Facelift Surgery – What You Need To Know

According to the American Society of Plastic Surgeons, face lifts are one of the most popular forms of plastic surgery to reverse the visible signs of aging in both men and women.

In the medical world, a face lift is technically known as a rhytidectomy, and under the hands of a good plastic surgeon it could make you look up to 10 years younger! So it is not surprising that so many age conscious people have this particular procedure at the top of their cosmetic surgery wish list.

The primary aim of a face lift is not actually to remove wrinkles, as many people seem to think, although this will occur to some extent as a side effect of the procedure.

The main goal of a facelift is to lift skin which is lax, or sagging, around the jowls, jaw line, cheeks or neck area. Providing that things go according to plan, the end result will be smoother, tighter and less wrinkled skin giving your face an overall more youthful and radiant looking appearance.

A rhytidectomy may be carried out by itself as a single surgical procedure, or combined with other surgical procedures such as eye lid surgery (blepharoplasty) or brow/forehead lift surgery (browplasty).

It may also be combined with non surgical procedures such as laser skin resurfacing, microdermabrasion or dermal fillers such as collagen, restylane or Botox injections to more visibly reduce the appearance of fine lines and wrinkles.

Generally, combined surgical procedures can be carried out simultaneously at reduced cost, although when combining a surgical and non surgical procedure, they will usually be carried out separately.

Types Of Face Lift Plastic Surgery

One common misconception about face lift plastic surgery, is that only mature or elderly adults will benefit from it. The reality however, is that a face lift can be carried out at virtually any age because there are many different types of face lift procedures that can be performed.

You can for example, get what is known as a traditional face lift which is mainly intended for people who have a significant amount of sagging skin throughout the lower facial region. This type of procedure is more suitable for older adults, such as people in their 50s or 60s, but if you only have localized regions of sagging, such as around the jaw or neck line, then you can get what is known as a mini facelift to just target those problems areas.

This latter procedure is mainly intended for younger adults aged between 30-50, so regardless of how much facial sagging you have, age isn’t really a concern unless you are deemed to be too young or too old to undergo surgery.

If you are thinking of having a face lifting procedure done, it is therefore important to know what your options are as you may or may not require a full face lift. Below, you will find listed some of the most common types of face lift procedures carried out by cosmetic surgeons, and what each procedure is likely to involve.

Traditional Face Lift

To carry out a traditional face lift, your surgeon will start by making an incision within the temple hairline and then extending that incision down the side of the face, still within the hairline, until he reaches the skin that sits in front of the ear where your hairline ends and where men sometimes grow sideburns. By keeping the incision within the hairline, the vast majority of the eventual scarring will be naturally hidden by your hair. So you won’t have to worry about a big scar running down your face!

The procedure then continues by extending the incision along the front of the ear, around the earlobe and then up behind the ear into the hairline at the back of your head. The surgeon will try to stay within the natural skin creases and folds as much as possible, so that visible scarring can be kept to an absolute minimum.

With the incisions that the surgeon has made, they will then be able to surgically separate the skin from the underlying connective tissue, fat and muscle. Once this has been done, the surgeon will tighten the skin by pulling it backwards at a slight upwards angle until the loose skin has been tightened to the surgeon’s satisfaction and the excess skin removed. If your facelift involves operating on the neck, the skin on your neck will be lifted down to just above your collarbone and across your entire neck.

To make your face lift last longer, some cosmetic surgeons will also tighten a deeper layer underneath the skin known as the submusculoaponeurotic system if you are having an SMAS face lift procedure done. How this is carried out will vary from surgeon to surgeon, although the ultimate goal is to tighten the muscles of the neck and the connective tissue of the cheek.

You can get a rough idea as to the type of result that you can expect from a traditional facelift, by placing two fingers just in front of your ear, with the top of your fingers roughly level with the middle of your ear, and then pulling the skin backwards at a slight upwards angle. This will also help you to determine whether or not you would actually benefit from having a face lift done.

The procedure ends when the surgeon sutures up the incision and then bandages you up for recovery. Face lifts are carried out under general anesthesia, so thankfully, you won’t be awake during the operation! The operation itself generally takes between two to four hours to complete depending on the amount of work that needs to be done and you will usually require an overnight stay in hospital.

The key to performing a good facelift is to tighten the skin just enough so that it doesn’t sag, but is still loose enough to look natural. If the skin is pulled too tightly, then this may interfere with your normal facial expressions and could even alter the overall appearance of your face to the extent where it becomes obvious that you have had a face lift done.

Full Face Lift

If you want to reverse significant sagging from across the whole of your face, then you will need a full face lift. This will involve a brow lift, mid face lift and lower facelift.

Minor Facelifts

A regular face lift tends to be only needed for people with lots of sagging skin, and is the most invasive of all facelift procedures with the longest recovery time and the greatest financial cost. However, depending on your age and the condition of your skin, you may not actually require your whole face to be lifted.

If you are relatively young, such as in your 30s or early 40s, you may only need a minor facelift that addresses localized problem areas to give your whole face a slightly younger and fresher looking appearance than what it currently has.

Besides being a lot cheaper than a standard facelift, minor face lift procedures take less time for the surgeon to perform, have a quicker and less painful recovery and also leave less scarring. Below we will look at four of the most common types of minor facelift procedures that you can have done.

Mini Facelift

A mini facelift, sometimes called a weekend face lift, is most suitable for people who do not require a full facelift and are relatively young with only minor skin sagging around the jaw line or cheek areas.

A mini facelift can also be appropriate if you have had a facelift done before, but now your skin is starting to sag and needs tightening up again. At this point, it is worth mentioning that facelifts don’t last forever, as typically, the results you get will last you up to 10 years depending on the type of procedure that you have done.

Because a mini face lift involves less work around the neck area, rarely involves any muscle work and uses smaller incisions that don’t go very far above the ears, the results that you will get from this type of procedure won’t be as drastic as you would get from a traditional face lift.

A mini facelift should therefore be seen more as a way to subtlety enhance the appearance of your face, rather than to make any dramatic changes to it. This is why it tends to only be suitable for younger faces.

To minimize scarring, your surgeon may choose to perform an endoscopic facelift, sometimes called a scarless face lift. This involves the use of a small wire-like device that contains a camera to allow the surgeon to see underneath the skin. An endoscopic face lift works best with patients who still have good skin elasticity, as a lack of elasticity in the skin is unlikely to produce satisfactory results.

But even if you don’t have an endoscopic face lift, the eventual scarring that you get will be barely visible from a mini face lift because the surgeon will only make an incision along the temple hairline down to the earlobe. As a result, your scars will be hidden by your hair and disguised within the skin crease of the ear.

The S-Lift

An S-lift, or short scar facelift, gets its name from the type of incision that is made during the face lifting procedure. An S-shaped incision is made starting in the hairline just above the ear, which is then extended downwards along the ear and around the earlobe before being extended upwards slightly behind the back of the ear if a greater lifting effect is required.

One of the main advantages of an S-lift is that it can be carried out much quicker than a regular facelift, typically in about a third of the time, and also tends to avoid overtightening the skin thereby producing a much more natural looking end result. Furthermore, due to the smaller size of the incision, there will be less visible scarring after surgery.

An S-lift is similar to a mini facelift in the sense that it is more suited for addressing minor facial and neck sagginess as a result of the small incisions that are made. This procedure is much cheaper than a regular face lift, so if you are quoted the same price for both procedures then you may want to consider looking elsewhere.

The Midface Lift

If you mainly have sagging skin in the middle of your face, such as in the cheeks and above the upper lip, then a midface lift, sometimes called a cheek lift, may be just what you need.

Usually, the incisions will be made in your hairline by your temples, although they can also be made in the lower eyelid skin or within the mouth. The cheek will then be separated from the underlying cheekbone and then later attached to bone or muscle depending on the surgeon’s preference after repositioning of the malar fat pad has been completed.

If done correctly, a mid face lift can produce dramatic looking results. Your cheeks should appear fuller and more youthful and there will be less sag from the lower eyelid region. As an added benefit, you may also notice a reduction in the appearance of the lines that run from the sides of your nose to the corners of your mouth (i.e. the nasolabial folds).

However, this procedure is not without its risks, as if it is not done correctly, then you may experience sagging in the lower eyelids, injury to muscle nerves causing involuntary facial twitching and prolonged swelling.

Mini-Incision Lift

A mini incision facelift is suitable for those who only require minor tightening of the skin. Such facelifts are usually carried out by a dermatologist who has had little surgical experience or training. Typically, the procedure involves microliposuction of excess fat in the neck and an incision under the chin to tighten the neck muscles.

A mini incision facelift is best combined with other treatments such as a facial peel or laser skin resurfacing, as the results you get from this type of procedure will be fairly subtle on its own.

FaceLift After Weight Loss

Face lift surgery tends to be most popular with women, although in recent years the number of men undergoing surgery has been steadily increasing. One of the reasons for this has been the rising levels of obesity in western society, as when people who are obese lose weight, they are likely to have significant facial sagging which causes them to look much older than they are.

To address this facial sagging, a face lift may be carried out after a person has lost a lot of weight. If they also have sagging skin in other regions of the body, such as around the abdomen, buttocks, thighs and arms, then separate procedures can also be carried out to tighten and remove their excess loose skin.

However, most plastic surgeons who specialize in body contouring procedures for overweight patients, will usually not agree to operate on you immediately, as they will ask you to maintain your current weight for a set amount of time.

This is necessary to allow for any more weight loss that may occur, and also to ensure that you are not going to quickly put back on the weight which you have lost. Once your weight has stabilized and your body has had time to adjust, your surgeon will then proceed with the procedure.

The Face Lifting Procedure

A face lift after weight loss can be carried out in several ways depending on how much weight you have lost and the resulting laxity of your skin.

If you have lost a moderate amount of weight and now have sagging skin on your face and/or neck, then your facelift will most likely be carried out in the standard way with incisions made within the temporal area and behind your ears. As a result, your facelift won’t be very much different from anyone else of regular weight.

If however, you have lost a significant amount of weight, then a slightly different approach may be used by the surgeon. In such cases, an incision will usually be made in front of the hairline, in front of the ears and along the hairline behind the ears.

This allows the surgeon far more freedom when operating on you so that more noticeable results can be achieved. You may also have incisions extended along the back of your head where your hairline meets your neck, so that extra skin which is present can be excised, or cut, away.

If you are a female, then you will probably be able to hide these scars with your natural hairstyle, although some receding men may find their scars more difficult to conceal.

Cost

How much a face lift costs can vary greatly depending on the type of procedure that you are having done and the extent of that procedure. But to give you a rough idea as to how much facelifts costs, some estimates have been provided below.

• SMAS Face Lift – $10,000-$15,000

• Short Scar Face Lift – $6,000-$10,000

• Mid Face Lift – $6,000-$10,000

• Lower Face Lift – $4000-$10,000

• Endoscopic Face Lift – $6,000-$10,000

• Full Face Lift – $7,000-$15,000

• Thread Lift – $1,500-$4,500

• Mini Face Lift – $3,500-$6,500

You may be able to reduce the cost of your surgery quite substantially if you choose to have plastic surgery done abroad rather than in your home country. Popular destinations for having cosmetic surgery overseas include Asian countries such as Thailand or Eastern European countries such as Poland.

You will have to factor in the cost of travel, food and accommodation in to the overall cost of your surgery, so this may or may not work out to be a cheaper option. Generally however, if you are having multiple procedures carried out at once, or a very expensive single procedure, then you can usually achieve some quite substantial savings compared to if you have your surgery done at home.

Recovery Period

Immediately after your operation has been completed, you will most likely have drainage tubes running on either side of the face for one or two days. The purpose of these drainage tubes are to remove excess blood and fluid so that they don’t pool under the skin and cause swelling. This is important as otherwise a hematoma or edema could develop that causes an uncomfortable pressure on the face.

Your head and face will then be wrapped in surgical dressing, after which, you will be sent to the recovery room. When you wake up after your facelift, your face is likely to feel tender, swollen and sore. It may be too painful to move your mouth to chew solid food for the first few days, so you can expect to eat mainly liquid foods for at least 3-4 days post surgery.

Although a facelift can at times be quite a long and complicated procedure, it may surprise you to learn that most people tend to recover quite quickly and are usually back to work in 2-3 weeks.

Of course, you will not have made a 100% recovery in this short time period, but you should be feeling well enough to start resuming your normal everyday activities. Typically, it can take many more months, sometimes even up to a year, for your swelling to go down completely and for your scars to heal fully.

Normal Reactions

If you have never had a facelift before, then the new symptoms and sensations that you will experience can take you by surprise. It is therefore worth taking the time to familiarize yourself about some of the things that could happen, so that you will be better able to prepare yourself for them and deal with them if and when they occur.

The best way to do this is to speak with your facelift surgeon during your consultation period, although it can also be helpful if you can speak with past facelift patients as they will be able to give you a firsthand account of exactly what they went through.

Most people though, will react to a facelift differently in terms of the physical and mental symptoms they experience. But in general, you can expect your face to feel tight, numb and uncomfortable in places which is perfectly normal after having a major invasive surgical procedure carried out on your face.

If however, you find yourself in intense pain, have developed a high-grade fever or your wounds look infected, then you should report these symptoms to your surgeon as soon as possible because something may be wrong. In the large majority of cases, if such symptoms are dealt with promptly then the risk of them progressing into something more serious can be greatly reduced.

Emotional Symptoms

In terms of emotional symptoms, most facelift patients tend to feel depressed for the first few days after their surgery. This may be due to their appearance after surgery which they must wait to heal, the discomfort that they are in or simply due to the fact that they are alone and must spend time by themselves recovering.

It is also normal to feel some degree of nervousness, apprehension or anxiety about how your facelift is going to look, as it won’t be until 2-3 weeks later that will you be able to judge how successful your procedure was, and most importantly, whether or not you like the end result. Some patients also have concerns as to what other people will think of them, in particular, whether their friends and family will like, or accept, their new look.

This can be quite a significant concern if you are having a full facelift procedure, because in some people, the results can be quite drastic making them visibly look many years younger than they previously did. So this will take some time for other people, and yourself, to get used to.

Pain

A common concern that all patients have about any form of plastic surgery, is how much pain they will be in once their procedure has been completed. When it comes to facelift surgery, how much pain you will be in largely depends on the extent of your procedure.

If for example, you are having a mini-facelift, then you should make quite a speedy recovery and so the amount of pain that you will be in shouldn’t be too bad. If however, you have a full face lift that targets the lower, middle and upper regions of the face, then obviously you can expect to be in more pain as more of your face has been operated on.

But regardless of the type of procedure that you have, it is natural to experience some amount of pain following your surgery. Specifically, you can expect heaviness, swelling, soreness and increased sensitivity or tenderness in the areas that the surgeon has operated on.

You are also likely to feel some tightness in the face and neck regions, and may not be able to turn your neck from side to side fully during the first couple of days after surgery. If you had a cheek lift done, then your ability to see may be impaired somewhat until your swelling goes down.

The good news however, is that most of the pain can be controlled with pain medication. So you are likely to experience more discomfort than intense physical pain. It would be a mistake however, to think that you will be pain-free post surgery, as even pain killers won’t necessarily make your pain disappear entirely, but instead will just make it easier to manage and live with.

In terms of the duration of your pain, for minor procedures that target localized regions of the face the majority of your pain will be over within 1-2 days. For more complex and invasive procedures this duration can be extended an additional 5-6 days, although your pain will always be greatest immediately after your surgery. Pain can also be reduced somewhat with anti-inflammatory medication.

Scarring

Patients who undergo invasive procedures such as breast augmentation, rhinoplasty, abdominoplasty and thigh lift surgery, tend to almost always express concern regarding the eventual scarring that will be left behind from the incisions made on their body. Patients undergoing facelift surgery are no different.

Unfortunately, it is not possible to give a concrete answer as to how one’s scars will turn out. This is because different surgeons may use different techniques, for example a standard incision vs. endoscopic incision vs. microliposuction incision, which may be placed in different areas of the face depending on what the patient is trying to correct.

However, the main reason why it is difficult to accurately predict one’s eventual scarring, is because people can heal from their incisions differently. Some people heal very well from their incisions and have thin light scarring, whilst others may develop thicker scars that are darker in appearance. Post surgical care of one’s wounds also plays a significant role in scar formation, and a surgeon cannot predict how well their patient will tend to their wounds.

So as a very rough guideline, you can expect your incisions to start just above the ear within the hairline following it down past the front of the ear and then curving around the earlobe and going back upward towards the hairline on the back of the head behind the ear.

Initially, your incision marks will be very visible and the resulting scars can take anywhere from 4 to 6 months to fully heal to the point where they fade from a purplish color to a whitish skin color. Once your scars have fully healed, they should be barely noticeable and most likely will be fully concealed by your hair.

There is a risk however, of hair loss occurring along the incision line which could then make it more difficult for you to conceal that scar with the surrounding hair.

Relaxing After Surgery

For the first two weeks after having cosmetic facial surgery, it is important that you avoid any strenuous activities and this includes exercise. It is generally recommended to take things easy, but that you allow yourself to do the things which you feel capable of doing.

Doing some amount of daily physical activity, even if that just involves walking around for a few minutes, will help to promote healthy blood circulation within the body and reduce your risk of developing a deep vein thrombosis (DVT) which could potentially lead to very serious post surgical complications, one of which, is death via a pulmonary embolism. The risk of this happening however, is extremely low providing that you are not lying down without movement for 24 hours a day.

If you have had a full facelift performed, then you may not be able to drive for the first week as your neck movements are likely to impaired as well as your sight from swelling. The pain medication that you are taking can also cause you to feel weak or tired at times, so you shouldn’t be doing anything that poses a risk of injury until you are free from the influence of your drugs and mental clarity has been restored.

In terms of what you can eat after your surgery, you can eat anything that you feel able to eat. Although, for the first few days this will probably be limited to liquid based foods, such as soups or fruit smoothies, as chewing food too soon after your operation can cause your wounds to become more tender and sore.

Your overall aim though, should be to focus on eating healthy natural foods that are high in vitamins, minerals and protein, as this will greatly help to assist the healing process. In particular, vitamin C and zinc can be beneficial for wound healing.

Alcohol should be avoided for the first week, as alcohol can increase the risk of postoperative bleeding.

Your Results

It will take about 2-3 months for your swelling to go down fully, although for some people, it may take up to a year. So you won’t be able to judge your results properly until all your swelling has gone down.

The scars take a little longer to heal, typically taking 4-6 months to fade from a dark color to a light color, but some people may take 9-18 months to see their scars fade.

Providing that you chose your cosmetic surgeon carefully, you should end up with good results and look younger than you did before surgery. However, because it does take such a long time to fully recover from a facelift, you may forget what you used to look like which can make your facelift results seem less impressive than they actually are.

You may therefore, want to take a photograph of your face before surgery and then take one under similar conditions once you have fully healed (i.e. in 4-6 months time). This will allow you to see the full results of your surgery and how much your face has actually changed.

Minimizing Risk

Even though thousands of people undergo facelift surgery safely and successfully each year, a face lift is still a major surgical procedure, which means that there are risks involved with having one done.

The good news however, is that most of these risks can be avoided providing that you research your surgeon properly and then are honest with them about your current state of health.

Choosing Your Surgeon

It is important that you find a surgeon who has experience performing facelifts, and ideally, also specializes in the area of cosmetic facial surgery performing facelifts, and possibly other facial procedures, regularly each week or month.

Some surgeons who do not perform facelifts on a regular basis may be inexperienced or out of practice, and so you are unlikely to get the best results from them.

When you find a potential face lift surgeon, always ask to see before and after photos so that you can assess the quality of their work. If possible, also speak with past patients of that surgeon so that you can see the surgeon’s results up close.

Be Honest

Being honest about your current state of health is vitally important in not only reducing the risks of facelift surgery, but also in ensuring that you get the best possible results.

If you have any current medical conditions, psychological disorders or are taking drugs for anything, then make sure that you inform your surgeon about them. Certain medical conditions and drugs can cause complications during or after surgery, which in some cases, can be life threatening.

Other factors, such as alcohol abuse, recreational drug use and smoking can all affect your ability to heal, and therefore, also affect the end results that you are likely to get.

Cosmetic Surgery Risks

Below you will find listed some of the main risks that are associated with face lift plastic surgery. Your surgeon should inform you about these risks prior to your surgery, so that you are fully aware of what could happen. Stay away from any plastic surgeon who does not tell you about the risks of face lift surgery or tries to downplay the risks, as they are probably more concerned with your money than your safety or your results.

Bleeding

One of the most common risks following facelift surgery is excessive bleeding. This can lead to bruising of the skin, or in more serious cases, hematoma (swelling under the skin) which may require another operation to correct.

Generally, small hematomas are more common than large hematomas, and most of these can be suctioned out with a needle (surgical syringe). This however, can delay the healing process.

Excessive bleeding can also occur during surgery, and the risk of this happening can be increased if you have a blood clotting disorder (e.g. haemophilia) or are taking blood thinning medication (e.g. asprin).

Infection

The risk of infection from facelift surgery is greatest after your surgery during the healing process. Your risk can for example, be increased if you do not receive proper aftercare, if you do not clean or disinfect your wounds or if you fail to take your antibiotic medication.

There is also a risk of infection occurring with synthetic facial implants if the implant has not been properly sterilized. If an implant does become contaminated, it will need to be removed and replaced.

Wound Healing

There are two main types of wounding healing problems that can occur after face lift surgery.

The first is that the incisions the surgeon has made do not heal properly, or heal slowly, which eventually leaves a much more noticeable scar.

The second problem, which tends to be most common in smokers, is that parts of the face do not receive adequate blood circulation which then causes the skin to die and slough off (i.e tissue necrosis).

Your incisions may heal better with scar massage therapy, so be sure to ask your surgeon about this.

Nerve Damage

If any of your facial nerves are damaged during surgery, then you may later experience partial facial paralysis or involuntary facial twitching.

An experienced facial cosmetic surgeon will be aware of where these nerves are and so will be able to avoid them.

Facelift Asymmetry

Some people naturally have asymmetrical faces, and so each half of their face looks slightly different from the other.

Asymmetry can also occur after face lift surgery if one side of the face is tightened more or pulled differently than the other. Fortunately, asymmetry can be corrected with a revision facelift surgery, but this will obviously come at extra time and expense to you.

Should You Worry?

Although some of the risks of face lift surgery can be very off-putting, it is important to remember that the likelihood of these complications occurring is minimal providing that you are in the hands of a well-trained and experienced facial plastic surgeon.

So don’t let these risks put you off getting your facelift, but just be aware that they exist and make sure to speak with your surgeon should you have any specific concerns regarding your operation.