Face And Neck Lifting

What Is Face and Neck Lift?

The facelift (technically known as rhytidectomy) was developed over the years to restore what time and gravity undo, by restoring a look of youth and freshness to the face. A face lift is a procedure that rejuvenates and restores the appearance of the face and neck.

As we get older, the face in the mirror loses its youthful vigor. The skin and fat around the jaw line sags. The furrows between the cheeks and nose deepen. The corners of the mouth turn down. The neckline sags. These effects are caused by the pull of time and gravity on the supporting framework of the face – the SMAS (Subcutaneous Musculo-Aponeurotic System). The SMAS holds up in youth the muscles, fat and skin of the face. As we age, the SMAS ages too, causing the face to sag and look older.

One interesting question is “what is a facelift”? Different patients and doctors have different definitions for this. In reality, a facelift is a procedure with incisions in front of and/or behind the ear. A facelift by definition tightens the lower face and neck. Some patients have a facelift and at the same time have other surgical procedures such as eyelid surgery, brow surgery, etc. Some patients call the combination of all of these procedures a facelift, but again, a facelift by definition is a single procedure for the lower face and neck. It is most common for patients to have other cosmetic facial surgery procedures at the same time as their facelift. There is some economy of scale in this case as the patient can have multiple surgical procedures but only endure a single recovery and anesthesia. Also, when multiple procedures are performed at the same time the fees are frequently discounted. The biggest advantage of multiple procedure surgery is the ability to perform comprehensive rejuvenation with a single recovery and anesthetic. If a patient is in good health, there is usually no reason not to perform multiple simultaneous procedures.


The Face and Neck Aging Process

As we age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in our faces. Deep creases form between the nose and mouth; the jaw line grows slack and jowly; folds and fat deposits appear around the neck. Skin elasticity decreases and the skin also becomes thin. A facelift can’t stop this aging process. What it can do is “set back the clock,” improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and rewrapping the skin of your face and neck.

The aging process described is accelerated by: smoking, genetic predisposition, emotional stress, disease processes, dramatic changes in weight, exposure to extreme climates like chronic sun exposure, cold temperature or wind exposure.


Who Is a Good Candidate for Face and Neck Lift Surgery?

Men and women ages 40 to 70 who have noticeable signs of aging around their face and neck are the most common people seeking facial rejuvenation. It important to have realistic expectations about what a facelift can accomplish. Discuss all your options with your surgeon before deciding on what procedure is right for you.


How Should You Prepare for Face and Neck Lift Surgery?

The initial consultation with your surgeon will require your complete medical history, so you will want to be prepared to provide the necessary information. You must be completely open and honest with your surgeon. If there is any medical problem, you will be referred to a specialist.

With all of this information, your surgeon can plan the best procedure for your needs and tell you how to adequately prepare for the procedure by giving you guidelines.

The physician and patient discuss procedure, anesthesia type, possible risks and complications as well as the incision site.

Pre-operative instructions may include the elimination of certain drugs and smoking habits. Your surgeon should 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.

Your surgeon will advise you to do a few common things that will aid you during the procedure and your recovery. Quitting smoking at least four weeks before surgery promotes increased healing and reduce scarring. Restricting your aspirin or anti-inflammatory medication intake is also important.

You might want to let your hair grow a bit before your facelift, as longer hair helps conceal scars while they heal. Arrange a ride home after the procedure and have someone around during the first few days after the operation.


How Is Face and Neck Lift Surgery Performed?

Majority of the procedures are performed under conscious sedation or general anesthesia. A facelift usually takes several hours. The incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear, and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin.

The skin is then carefully separated from the fat and muscle below. Fat may also be trimmed or suctioned around the neck and chin to improve contour. The underlying muscle and membrane are tightened, skin rewrapped, and any excess removed. When the surgery is complete, the incisions will be closed and the area will be washed. Gauze and an elastic bandage will then be used to minimize bruising and swelling. Following surgery, a small, thin tube may be temporarily placed under the skin behind your ear to drain any blood that might collect there.


Are the Scars Visible?

As we described, the scars from facelift surgery will typically start in the hairline of the temple, progressing down in front of the ear and then turn around under the earlobe behind the ear and into the hairline of the neck. Scars from invasive surgical procedures are inevitable. The scars are placed in locations that will tend to naturally conceal them such as within the hair or in natural folds. Initially the scars will be visible because they will be pink and sometimes a little lumpy. In due course the vast majority of these scars will settle to become very difficult to find. The scars on the neck are more commonly affected by processes such as widening because of the increased mobility in this area. These scars on the neck are also the easiest scars to conceal (by hair).


What Is Recovery Like After Face and Neck Lift Surgery?

There isn’t usually significant discomfort after surgery. Incision site pain is usually minimal and can be controlled with medication. For a few days after surgery, keeping the head elevated will help keep the swelling down. Some numbness of the skin is normal; it will disappear in a few weeks or months.

Although many patients are up and about in a day or two, plan on taking it easy for at least the first week 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. Bandages are removed between one to five days. It is common for the face to be pale, bruised, and puffy at this time. The stitches in the front of the ear are removed after about five days. The remaining stitches and clips in the hairline are removed a few days later.

Most patients are back to work in 10 to 14 days. Avoid strenuous activity, including jogging, bending, heavy housework, sex, or any activity that may increase blood pressure. By the third week, you’ll look and feel much better.


Will the Results of Face and Neck Lift Surgery Be Permanent?

This is a very common question. In some respects the surgery will last forever. If we had a 55 year old patient and his or her twin and we performed a facelift on the patient but not the twin, the patient will pretty much always look younger.

Although we can turn back the clock, we can’t stop it, so all patients will continue to age. Most minimally invasive procedures will not last as long as more comprehensive ones. Facelifts that involve treating multiple layers of the face the neck including the muscle, connective, fat and skin – is harder to do and takes more effort on the part of the surgeon, but studies have shown these techniques to last 10- 15 years. In rare cases some patients with elastic skin or weight gain may need a touch up procedure in 1-2 years after a lift. Other patients with healthy skin and those that take care of themselves may have cosmetic results that last 20 years or longer.

No one can provide a guarantee on how long any cosmetic procedure will last and many variables are involved including the patients genetics, healing and after care as well as what type of surgical procedure was performed. One thing that can be safely said is that facelift surgery in experienced hands is an excellent long term investment.


What Are Possible Complications From Face and Neck Lift Surgery?

When the procedure is performed by a highly qualified cosmetic surgeon complications are rare and usually minor. However, as with any surgery, there are potential complications and risks. Your physician will spend time discussing these with you during your scheduled consultation. Be sure to bring a list of questions or concerns with you.  All patients are instructed to discuss the general surgical risks with their surgeon.     

Significant complications from facelifts and neck lifts are infrequent. Most people experience no major problems, however there are inherent risks connected with every surgical procedure.

Some of the potential complications include hematoma (an accumulation of blood under the skin that may require removal), infection and reactions to anesthesia. Injury to underlying structures (like nerves) is possible, though it is usually only temporary. Facelift incisions are most often inconspicuous, but this is not entirely predictable due to individual variations in healing. Each person heals differently and neither the physician nor the patient can control the patient’s healing.

Smokers are at greatly increased risk of poor scarring, so you must quit smoking at least 2-3 weeks prior to your surgery.