A face-lift, or rhytidectomy, is a cosmetic surgery to give a more youthful appearance. Facial tissues are lifted, firmed, and tightened, excess skin is removed, deep folds are smoothed, and the face is re-contoured.
Face-lift procedures are not limited by sex or gender—face-lifts for males has increased by 20% since 2000.
This article will discuss what a face-lift can do, the risks involved, and how to explore getting the procedure.
Purpose of a face-lift
Some people may choose to have a face-lift if they feel unhappy with the signs of ageing they notice or feel held back by them.
A face-lift can address:
- Sagging skin due to loss of elasticity, particularly around the cheeks, nose, and mouth
- Deepening of the lines between the nose and mouth (“laugh lines”)
- Loss of volume in the face
- Development of jowls in the cheek and jaw
- The appearance of a “double chin” or loose skin in the neck area
- Changes in the contours of the face
- Lines below the lower eyes
Why do people also get a neck-lift
Other procedures may be performed along with a face-lift, including a brow-lift, eye-lift, dermal fillers, and skin texture treatments.
Some people may choose to get a neck-lift (platysmaplasty) on its own or in conjunction with a face-lift. A neck-lift removes excess skin and fat from the neck to address wrinkling, creasing, and sagging in the area, creating a smoother profile.
What a face-lift isn’t
A face-lift does not treat the whole face on its own. A face-lift only addresses the lower two-thirds of the face (the cheeks and jawline).
The eyebrow and eyelids require a different set of techniques than the ones used during a face-lift. Though it is common for an eye lift, brow lift, and/or neck contouring to be performed at the same time as a face-lift, they are distinct procedures.
It’s also important to recognise that a face-lift is a restorative surgery. It doesn’t change your fundamental appearance, and it will not halt the ageing process.
Who is eligible for face-lift surgery?
Generally speaking, good candidates for a face-lift are:
- In good overall health and do not have medical conditions that impair healing
- People who do not smoke
- Going into the procedure with a positive outlook and realistic expectations
The cost of cosmetic surgery varies due to a number of factors. According to statistics from the American Society of Plastic Surgeons, the average cost of a face-lift is USD 8,005 (SGD 10,691).
This is a partial cost, which does not include expenses such as:
- Anesthesia (medication to make a person sleep and insensitive to pain)
- Operating room facilities
- Other related expenses
Consult with board-certified cosmetic surgeons in your area to get an idea of pricing.
Are there any risks?
Common side effects after face-lift surgery include:
- Stiffness, puffiness, and numbness in the face (can last a few weeks to months)
- Temporary bruising of the cheeks that moves down the neck with gravity over time
- Scarring (will fade but not completely disappear)
- A raised hairline or sideburn
With face-lift surgery, there is some risk for complications, including:
- Hematoma (a collection of blood underneath the skin)
- Seroma (a collection of fluid underneath the skin)
- Nerve injury/loss of sensation or movement in the face
- Unevenness of the face
- Numbness or changes in skin sensation
- Changes in skin colour
- Irregular contouring (skin shape)
- Hair loss or reduction of hair growth around scars
- Thick/noticeable scarring
- Excessive bleeding
- Breathing problems
- Blood clots
- Allergy/reaction to the anaesthetic or medications
- Lasting pain
- Poorly healing wounds
- Irritation from sutures
- Bruising or swelling that lasts longer than three weeks
- Dissatisfaction with results
The exact technique used depends on the person and their surgeon.
Once the person has been anaesthetised (given anaesthesia), the cosmetic surgeon begins by making an incision in the temple area (just above and in front of the ear), and continues the incision under the earlobe and blending into the hairline along the back of the ear.
The skin is separated from the underlying connective tissue and muscles. The skin is lifted while the underlying muscle and connective tissue are repositioned and tightened. Excess skin and sometimes some fat is removed, and the remaining skin is placed back over the facial tissues.
The cosmetic surgeon closes the incisions with fine sutures and/or metal clips, then applies a dressing to protect the area.
Former and current techniques
A face-lift used to involve removing excess skin and pulling the remaining skin towards the ears. By the mid-1980s to early 1990s, the procedure began including the tightening a layer of tissue called the superficial musculoaponeurotic system (SMAS).
In the 1990s, surgeons began cutting the SMAS and moving it several centimetres. This became known as a deep plane face-lift, and is generally considered to be the “gold standard” for face-lift surgery.
Face-lift surgery may consist of a standard face-lift or a mini face-lift.
- It more fully addresses moderate to advanced ageing around the mid-face and neck.
- It is more extensive than a mini face-lift, with more recovery time needed and more dramatic results.
- It usually requires general anaesthesia (being put under for the procedure).
- Incisions start near the temples, go down the front of the ear, under the earlobe, and follow the back of the ear up (near the hairline).
- Deeper tissues beneath the skin are repositioned, and excess skin is removed.
- May be considered for people with a mild degree of sagging skin and jowling
- Is less invasive than a full face-lift
- Uses shorter incisions, typically along the hairline above each ear and/or in the creases surrounding the ear.
- Lifting and tightening the structural tissues around the cheeks
- May be performed using local anaesthesia and sedation,
Before surgery, you will have a consultation with your cosmetic surgeon.
During this consultation:
- Your surgeon will ask about your medical and family history.
- There will be a physical and psychological exam.
- You will be asked and advised about medications you are taking, as well as vitamins, herbal supplements, alcohol, tobacco, and drug use.
- You will discuss your goals, options, and recommendations, including likely outcomes, risks, and potential complications.
- Your surgeon will examine and measure your face and may take photographs.
- If you are a smoker, you will likely be told to stop for a certain amount of time before surgery.
- You should ask any questions you have.
In the week to days before the surgery:
- Stop taking or adjusting your prescription and over-the-counter (OTC) medications and dietary and herbal supplements according to the instructions from your surgeon, if necessary.
- Tell your surgeon if you have a cold, flu, fever, herpes breakout, or any signs of illness, on the day of or leading up to your surgery.
On the day of your surgery:
- It’s likely you will be told not to drink or eat anything after midnight the night before your surgery (including chewing gum or breath mints)
- If your mouth feels dry, rinse it with water and be careful not to swallow.
- Take any medications you have been told to take with a small sip of water.
- Be on time.
- Carefully follow any instructions given by your surgeon or healthcare staff.
During your consultation, tell your surgeon about any medications you are taking. Your surgeon may advise you to stop taking certain medicines for some time before your surgery.
This may include:
- Motrin, Advil (ibuprofen)
- Aleve, Naprosyn (naproxen)
- Other anti-inflammatories
- Some herbal supplements
Talk to your surgeon before stopping or changing these medications if you are taking them:
- Jantoven (warfarin)
- Pradaxa (dabigatran)
- Eliquis (apixaban)
- Xarelto (rivaroxaban)
- Plavix (clopidogrel)
Immediately after surgery, you will be taken to a room to recover from the anaesthesia.
During surgery, you may have had a thin drainage tube placed temporarily to help drain blood that could collect. Your head will be wrapped loosely with bandages.
Any discomfort you may feel can be relieved with pain medication prescribed by your surgeon.
Full recovery from face-lift surgery takes about two to four weeks. During this time, you will need to be off work.
Contact your healthcare provider immediately if you get a fever of 100 degrees F or higher, any abnormal discharge (including pus) from the surgical wound, or feel extreme pain, tenderness, or swelling of the area.
It can take up to six to nine months to see the full results of the face-lift.
Bruising and swelling are normal and reach their peak about two days post-surgery. This will gradually improve and become much less noticeable after 10 to 14 days. Propping your head with a pillow while resting may help with swelling in the first few days.
Avoid taking aspirin, ibuprofen, or other nonsteroidal anti-inflammatory drugs (NSAIDs) for the first few days after surgery or until your surgeon says it is OK. You should also avoid bending, straining, and lifting during this time.
Protecting your face from the sun for several weeks after your surgery is important. Stay out of the sun and wear a wide-brimmed hat. When your surgeon says it’s OK to be in the sun, apply sunscreen regularly.
Follow your surgeon’s guidance on when you can resume activities such as driving, showering, wearing make-up, etc.
If you don’t have dissolvable stitches, your stitches will be removed after about a week.
Avoid smoking and being exposed to secondhand smoke.
It can take up to six to nine months to see the full results of the face-lift.
A face-lift won’t halt the ageing process, but there are some things you can do to help your results last as long as they can.
Maintaining a stable weight that is healthy for you can help prevent skin stretching that can happen with weight fluctuations.
You can also help keep your skin healthy by consistently following a good quality skin care regimen.
Choosing a face-lift surgeon
It is essential to choose a cosmetic surgeon who’s certified by the American Board of Plastic Surgery and a member of the American Society of Plastic Surgeons.
You also need to ensure your cosmetic surgeon has specific training and experience in face-lift surgery, as not all cosmetic surgeons do.
The American Society of Plastic Surgeons has a search tool that can help you locate cosmetic surgeons in the United States, Canada, and internationally.
A face-lift is a surgical procedure that tightens and lifts the tissues in the face to give a more youthful appearance.
Recovery from face-lift surgery takes about two to four weeks. Contact your healthcare provider if you develop a fever, discharge from the surgical wound, or extreme pain or swelling. The full effects of the face-lift are seen in up to six to nine months.
If you feel you would benefit from what a face-lift can offer, consult with a board-certified cosmetic surgeon. Make sure to ask lots of questions and to look at before and after photos from face-lifts that the surgeon has personally performed.
This story first appeared on www.verywellhealth.com
(Hero and featured image credit: Delmaine Donson/Getty Images)
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Frequently Asked Questions (FAQs)
Question: How does a ponytail face-lift compare to a deep-plane face-lift?
Answer: A deep-plane face-lift is more extensive and has more dramatic results, but also has a longer recovery time. A ponytail face-lift is less invasive and has a shorter recovery time, but the results are less dramatic.
Question: Does insurance cover face-lift surgery?
Answer: A face-lift is considered cosmetic and is unlikely to be covered by insurance.
Question: What helps with face-lift swelling?
Answer: Resting with your head elevated on a pillow for the first few days after a face-lift can help with swelling.
Question: Will face-lift surgeons operate on patients of any age?
Answer: Generally speaking, an adult of any age who is cleared for surgery can have a face-lift, but you need to speak to a cosmetic surgeon to see if it is appropriate for you.
Question: What can you do to conceal face-lift scars?
Answer: Scarring from a face-lift is usually hidden by hair or the natural creases of the ears. Once the incisions are healed enough, makeup can be used if desired.
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