Written by Annie Tye, PhD
Facelift surgery, also known as a rhytidectomy, is a type of plastic surgery that restores a youthful appearance to the face. During the procedure, excess skin and fat is removed while the tissues under the skin of the cheek, jaw, and neck are lifted and contoured. The result is a younger and significantly rejuvenated appearance.
Most people who undergo facelift surgery enjoy increased self-confidence and feel more comfortable in social settings. In addition, several studies have shown that people are rated as younger, more attractive, more successful, and healthier after a facelift compared to their appearance pre-surgery.
Specifically, facelift surgery provides benefits including:
- Tighter, smoother skin around the face, neck, and jawline
- Removal of excess fat from the face, particularly the chin area
- Smoothing/softening of wrinkles or deep creases
- Elimination of loose skin
- Tightening of facial muscles
You may be a good candidate for facelift surgery if the following circumstances apply to you:
- You are between the ages of 35 and 65
- You are concerned about the appearance of visible signs of aging, including facial lines, wrinkles, sagging skin, and deep facial folds
- You have some skin elasticity that will allow your skin to adapt to your new facial contours
- You are realistic about the results that a facelift can deliver; while facelift surgeries provide a significant enhancement, they do not transform facial structure or appearance
- You are in good health and do not have serious medical issues
- You are at or near a healthy weight
It is important to understand the limitations of facelift surgery. A facelift will not directly address sagging eyebrows, excess skin and fatty deposits in the upper and/or lower eyelid area, or wrinkles around the mouth. However, there are other surgical techniques that do address these concerns, and they can be performed in conjunction with a facelift.
For example, a facelift may be performed simultaneously with:
- Nose reshaping
- Neck lift
- Forehead lift
- Eyelid surgery
- Laser skin treatments
During your initial consultation, describe what you hope to achieve through surgery and discuss your options with a skilled surgeon. He or she will be able to develop a comprehensive strategy that will address your concerns.
- A facelift will not correct fine lines and wrinkles, sun damage, uneven pigmentation, or other surface imperfections. You’ll need additional treatments to address those concerns.
- A facelift does not include any work to the eyelids or brow, but brow lifts and upper/lower eyelid surgery (blepharoplasty) can be performed at the same time as a facelift.
- Facelift surgeries cannot stop the aging process. While results often last for several years, research suggests that some areas (particularly the neck and jowl) are more prone to relapse. However, over 75% of patients maintain a more youthful appearance more than 5 years after undergoing facelift surgery.
- Men face unique challenges when it comes to facelift surgery. Due to the presence of hair in front of their ears (sideburns), it can be harder to achieve a natural appearance after surgery. A facelift typically pulls the skin backward and upward, which can lead to an unnatural pattern of hair growth.
- Patients who have concerns that are not addressed by facelift surgery may be able to have additional procedures at the same time as their facelift. The goal of multiple procedures is to provide a balanced, youthful look.
Facelift procedures can be tailored to address specific concerns, and there are a number of variations on the traditional facelift.
Different types of facelift surgeries are frequently categorized by the type of incision, the area of the face that is affected, the degree of invasiveness, and the number of tissue layers that are treated.
In some cases, different types of facelift surgeries may have overlapping purposes, which can lead to confusion among patients and surgeons alike.
Broadly speaking, there are three types of facelift surgery:
- Traditional facelift surgery tightens the forehead area (upper face), the nose and cheek area (midface), and the jawline and laugh lines (lower face). Small incisions are made in front of, within, and behind the ear.
- Mid-facelift surgery is limited to the nose and cheek area and is particularly appropriate for someone who has lost fullness in the upper cheek area. Elevating the fat pad in the cheek (the malar fat pad) refreshes the face and leads to a youthful, rejuvenated appearance. There are minimal incisions with this method.
- Mini-facelift surgery typically aims to correct early signs of aging. A mini-facelift is associated with shorter incisions and less skin removal than a full facelift, but may also be associated with underwhelming results.
Because facelift surgeries can be combined with a number of other facial surgeries, many surgeons mix-and-match techniques in order to provide patients with the most aesthetically pleasing outcome. These “you-name-it” combination facelift surgeries offer patients the chance to address any concern they may have, but because of the inconsistent terminology there is a risk that the patient and the surgeon may not be on the same page in terms of the exact procedures that are going to be used.
It is imperative that you clearly describe what your goals and expectations are for your facelift surgery to your surgeon during your initial consultation. Equally as important is for your surgeon to clearly describe what he or she intends to do during the surgery. This will circumvent potential sources of miscommunication due to inconsistent terminology. Look at before-and-after pictures with your surgeon to come up with a very specific strategy that addresses your needs.
There are a number of non-surgical alternatives to facelift surgery that can provide some degree of facial rejuvenation. Among the most effective techniques are:
- Volumizers, including dermal fillers and fat transfer, restore a plump appearance to hollow eyes, cheeks, and lips
- Skin tighteners, including lasers, radiofrequency, ultrasound, mesotherapy/needling, and infrared technologies can stimulate collagen growth
- Neuromodulators like Botox paralyze facial muscles, which can allow elevating muscles around the eyebrows to lift while simultaneously preventing further wrinkle development
- Muscle relaxants can relax depressor muscles in the face, allowing elevating muscles to partially lift facial tissues
- Fat dissolving injections liquify fat cells, which can help to sculpt the jawline and under the chin
Non-surgical alternatives have proven to be valuable in many cases, but they have yet to deliver the same level of result that facelift surgery reliably produces. Furthermore, they often require multiple sessions in order to produce noticeable results that are often short-lasting. Facelifts remain the undisputed gold-standard for facial rejuvenation.
As with most surgical procedures, facelift surgery comes with potential risks and side effects. Some of these include:
- Numbness, swelling or sensitivity
- Infection or poor wound healing
- Nerve damage
- Facial asymmetry
- Loose skin
- Deep vein thrombosis or cardiac and pulmonary complications
Before moving forward with face lift surgery, be sure you fully understand the potential risks associated with the procedure.
Each person will have a somewhat unique recovery experience, and there are a number of factors that may influence how long your facelift recovery will take, including:
- Type/extent of facelift surgery
- Whether additional procedures were performed
- Your age
- Your overall health
- Post-surgery care
It is very important that you carefully follow all instructions that are provided to you by your surgeon in order to minimize your risk for complications and to ensure that you heal properly.
1-3 days post-surgery:
- Expect to feel some pain and discomfort
- Bruising and swelling frequently peak in severity around day 3 before beginning to subside
- A follow-up appointment on day 2 or 3 will allow your surgeon to evaluate your incisions and change your bandages
4-7 days post-surgery:
- Pain, bruising, and swelling should begin to subside
- You may slowly begin to return to normal daily activities that do not elevate your blood pressure (light housework, for example)
Week 2 post-surgery:
- Swelling and bruising will continue to subside
- Stitches are typically removed in the second week
- Initial results of your surgery will begin to become apparent
- Many people feel comfortable returning to work and normal social activities towards the end of the second week
Weeks 3-4 post-surgery:
- Bruising should be mostly or completely resolved
- Some swelling will persist
- Most people can resume exercise and other regular activities, but make sure to discuss this with your doctor ahead of time
By the end of your first month post-surgery, you should be able to resume all normal daily activities. Early results of your facelift will be visible, but minor swelling will continue to be present for several months after your surgery.
The final, stable results of your facelift will be visible within 3-6 months after the surgery. Results of facelift surgery can be expected to last for 5-10 years, but a facelift cannot stop the normal aging process. Some people elect to have subsequent facelift surgeries or other procedures within a decade of their initial surgery.
In general, the results of a well-done facelift can be expected to last for 7-10 years. However, there are a number of factors that can contribute to how well (or poorly) your skin ages. Steps you should take to maximize the longevity of your facelift include:
- Wear sunscreen every day
- Maintain a skincare regimen
- Avoid smoking and drinking
- Eat a healthy diet
- Exercise regularly
People who undergo facelift surgery at a younger age (before substantial signs of aging become apparent) are more likely to have long-lasting results.
Some people augment their facelift with regular non-surgical treatments, including soft tissue fillers and Botox. Additional surgical procedures can also substantially increase the longevity of your facelift surgery.
Importantly, the goal of a facelift is to restore a healthy, youthful look. A successful facelift surgery enhances and rejuvenates your natural facial features without distorting them.
The average cost of facelift surgery is $7,655. However, extensive procedures can cost $20,000 or more.
There are a number of factors that influence the cost associated with facelift surgeries, including:
- The surgeon’s fee
- Anesthesia fee
- Surgical facility fee
- The type of facelift surgery
- Whether additional procedures are done
- Post-surgical care
- Prescription medications
When asking your surgeon about the cost, always make sure that you’re getting the total cost, not just the surgeon’s own fee for performing the surgery, so that you’re not surprised by these charges later on.
Many cosmetic surgeons offer financing options for people who cannot afford the substantial out-of-pocket expense of a facelift. Ask your surgeon whether he or she provides financing during your consultation.
Q: Facial microcurrent: Does it work like a facelift?
A: A facial microcurrent uses a low-grade electrical current to tighten your facial muscles, theoretically leading to the appearance of firmer, more lifted skin. However, rigorous scientific studies have yet to be carried out. Anecdotal evidence suggests that microcurrents may help maintain a youthful appearance, but it is unlikely that they are able to reverse signs of aging. Currently available data suggests that facelift surgery delivers far more substantial and long-lasting results than facial microcurrents.
Q: What is the best age for your first facelift?
A: The answer is, it depends. Facelift surgery is most effective when it is done before substantial signs of aging become apparent. Most people have their first facelift when they are in their 50’s, but many of them wish they had not waited as long as they did. No matter your age, if you are concerned about aging skin it is worth consulting with a surgeon to learn about your options.
Q: What is a weekend facelift?
A: Mini-facelifts are often called “weekend facelifts” because they are minimally invasive and people can recover over the course of a weekend. However, minimal surgery will deliver minimal results, and many people find that they require more comprehensive facelift surgery in order to achieve their desired results.
Q: How can I avoid bruising after a facelift?
A: While a skilled surgeon can minimize bruising, there is no way to completely avoid bruising after a facelift. In general, more extensive procedures are associated with more bruising. The best way to minimize bruising is to work with a highly skilled surgeon and carefully follow his or her post-operation instructions.
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