Aging is unavoidable. Everyone’s skin loosens over time, causing the appearance of aging. While it varies from person to person, most people will eventually exhibit some combination of wrinkling around the mouth and eyes, forehead lines, pouches along the jawline, a double chin, folds on the neck, and sometimes even a web of fine lines throughout the entire face. The speed of aging varies by the person, depending on factors like genetics and lifestyle effects, but it is guaranteed to hit everybody.
Fortunately, a facelift, or rhytidectomy, can correct these signs by removing excess skin, tightening the underlying tissue, and redraping the skin on the face and neck to remove folds. With these techniques, it is able to correct facial sagging, marionette lines, double chins, and jowls, making the facelift the most comprehensive procedure for facial rejuvenation. Facelifts can also be combined with a necklift to remove excess fat or folds under the chin. Or adding a blepharoplasty or forehead lift to the facelift can further reduce signs of aging. This makes the facelift a great option for those who feel that their aging face does not reflect their self-image or that they just don’t look like themselves any more.
Your first step when thinking about a facelift is a consultation with Dr. Masri. During the consultation, you will talk about your needs and goals, and Dr. Masri will discuss the types of facelift available to you. The traditional facelift, which is what most people think of, has the most incisions, but it also gives the most comprehensive results, which can often last well over ten years. There is also a limited incision or mini-facelift, which is faster and less invasive. In this version, all work is done through small incisions, which means less recovery time and fewer scars. This limited version reduces sagging but will not eliminate loose folds and cannot affect the forehead or eyes, and the results last about 5 years. There are also specific versions like the neck lift suitable for patients whose problems are localized to one small area.
Depending on your preferences and on the extent of the lift you’re having, your procedure will begin with either intravenous sedation or general anesthesia.
For patients getting the traditional facelift, the incision will start above and in front of the ear. It moves down around the ear and extends back through the hairline. The incisions will be carefully placed where they look like natural creases near the ears.
After the incisions have been made, the skin is then moved out to the temples, cheeks, and neck so that underlying tissues can be repositioned, then the excess skin is removed.
Fat may or may not be removed, depending on the needs of the patient, and a small cut may be made under the chin. At this point, drainage tubes may be placed, after which the skin edges will be secured and the dressings applied before the patient is removed to the recovery area.
You will experience a moderate amount of pain and discomfort for first 48 hours, but at no point should you be in severe pain. It should be controllable with oral medications and will typically begin to fade within 48 hours. There will be a considerable amount of bruising and swelling, as well as liquid drainage for a couple of days. For the first 48 hours or so, you will need to wear a bulky dressing to prevent blood from collecting under the skin. This dressing is generally replaced with an elastic face garment to support everything while it heals for several more days.
For the first few weeks, you will need to recline rather than lie down to hold down the swelling, which will peak around 48 hours post-surgery. It will decline after that, but most patients do not feel comfortable resuming normal social activities for 10-14 days due to remaining swelling and bruising.
Your activities will be restricted for some time. You should not drive or exercise for the first week, but you should try to stay vertical as much as you can to help with the swelling. Water activities should be limited to brief showers for a full month after surgery, and strenuous exercise should be avoided. You’ll also need to stay out of the sun as much as possible. Strong sunscreen and wide-brimmed hats are recommended to avoid scarring.
In most cases, it will take about six months for everything to heal up fully and up to a year before the scars fade to their final shade.
Possible Risks and Complications
Like all surgeries, a facelift carries the risk of bleeding, anesthesia complications, and infection. We minimize these through good surgical practices, but you should discuss them with Dr. Masri if you are concerned.
There are also risks that are more specific to facelifts. Numbness around the incision sites is quite common. It typically goes away within several months but can sometimes last a year or more. Possibilities such as temporary skin discoloration or hair loss near the incision sites can be likely. There is also a risk of scarring. While all facelifts produce faint permanent scars, a few people may develop red or raised scars. The appearance of these can often be treated with corticosteroids or other medications. Men may also find that they need to shave in places that they didn’t have to before because the skin has moved.
More seriously, there is a chance of injury to the nerves controlling the facial muscles. This is extremely uncommon, but if it happens, it can lead to temporary or, even more rarely, permanent weakness of certain facial muscles. Finally, smokers may have problems with healing that can lead to skin loss. For this reason, we recommend that all patients stop smoking several weeks before the surgery.
Q. Is 40 too young for a facelift?
A. There is not really any particular age that is too young for a facelift. If you are dissatisfied with your appearance due to facial aging, the problem will only get worse without treatment, so there is no reason to wait for an arbitrary age to have things corrected. In fact, having a facelift done younger may even yield some benefits in terms of having higher skin elasticity than if you were to wait.
Q. How can I avoid that pulled-tight facelift look?
A. Facelift techniques have improved over the last decades, but unfortunately, the stereotypes have not changed. We can now perform gentle facelifts that preserve all of your existing facial structures and leave you with your own face, just younger. When you think of the stereotypes about celebrities with bad facelifts, remember that you only see those few people who have problems and would never even guess about the vast majority who have had good results.
Q. Can a facelift correct asymmetric facial features?
A. A facelift is not the best procedure to correct asymmetric features because facial asymmetry typically is caused by small differences in the bone structure on each side of your face. That said, asymmetry may be corrected with another procedure at the same time as a facelift. Please see Dr. Masri for a consultation on the best method to treat your problem.
Q. I keep hearing about “natural facelift creams.” Do they work?
A. Unfortunately, no. Some topical creams such as retinoids do have proven anti-aging benefits, and other non-surgical options like Botox can reduce wrinkles, but if your problem is drooping facial skin, no cream will help you.
Q. I’ve just had a facelift, and my skin feels like it has been pulled too tight. Will this get better?
A. Yes, almost certainly. For the first few weeks after getting a facelift, your facial tissues will be very swollen, making your skin look and feel much tighter than the final result will be. As everything heals and settles into place, your face will feel much more comfortable soon.