
- Long-lasting results
WHAT IS EXPECTED IMMEDIATELY AFTER THE SURGERY?
Post operative period is extremely important for a quicker healing and recovery period. Following are most likely to be expected within the first few days after the surgery:
- You will be kept under observation for few hours following the surgery
- You may experience minimal discomfort, numbness, bruising and swelling where should be subsided after a week
- Your head will be bandaged to minimize swelling and drainage tube may be inserted to prevent fluid collecting under the skin
- You may have the feeling of tightness in your neck and face
- You will have cold compress gauze dressing over your eyes
- Your hair will be washed by nurses before discharging from the hospital
HOW LONG IS THE FACELIFT SURGERY?
The length of the surgery is typically between 1 ½ – 2 ½ hours whether facelift surgery is performed alone. Since it is very common to undergo facelift combined with eyelid lift blepharoplasty and brow lift forehead lift or other various type of cosmetic procedures, the length of the procedure may take from 3 up to 7 hours depending on the number of different procedures as well as the extent of each of them.
HOW OLD DO I HAVE TO BE TO UNDERGO THE SURGERY?
There is no certain age limitation to undergo the procedure, however most of our patients tend to be middle aged and older range from late 30’s to 80s.
WHAT KIND OF PAIN SHALL I EXPECT AFTER AN FACELIFT?
Although pain tolerance may vary from patient to patient, most of the patients are surprised to experience how mild the discomfort is. Patients commonly complain more about the pulling sensation and tightness from swelling. Pain medication is prescribed to reduce any possible discomfort and often used between 2-5 days as most of the patient also stop taking the pain reliever after 48 hours following the procedure. It is very uncommon for the patients to report extreme pain following the surgery.
WILL MY SCARS BE NOTICEABLE?
One of the primary goals of a facelift surgery is to leave the scars in unnoticeable locations. Although the scarring depends on the technique performed and how extensive the loose skin is, scars will be well hidden in the hairline and within the natural creases of the skin.
HOW LONG IS THE RECOVERY TIME?
After the surgery, you may experience minimal discomfort. Some numbness, swelling, bruising and skin discoloration is expected for up to 2 weeks, where majority of it should be gone after a week depending on the type of facelift performed. It is recommended to keep your head elevated, may be to sleep with three or four pillows for the first few days for the swelling to subside more faster.
Alcohol and all kinds of blood thinner medications should be avoided for 5 days. Sitting under the sun, hot tubbing and hot hair dryer should be avoided for 3 weeks, sauna and steam room for several weeks following the surgery, whereas smoking should be avoided for at least 2 weeks and if possible a couple of weeks more to fasten the recovery period and achieve better results. Initial recovery period is between 7-10 days, whereas 3-5 weeks are generally required for a full recovery from a facelift.
CAN BRUSUING BE PREVENTED?
Most patients of the patients will have a bruising in to a certain extent. Bruising can be minimized by using Arnica 2 days before and after surgery and following the complete instructions of your surgeon.
SHOULD I NEED TO STAY IN THE HOSPITAL AFTER FACELIFT SURGERY?
It is typically an outpatient procedure meaning that it is not required to stay at the hospital overnight.
WHEN WILL THE STITCHES REMOVED?
The stitches will be typically removed within a week after surgery if they are not dissolvable type.
WHEN CAN I GO BACK TO WORK?
Most of the patients are able to return for a desk job within 7-10 days after a more extensive facelift procedure such as SMAS facelift, mid-face lift and deep plane facelift, whereas a day or two off the work is sufficient followed by a thread lift and mini facelift. You may need to take few more weeks off for a physically demanding job. Your surgeon will advise you the recommended date back at work following the surgery based on your specific type of strenuous job.
CAN I DRIVE AFTER THE SURGERY?
It is typically 4-5 days required to start driving after the surgery.
WHEN CAN I HAVE A SHOWER AFTER THE SURGERY?
It is typically 1-2 days required after the surgery to have a shower. Your surgeon will provide you the exact period depending on the type of surgery performed.
WHEN CAN I START EXERCISING?
Light exercises can be resumed within 10 days after the surgery, whereas strenuous exercises such as running and heavy lifting should be avoided for 5-6 weeks.
IS THERE A NON-SURGICAL OPTION TO FACELIFT SURGERY?
Injectable fillers, skin resurfacing and Botox may be a temporary solution to improve the appearance of face. Thread lift which is a minimally invasive procedure may also be considered as a second option for those who are not willing to undergo a extensive facelift procedure. However, the results are not likely to be as dramatic and long-lasting as an extensive type of facelift surgery as an extensive facelift procedure remains to be the only permanent solution to achieve well face contour.
CAN FACELIFT SURGERY COMBINED WITH OTHER PROCEDURES?
There are number of different cosmetic surgical procedures that can be safely performed in combination with an facelift surgery. It is in fact very common to address other parts of the face in order to achieve a comprehensive facial rejuvenation.
Some of them include brow lift forehead lift , neck lift platysmaplasty , eyelid lift blepharoplasty , lip enhancement , rhinoplasty nose surgery , chin augmentation mentoplasty as well as non-invasive procedures such as laser resurfacing and Botox.
There are benefits of having these surgeries at once as initially it avoids the risks of two surgeries, anesthesia applied one at a time and advantageous in terms of minimizing recovery process, saving time and money accordingly.
WHEN CAN I SEE THE FINAL RESULTS?
Immediate improvements can be seen after the surgery, however these changes will not be the final results. It may take 4-6 weeks for the majority of swelling to fully resolve and the final results are more likely to be achieved within 6-9 months following the surgery when face reaches its final form and appearance.
POTENTIAL COMPLICATIONS AND RISKS OF FACELIFT SURGERY
Although a facelift surgery is generally a very safe procedure, all the surgeries carry uncertainty and risk in to some extent. Individuals have to weigh the potential benefits in terms of achieving the aesthetic goals with the risks and potential complications of a facelift surgery. Although rare, some of the complications and risks include:
- Anesthesia risks
- Swelling and bruising
- Seroma and hematoma
- Skin irregularities and discoloration
- Possible need for revision surgery
- Unfavorable scarring
- Nerve damage
- Temporary or permanent hair loss at the incisions
- Fluid accumulation
- Temporary changes in sensation
- Tissue loss (necrosis)
- Poor wound healing
- Deep vein thrombosis, cardiac and pulmonary complications
HOW LONG WILL THE RESULTS LAST?
The improved results will be long-lasting as long as maintaining a healthy lifestyle, for many it is a life-long permanent results. However, a touch-up procedure may be required after some years depending on aging, heredity, quality of skin or external factors including massive weight loss, smoking and sun damage. As a matter of fact, you will surely continue to look younger even years later than if you hadn’t had the facelift procedure performed in the first place.