Facelifts are ideal for a man or woman whose facial and neck skin have begun to sag. In many patients, underlying fat pads and muscles also begin to descend. And finally, accompanying soft tissues of the face often begin to disappear while underlying bone structures erode away. To help restore these anatomical losses and gravity descents, repositioning underlying tissues and muscles, restoring facial volumes with fat or facial implants and removing excess skin will turn back the clock 10 to 20 years! Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well. Although a facelift can refresh your look and make you look younger, it can’t give you a different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
Planning your Facelift Plastic Surgery
Facelifts are very individualized procedures. In your initial consultation the surgeon will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery.
Dr. Lille will check 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 Dr. Lille if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.
Preparing for your Facelift Plastic Surgery
Dr. Lille and his staff will provide you with specific instructions on how to prepare for surgery, including guidelines on diet, smoking, and the ingestion of certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it’s especially important to stop at least 6 weeks before and after surgery since smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas and cause large areas of skin to die.
Depending on the medical history and age of the patient, an overnight stay may be required to help and assist in recovery. Dr. Lille will go over each individual’s medical history and determine the ideal condition for each patient.
Types of anesthesia for a Facelift
Dr. Lille preforms his full facelifts under general anesthesia where you’ll sleep through the operation. Dr. Lille uses Board-Certified Anesthesiologists who will call his patients before their surgeries.
The Facelift Surgery
A facelift usually takes several hours-or somewhat longer if you’re having more than one procedure done.
The exact placement of incisions and the sequence of events depend on your facial structure and your specific requirements. For patients having primary facelifts for the first time, incisions are placed behind the hairline, in the ear and extending behind the ear into the back hairline. For those having secondary facelifts, the incision is identical except for the temporal hairline where the incision will be moved to the front of the hairline to eliminate sideburn displacement.
If the neck displays separated muscle bands, and excess fat, a small incision is also made under the chin.
In general, the skin is separated from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The surgeon then tightens the underlying muscle and membrane, pulls the skin back in a different vector from the skin to provide a more natural result, and removes the excess.The SMAS, or submuscularaponeurotic system, is a layer beneath the skin which invests the facial muscles. By tightening the SMAS, the jowls are lifted, the neck is tightened, and the cheeks are elevated. This “deep” or “2-layer” facelift is an improvement over earlier skin-only techniques.
Following surgery, a small, thin tube may be temporarily placed under the skin behind your ear to drain any blood that might collect there. The face will be wrapped with a dressing around your head loosely to minimize bruising and swelling.
After your Facelift Surgery
There isn’t usually significant discomfort after surgery; if there is, it can be lessened with the pain medication prescribed by your surgeon. (Severe or persistent pain or a sudden swelling of your face should be reported to your surgeon immediately.) Some numbness of the skin is quite normal; it will disappear in a few weeks or months.
Your head will be 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. Don’t be surprised at the pale, bruised, and puffy face you see. Just keep in mind that in a few weeks you’ll be looking more normal.
Most of your stitches will be removed after about one to two weeks.
Recovery after Facelift Surgery
You should be up and about in a day or two, but plan on taking it easy for the first 2 weeks 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.
Avoid strenuous activity, including sex and heavy housework, for at least two weeks; avoid alcohol, steam baths, and saunas for several months. Above all, get plenty of rest and allow your body to spend its energy on healing.
At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff and you’ll probably be self-conscious about your scars. Some bruising may persist for two or three weeks, and you may tire easily. It’s not surprising that some patients are disappointed and depressed at first.
By the third week, you’ll look and feel much better. Most patients are back at work about two weeks after surgery. If you need it, special camouflage makeup can mask most bruising that remains.
Your new look after Facelift Surgery
The chances are excellent that you’ll be happy with your facelift, especially if you realize that the results may not be immediately apparent. Even after the swelling and bruises are gone, your hair may be thin and your skin may feel dry and rough for several months. Men may find they have to shave in new places-behind the neck and ears — where areas of beard — growing skin have been repositioned.
You’ll have some scars from your facelift, but they’re usually hidden by your hair or in the natural creases of your face and ears. In any case, they’ll fade within time and should be scarcely visible.
Having a facelift doesn’t stop the clock. Your face will continue to age with time, and you may want to repeat the procedure one or more times-perhaps five or ten years down the line. But in another sense, the effects of even one facelift are lasting; years later, you’ll continue to look better than if you’d never had a facelift at all.
How long does a Facelift last?
No one can say for sure how long a facelift lasts. It often depends on lifestyle, eating habits, genes and the age when surgery was performed. The clock is turned back, but keeps on running.
Ten years later, you will look better than if you never had facelift plastic surgery. Many patients never have a second facelift, while others may desire further plastic surgery seven to 15 years later.
How can I hide things during the time until I return to normal?
After facelift surgery, your plastic surgeon will discuss post-operative camouflage techniques with you prior to your surgery, but be assured that while almost everyone has some sort of temporary side effect such as bruising and swelling, there are makeup techniques that both men and women can use almost immediately to disguise them.
Generally speaking, makeup techniques can be used soon after facelift plastic surgery to cover discolorations, and to hide incision lines after the stitches have been removed and the incision is completely closed. Camouflage cosmetics include three basic types of products: concealers to hide incision lines and discolorations; contour shadows to disguise swelling; and color correctors to neutralize color in reddened skin.
Color correctors disguise yellowish discolorations or the pinkness that follows chemical peel and dermabrasion. Lavender neutralizes or removes yellow, and green has a similar effect on red. It will take a little patience and practice to master camouflage techniques, but most post-op patients feel its well worth the effort.
All Facelift Surgery carries some uncertainty and risk
When a facelift is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Still, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable.
Complications that can occur include hematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles (usually temporary), infection, and reactions to the anesthesia. Poor healing of the skin is most likely to affect smokers.
You can reduce your risks by closely following Dr. Lille’s advice both before and after surgery.
1) What does a facelift mean?
A facelift involves a removal of excess face and neck skin, via incisions along the sides of the face and neck. It also involves contouring excessive fat along the neck area both by liposuction and excisional removal of skin in the central part below the neck muscle. Besides contouring the fat it also involves repositioning or lifting facial fat pads and tightening muscles that all help in conjunction to reposition tissues restore natural youthful angles of the face and tighten skin. A face and neck rejuvenation should also involve addressing excessive skin wrinkling and loss of volume in the face.
2) How does Dr. Lille address each area of the face?
Dr. Lille addresses the face in four compartments. The first dimension is the superficial skin that manifests in the aging process with excessive skin pigmentation or sun spots and fine line wrinkles. Often these can be addressed in office procedures such as chemical peels, Botox injections and soft tissue fillers like Juvederm. Soft tissue fillers and Botox are temporary and fine wrinkles are very amenable to laser resurfacing. Wrinkles around the mouth can be done at the same time as facelift; however, other areas of the face must wait for at least 6 months to avoid damaging the skin tissue viability. After addressing the first dimension of the face, I move to the second dimension which involves the excessive skin. This is addressed by redirecting the pull of the skin and removing the excess amount over the incision line. It is important to re-orientate the pull in certain lateral vectors and directions otherwise a poor result can occur by revealing a wind tunnel face look or elimination of the side burn or too much pull on the corner of the earlobe making it a pixy ear deformity. The third dimension is repositioning deep facial tissues such cheek fat pads, jowl fat pads and excessive loose facial and neck muscles. The fourth dimension is replacing lost volume along the face such as the fat.
3) How many years can I expect a face lift to turn back the clock?
Results vary depending upon the age of the individual as well as the advancement of the aging signs, but generally speaking, a facelift can turn back the clock as much as 7-15 years. Ancillary procedures such as fat grafting to areas of facial tissue loss, eyelid lifts, brow lifts and laser skin resurfacing can be added if required which can turn back the clock even more. Despite reversing the clock, the clock keeps on ticking and aging continues, but regardless after ten years the patient will still be ahead if nothing was done at all.
4) How long does a facelift last?
The duration of the result of a facelift can vary between patients. The patient’s lifestyle, genetics, the number of facial aged signs on presentation along with the patient’s age, can all affect the longevity of a facelift. In general, the neck, brows and eyes require rejuvenation anywhere from 7-12 years. The jowling area and the cheek, unless fat grafts are placed, may need a mini tuck anywhere from a year to two years to maintain the original look. Overall a patient should expect to do a complete, secondary facial surgery anywhere after 7-12 years following the initial procedure.
5) What is the recovery of the facelift?
Patients having facelifts usually require two weeks before returning to a desk job. After two weeks, they are able to wear makeup and all sutures are removed. Some patients require an overnight stay if blood pressure is an issue pre operatively and ancillary procedures are performing pushing the operating time to over five hours. Gym activities are not commenced for three weeks after the surgery. The vast majority of swelling is resolved at two to three months.
6) What are the risk factors from a facelift?
Risk factors include bleeding, infection, scarring, loss of sensitivity and facial nerve paralysis, along with wound breakdown, skin loss, contour irregularities and damage to deep underlying structures. Dr. Lille has had very successful outcome with his many procedures with an overall complication rate of less than ½ percent.
7) Are any bandages required for a facelift?
Bandages are removed the first day following surgery. A light chin strap will be applied and worn the majority of the time during the following 1-2 weeks.
8) When are the suture removed?
Half the sutures are removed the first week and the remainder removed ten to twelve days following the procedure.
9) Will I look different after the surgery?
Dr. Lille aims to perform a very natural facelift. To obtain a natural facelift one must be able to respect the inherent characteristics of the patient’s skin and their underlying tissues. Deep tissues and skin must be treated separately and pulled in different vectors in order to obtain a natural result. They cannot be treated and pulled as one single unit obtaining the wind tunnel look. In additional, tension must be appropriately applied. With Dr. Lille’s extensive experience with facelifts, skin incisions and tension are appropriately placed, allowing the minutest scar without disturbance to facial landmarks.
10) Where are the scars placed for the facelift?
Dr. Lille places his scars behind the hairline in the temporal region extending down to the inner part of the ear hugging the earlobe, going behind the ear and back into the hairline.
11) What is it like after the procedure?
Light pain medications are given to help ease any discomfort. Although it is unusual to have any pain following a facelift, there will be a feeling of being uncomfortable with a “tightness” sensation around the neck. Antibiotics and sleeping aids are given following the surgery. If a perioral laser is performed at the same time as the facelift, antiviral medications are started the day before the procedure.
12) What do I need to do to prepare for the surgery?
Make sure you have refrained from taking any substances that can thin out the blood like aspirin, Ibuprofen, Aleve, Advil and other similar medications. Bleeding complications or excessive bruising can result. Also, it is best to refrain from naturopathic substances that have excessive vitamin E/C or contain glucosamines. A list of refrained medications will be given during the initial clinic visit. Also, if the patient is older than 45 or has concurrent medical issues, a medical clearance test from your primary medical doctor may be required. In some cases, depending on certain factors associated with the patient, only tests without seeing the primary doctor can suffice.
13) What is the process if I want to schedule surgery after the initial consult?
After the initial consult, a surgery date that is convenient to the patient along with a another clinic appointment to go over pre-operative issues such as medication list, obtaining photos, consents, along with pre-op and post op instruction direction documents.
14) Is smoking harmful for facelift surgeries?
Tobacco ingestion either with smoking or chewing has shown in studies to significantly increase the risk for wound complications and skin death. A 6 week cessation before the surgery should be effective in significantly reducing this risk.
15) What types of anesthesia are available?
Dr. Lille likes to use only general anesthesia, however, in the mini-facelift procedures, a sedative administered anesthesia can be used. All anesthesiologists are board-certified.