Facelift and Neck Lifts

Overview

A facelift is a surgical procedure that addresses issues common to the aging face: sagging of the soft tissues of the cheek, lower face, and neck region. The procedure elevates falling cheek tissues, redefines the jaw line by lifting sagging jowls, and repositions and tightens the skin of the neck. Facelifts often are combined with other procedures, such as a browlift and/or an eyelid rejuvenation procedure (blepharoplasty).

Who Is a Candidate?

Patients may range in age from 45 to 80 and should be in reasonably good health. Potential patients typically have sagging facial and neck tissues. The goal is to enhance each patient’s features, and leave the patient looking refreshed and energetic. If a patient has loose skin of the neck but minimal jowling, they may be a candidate for an isolated neck lift, which may utilize short-scar approaches around the ear.

Facelift/Necklift Risks

A facelift often will enhance the appearance of your cheek, jaw line and neck region but is considered major surgery. You should think carefully about your specific expectations and communicate your goals to your plastic surgeon. Complications from a facelift procedure are uncommon but slight facial asymmetries, which often exist prior to surgery, are possible. There is a slight chance of nerve damage which usually resolves itself but, in some cases, additional treatments or unplanned surgery is required. 

Other potential risks include:

• Temporary loss of skin sensation
• Unfavorable scars
• Anesthesia-related risks
• Hair loss

Not every person is a candidate for this procedure, and your risk may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to the surgery.

Before the Procedure

Your surgeon will give you specific guidelines about preparing for surgery, including:

• Smoking cessation
• Medications to avoid
• When to take your prescribed medications
• Proper washing techniques
• Restrictions regarding eating and drinking the night before surgery

To optimize the facelift’s results, a skin care program by a licensed aesthetician usually is recommended.

Procedure Details

Facelifts can be done in a variety of ways with different types of incisions but typically, the incisions are located in front of and behind the ear, and also under the chin. The procedure is individualized based upon your goals and anatomic issues.

Your plastic surgeon will perform a detailed aesthetic analysis and a careful evaluation of the face including:

• Skin
• Fat and muscle layers
• Eyebrow area, orbit
• Midface
• Jowl area
• Jaw line
• Chin region
• Neck

Following the initial evaluation, the surgeon also will make suggestions about other areas of the face that can benefit from surgical enhancement such as sagging or drooping eyebrows, or extra skin or fat around the eyelids.

With aging or weight loss, there is often a loss of volume in the face. Fat injections, taken by liposuction from other areas of the body, can be injected into the face to restore lost volume and refill the face to a more youthful appearance.

In addition to the aesthetic evaluation, your surgeon will perform a careful evaluation of your overall health, as well as issues that could cause complications, such as:

• Your blood pressure
• Bleeding tendencies
• History of adverse scar formation after previous surgeries

Types of anesthesia for facelifts and necklifts

Your doctor will recommend the best type of anesthesia for you but a facelift can be performed under local anesthesia with the addition of intravenous sedation, or it can be done under general anesthesia.

Where Will the Surgery Be Performed?

A facelift is done in a hospital as outpatient surgery but an overnight stay typically is recommended. You will have to be driven to and from the hospital by a friend or family member.

Facelift/Necklift Recovery

In most cases, patients may experience moderate pain in the facial area for the first 24-48 hours but then it rapidly subsides. Swelling of the cheek and neck tissues usually is mild, and there may be bruising (black and blue discoloration). Both the swelling and bruising will begin to disappear in a week. To minimize swelling and discomfort, you should keep your head in an elevated position the first few days after surgery.

In most cases, patients should be able to go out in public after 10-14 days. Showering is permitted within the first several days. Vigorous physical activity is limited for several weeks following surgery. Signs of surgery should completely fade after three weeks.

Anticipated Results

A facelift usually produces a refreshed and rejuvenated look. You will have some scars from the procedure but these usually are hidden in the creases of your face and ears, and become unnoticeable with time. Facelifts won’t stop the aging process.

More About Plastic Surgery

• The American Society for Aesthetic Plastic Surgery
• American Society of Plastic Surgeons