Facelift surgery

As your age, your skin gets less elastic and droops, and also your facial muscles slacken. The natural fat under the skin will sags and then making you look older. The rate this happens at varies from person to another and is probably determined by your genes. The stresses of daily life, the effect of gravity and exposure to the sun also will affect your face.
A facelift will give you the best results in case your face and neck have started to sag but your skin still has some elasticity and your bone structure is strong and well defined. Most people who have facelifts are in their 40s to 60s, but facelifts can be done successfully on people in their 70s or 80s. It should not be obvious that you have had a facelift, but you should look younger, healthier, lively and cheerful.

What is Facelift Surgery

A facelift is a surgical method that removes excess facial skin to make the face appear younger. However, the aging face not only loses skin elasticity and develops looser skin, but also loses fat and muscle tone. Additional procedures that may be necessary to achieve the best results include neck lift, blepharoplasty (eyelid surgery) , liposuction, autologous fat injection, removal of buccal (cheek) fat pad, forehead lift, browlift, chemical or laser peel, and malar (cheek), submalar or chin implants.

How to Prepare For Facelift Surgery

Six weeks before your surgery, you should begin to prep your body. If you smoke, quit until at least six weeks after your surgery because smoking can affect your circulation and the healing process. A week before your facelift surgery, you will have your final consultation with your surgeon. They will go over the changes that will be made during your surgery and also will answer any final questions you may have. You should fill your pain and antibiotic prescriptions early so they are prepared when you arrive at your home. Before your surgery, it is important that you don’t eat or drink after midnight the evening. Anesthesia can only be administered on an empty stomach. Have your ride home accompany you to the hospital. Make sure to relax and be prepared for your facial rejuvenation.

How is the surgery performed?

A facelift involves raising and repositioning the skin and soft tissue of the face. During the operation, cuts are made on both sides of the face in front of the ear, extending up along the hairline, just in front of or behind the cartilage, and around behind the earlobe, into the crease behind the ear and then into the lower scalp. Occasionally, the surgeon may need to make a small cut under the chin for the neck lift part of the surgery. Sometimes only the skin above the neck is lifted (a facelift only). Sometimes the neck muscle and the skin over is just tightened by stitching them together (a neck lift only).
Sometimes the neck muscle and the skin over and above it are tightened and then lifted and stitched tightly to the solid structures in front of and behind the ear (both a facelift and neck lift).
Excess skin is then removed, and the remaining skin is sewn into position. Fat and tissue is redistributed and is sometimes added to the face.

Alternatives to facelift surgery

One of the main alternative to get your facelift surgery is another procedure called fat grafting, or lipofilling. This involves taking fat from another part of your body by liposuction and then injecting it into your face to make your face look younger. This procedure can also be done as part of a facelift procedure.

The other alternative, less invasive procedure to a facelift is a thread lift. This involves inserting long stitches with hooks or barbs on them into your face, to help lift the skin up. It is less invasive than facelift surgery, much quicker to do, and can be done under local, rather than a general anesthetic. However it tends to work best when the sagging is quite minor, and the effects are only temporary.

There are some non-surgical alternatives to a facelift that you might want to consider if your wrinkles aren’t too deep. You can have these treatments instead of, or as well as, a facelift to improve the appearance of your skin. The main ones are listed below.

• Chemical peels: these involve applying certain chemicals to your face, which remove the outer layer of your skin.
• Dermal fillers: these are injections of hyaluronic acid, collagen or other types of filler, which can correct wrinkles and improve the shape of your face.
• Dermabrasion: It’s mostly used for lines around your mouth.
• Microdermabrasion: this involves blowing crystals or other abrasive substances onto the surface of your face, to smooth your skin.
• Laser resurfacing: this can help with wrinkles by removing outer layers of skin on your face.

What to expect?

Before surgery, the plastic surgeon will review the patient’s medical history.

They will look at:

• blood pressure

• blood clotting

• medications

• cigarette smoking

• drug use

• allergies

• scarring

• skin condition

The doctor and patient will discuss what the surgery will involve, where it will take place, the type of anesthesia used, the recovery, and potential complications that may develop. They should also examine the goals and expectations of the surgery, according to the skin type and bone structure.

Facelift Complications

Complications of facelift surgery are infrequent, and cosmetic procedures are generally safe, as long as they are carried out by a qualified and experienced professionals. However, any surgery comes with some risk.

The risks and complications of facelift surgery include:

• Bleeding
• Bruising
• Complications of anesthesia
• Damage to the facial nerves controlling muscles, usually temporary
• Hematoma
• Infection
• Loss of hair around the incision site, but this is uncommon
• Numbness, which can improve within days or weeks
• Scarring
• Skin necrosis, or tissue death
• Unevenness between two sides of the face
• Widening or thickening of scar

If the patient notices inflammation, pain, redness or swelling in the days following surgery, they should seek medical help. This could be a sign of hematoma. If there is a fever, they may have an infection.

Facelift Recovery

Bruising and swelling will be at their worst after 2 days, and they can persist for a few days.

Recovery normally takes around 2 weeks, and vigorous activity can resume after 4 weeks.

Sutures are removed about 5 to 10 days after surgery.

Incisions and bandages must be kept dry, and the patient should follow the specific instructions about bathing and washing.

It is important to follow the doctor’s instructions, as this will speed the healing process and allow for the best possible result.

Numbness and muscle stiffness is normal for some time. Scars can take nearly a year to fade and tone down.

It is worth remembering that while genetics play a role, a healthy lifestyle with a balanced diet and sufficient exercise can also help to maintain the appearance of the skin.

Avoiding smoking and limiting alcohol intake, stress, sun exposure, and contact with pollutants can all help extend the youthful appearance of skin.

Dr. Hamid Reza Vafaei