Some of the most visible signs of aging first appear on the face. Although the changes appear gradually, there may come a day when you look in the mirror and decide that the face you see doesn't reflect the way you feel about yourself. If you'd like to look as good as you feel, a facelift can help. Also known as rhytidectomy, a facelift smooths the loose skin on your face and neck, tightens underlying tissues and removes excess fat. As a result, your face will appear firmer and fresher.

Is a facelift right for me?

Facelifts are most commonly performed on patients in the 40-60 age range. However, the procedure can produce good results for people in their 60's, 70's and 80's as well. You may be a good candidate for a facelift if you have any of the following types of conditions:

  • A deep line that runs from the corner of your nose to the corner of your mouth.
  • Loss of a well-defined jawline.
  • Deep wrinkles in the cheeks and sagging skin near the cheekbones.
  • Loose skin, wrinkles or excess fatty tissue in the neck.

Facelift surgery needs to be approached with extra caution if you have any of the following medical conditions:

  • Uncontrolled high blood pressure
  • Blood-clotting problems
  • The tendency to form excessive scars

What should I expect from the consultation?

A personal consultation is the first step for every patient considering a facelift. During this meeting, your surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for surgery.

You should arrive at the consultation prepared to provide complete information about:

  • Previous surgical procedures.
  • Past and present medical conditions.
  • Treatments you have received.
  • Medications you are taking, including herbal remedies or nutritional supplements.

If you're overweight and have a realistic desire to lose more than 15 pounds, your weight loss could affect your results. It's important to discuss these plans with your surgeon.

During your physical evaluation, your plastic surgeon will assess your bone structure and the underlying tissues of the face. The thickness, texture and elasticity of your skin and the severity of the wrinkles and folds will also be considered. Your hairline will be examined to determine where incisions can be discreetly placed. All of these factors will be considered in developing your surgical plan.

Your plastic surgeon may explain additional procedures that can be preformed along with a facelift to meet your appearance goals. For example , a facelift is frequently combined with:

  • A forehead lift, to correct lines or furrows in the brow.
  • Eyelid surgery, to eliminate drooping upper eyelids or bags beneath the eyes.
  • Nose reshaping.
  • Skin treatments, such as chemical peel or laser resurfacing, to minimize fine wrinkles.

How is a facelift performed?

The technique chosen for your surgery depends on your features, your surgeon's preferences and your desired results.

There are many variations to the facelift procedure. However, the incision is typically hidden in the natural contour of your ear, and then extends around the earlobe and back into the hairline. Following surgery, the incisions are easily concealed by your hair or with makeup. There also may be a small incision hidden beneath your chin.

Working through these incisions, your plastic surgeon frees the facial skin from its underlying tissues and pulls it upward and back. The excess skin is removed. In some cases, the deeper tissues may also be repositioned to restore a more youthful contour to your face. If necessary, an incision under the chin allows your surgeon to remove fatty tissue in the area and smooth the cord-like structure of the underlying muscle in the neck.

What can I do to prepare for my surgery?

When the date for your surgical procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after your surgery. A number of points may be covered, including:

  • Avoiding certain medication that may complicate surgery or recovery.
  • Stopping smoking for a period of time before and after surgery.
  • Arranging for help or special care following surgery

How will I be cared for on the day of my surgery?

Your facelift may be performed in a hospital, an outpatient surgery center or an office-based surgical suite. If you are admitted to the hospital, your stay will be a short one, perhaps one or two days.

Medications are administered to keep you comfortable during the procedure. Often a general anesthetic is used so that you will sleep throughout the procedure. Abdominoplasty may also be performed using local anesthesia with intravenous sedation.

How will I look and feel right after surgery?

 When surgery is complete, you'll be taken to a recovery area. A bandage may have been wrapped around your face to help control swelling. In many cases, small drainage tubes will have been placed beneath the skin to help prevent fluids from accumulating. Any discomfort you may feel can be controlled with medication prescribed by your plastic surgeon. Dressing may be applied to your abdomen and covered with tape or an elastic bandage.

Although you may not be able to stand perfectly straight at first, you will be encouraged to get out of bed soon after surgery to promote blood circulation. In this early phase of healing, straining, bending and lifting should be avoided. Your surgeon may instruct you to sleep on your back with your knees up.

Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

The first day:

  • In the early stage of healing, you should rest with your head elevated to help minimize bruising and swelling.

Within the first week:

  • Stitches will be removed or dissolve.
  • Bruising and swelling will reach its peak, and then subside.
  • Bandages will be removed and you may shower.
  • You may return to light activity, but continue to sleep with your head elevated.
  • You can wear makeup to conceal any discoloration.

Within two weeks:

  • Most of the bruising will disappear.
  • You may resume many of your normal activities, including non-strenuous work.

After several weeks:

  • You may resume exercise.
  • Numbness in the facial area will diminish; however, some numbness may persist for several months.
  • Bruising and swelling will continue to subside and you'll begin to see your results.

Throughout the healing period, you should avoid exposure to direct sunlight and , for the long term, be conscientious about using sun block preparations to protect your skin.

What should I know about my results?

If you're like most people who have the procedure, you'll be very pleased with your refreshed and rejuvenated appearance. Although the healing may take some time, you can expect the end result to be worth the wait.

A number of factors, including your heredity and lifestyle, play a role in how long the results of your facelift will last. Even though the aging process continues, patients are usually happy with their appearance for many years following a facelift. Some patients find that they want to make additional improvements at a later time.

How long will I continue to see my plastic surgeon?

After the initial period, you will return to your plastic surgeon's office for a postoperative follow-up visit so that your healing and progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concern you may have.