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A facelift can improve the deep cheek folds, jowls and loose,
sagging skin around the neck that come with age.
Incisions usually begin above the hairline at the temples, follow
the natural line in front of the ear, curve behind the earlobe
into the crease behind the ear, and into or along the lower scalp.
Facial, neck tissue and muscle may be separated; fat may be
trimmed or suctioned and underlying muscle may be tightened.
After deep tissues are tightened, the excess skin is pulled up and
back, trimmed and surured into place.
Most of the scars will be hidden within your hair and in the
normal creases of your skin.
After surgery, you'll present a fresher, more youthful face to the
world.
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[
BACK TO PROCEDURES PAGE ]
 If
you are considering a facelift...
As people age, elastic fibers in the skin decrease and
the effects of gravity, exposure to the sun and the
stresses of daily life can be seen in their faces.
The cheeks appear to descend, deep creases form
between the nose and mouth, the jaw line grows
slack, double chins, heavy jowls and "turkey neck"
may also appear.
FACELIFT
If you are considering a facelift, the
following information will give you a basic
understanding of the procedure. This information may
also assist you in understanding when a face lift
can help, how it is performed, and what results you
can expect. This will, however, not answer all of
your questions since a lot depends on the individual
patient, health history and the surgeon. Please feel
free to ask Dr. Gutstein about anything you do not
understand.
Who Can Benefit?
The best candidate for a facelift is a
person whose face and neck may have begun to sag,
but whose skin still has some elasticity and whose
bone structure is strong and well-defined. Most
patients range in age from their forties to sixties,
but facelifts can be done successfully with good
results on people in their seventies or eighties, as
well. Lesser lifts, or "tucks," may also be
performed on people in their thirties, especially
those in print or film media.
A facelift can make you look younger and fresher,
and it may enhance your self-confidence. It can't
give you a completely different look, nor can it
actually restore youth itself, but it can give you a
more youthful appearance. Before you decide to have
surgery, think carefully about your expectations and
discuss them with the doctors.
Surgery Carries Some Risk
When a qualified plastic surgeon performs
a facelift, complications are infrequent and usually
minor. Still, individuals vary greatly in their
anatomy, their physical reactions, 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 a surgeon), swelling around, or injury
to, the nerves that control facial muscles (usually
temporary), infection, and reactions to the
anesthesia. Poor or slower healing of the skin is
most likely to occur in smokers and people with
diabetes.
Types of Anesthesia
Facelifts may be performed under local
anesthesia, combined with a sedative to make you
drowsy. You'll be awake but relaxed, and your face
will be insensitive to pain. You may feel some
tugging or occasional discomfort. Some patients
prefer general anesthesia. In that case, you will be
deeply asleep throughout the operation. An
intermediate method call dissociative anesthesia
keeps you asleep, but breathing on your own without
the need for a breathing tube.
The Surgery
A facelift usually takes several hours,
depending upon whether you are having one or more
concomitant procedures performed.
Incisions usually begin in the hairline at the
temples, extend in a natural line in front of the
ear or just inside the cartilage of the front of
your ear, and continue behind the earlobe to the
lower scalp area. If the neck needs work, a small
incision may also be made under the chin.
In general, the surgeon separates the skin from the
fat and muscle below. Fat may be trimmed or
suctioned from around the neck and chin to improve
contour. The surgeon then tightens the underlying
muscle and fascia, pulls the skin back and removes
the excess. Stitches are used to secure the layers
of tissue and close the incisions; fine metal clips
may be used on the scalp.
Occasionally, a small, thin tube may be temporarily
placed under the skin behind your ear to drain any
blood that might collect there. The surgeon may also
wrap your head in soft bandages to minimize bruising
and swelling.
After Surgery
Usually there is minimal discomfort after
surgery; if there is discomfort, it can be lessened
with the pain medication prescribed. Severe or
persistent pain or sudden swelling of the face
should be immediately reported. Some numbness of the
skin is normal and it generally disappears in a few
weeks or months. You will also be advised to keep
your head elevated for several days after surgery to
minimize swelling.
If you've had a drainage tube inserted, it will be
removed one or two days following surgery, along
with the bandages. Don't be surprised at the
slightly bruised and puffy face you see. Just keep
in mind that in a short time you'll be looking
normal and better than ever.
Most facial stitches will be removed in about one
week. Your scalp may take longer to heal, and the
stitches or metal clips in your hairline will be
left in a few days longer.
Getting Back To Normal
You should be up and about in a day or
two, but plan to take it easy for the first week
after surgery. Be very gentle with your face and
hair, since the skin will be both tender and/or
numb, and may not respond normally at first.
The doctors will give you more specific guidelines
for gradually resuming your normal activities. They
are likely to include the following suggestions:
Keep your head elevated, avoid strenuous activity
including sex and heavy housework for at least two
weeks (walking and mild stretching are fine). Avoid
alcohol, steam baths and saunas for several weeks.
Limit your exposure to the sun 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 slightly distorted
from the swelling; your facial movements may be
slightly stiff. It's not surprising that a small
percentage of patients experience depression at
first.
By the second week, you'll look and feel much
better. Most patients are back at work in seven to
ten days following surgery. If you need it, special
makeup can mask any bruising that remains.
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