A face lift improves the overall appearance of the face by tightening underlying muscles in the face, removing excess fat accumulated over the years and tightening the skin of the face and neck. In many cases, a facelift procedure is done in conjunction with other cosmetic procedures such as eyelid surgery, eyebrow lifts, or chin tucks. A facelift will improve creases that form between the nose and mouth (called nasolabial folds), will reduce sagging facial skin, and will reduce fat deposits that accumulate below the chin (also known as "turkey gobbler neck").

A facelift procedure will not prevent a patient from aging in the future. It will also not erase fine lines or wrinkles caused by sun exposure and the normal aging process (laser surgery is a better option for these problems). The improvements rhytidectomies will provide are completely dependent upon an individual's age, skin texture, and overall health. The procedure should improve the patient's self-confidence, and reduce visible signs of aging.

Candidates for a Facelift:
The best results from facelifts are experienced by patients whose face and neck have started to sag or droop, but whose skin still retains some of its elasticity, and whose bone structure is well-defined. Patients who are expecting the facelift to define the cheekbones may need to be consulted on cheek implants.

Most patients range between 40 and 60 years of age, but facelifts have been successful on people in seventies and eighties. Individuals under the age of 40 should give careful thought before having the procedure. Younger patients may not see the results that older patients see simply because they have fewer wrinkles and greater skin elasticity. However, some people who have lost excessive amounts of weight, or have genetic problems may want a consult on the procedure. It is important to consult with a Board Certified Plastic Surgeon who will set realistic expectations on improvements the procedure will provide.

Possible Complications:
In rare cases, some individuals experience complications with facelift procedures. Many of these complications are dependent upon the individual's health, anatomy, and healing ability. The outcome of any operation in never 100% predictable. Infection and reactions to anesthesia are complications that may occur with any operation.

Additional complications that may occur include hematoma, which is an area of blood that collects under the skin, and injury to the nerves that control facial muscles. Hemotomas must be surgically removed, and injuries to facial nerves are usually temporary. Complications rarely occur when patients use Board Certified Plastic Surgeons. It is important to follow all of the instructions the surgeon provides, before and after the procedure.

Consultation:
It is important to spend a great deal of time with the surgeon before agreeing to any procedure. For facelifts, the doctor will evaluate structure of the bones, evaluate skin condition and elasticity, and discuss realistic goals with the patient. It is important to divulge all medical conditions, especially clotting problems and high blood pressure. Disclose any medications that currently being used, especially drugs that will affect clotting, such as aspirin.

Without an accurate consultation, it is impossible to estimate the results of a facelift procedure. Since people are genetically unique, responses to cosmetic procedures will be different for everyone.

Notes on facelift surgery:
Smoking inhibits blood flow to the skin. Patients must stop smoking at least two weeks before and after surgery. Smoking can interfere with the healing process therefore, possibly resulting in greater scarring or a longer healing process.

Individuals with short hair may want to grow their hair before a facelift operation. With shorter hair, scarring is visible.

Individuals wearing contacts may need to wear glasses for a few days or weeks, especially if the patient is receiving additional procedures around the eyes. Some procedures, such as eyelid surgery, cause irritation to the eye, making contacts unbearable to wear.

Anesthesia:
Facelifts are usually performed with local anesthesia. Sedatives are also used to make the patient drowsy. Some doctors will recommend general anesthesia, especially if the patient is having multiple procedures at the same time.

The American Society of Anesthesiologists (ASA) has an entire section of their website devoted to Public Education. It contains a wealth of information and is recommended reading for anyone considering any treatment which involves anesthesia.

The Surgery:
The entire procedure usually takes several hours. For patients receiving extensive work, two different surgical procedures may be needed. There are two possible approaches to the actual procedure: completing one side of the face and matching the second side to the first, or moving back and forth between each side of the face. The approach is dependent upon the comfort level of the surgeon. There should not be a difference in the end result. The placement of incisions depends upon an individual's facial features and the method the surgeon uses.

The incision usually starts above the hairline at the temple, extending through the natural crease in front of the ear and around the earlobe, ending in the hairline of the lower scalp. A small incision may be put under the chin for patients receiving work within the neck.

The incision must provide the surgeon access enabling him to separate the skin from underlying muscle and fat. Any excess fat is trimmed or suctioned from the face and neck. Underlying facial muscles may be tightened. The skin is stretched upward and back toward the hairline. Excess skin is removed. The surgeon will then secure the skin using stitches and, sometimes, metal clips. Metal clips are usually used in the scalp area. A thin tube may be inserted under the skin behind the patient's ear to allow for fluid drainage. The tube is usually removed within the first or second day after surgery.

After the surgery:
Plan on remaining in bed or on the sofa for the first few days after the operation. Patients should be able to move around a day or two after surgery. Strenuous activity should be avoided for at least two weeks after the surgery. Discuss resuming any physical activity with your doctor. Most patients return to work from 10 day to two weeks after surgery. Ask your doctor about special makeup that can minimize the appearance of bruising.
Alcohol, saunas and steam baths should also be avoided for several weeks after the surgery. The skin on the face and neck should not be exposed to the sun for months after the surgery. The best thing a patient can do for himself/herself is get plenty of rest after the operation.

The patient's skin will be tender and numb after the procedure. The skin on your face may peel. Some individuals experience minor pimples on face for a few months. It is important to follow all cleansing and mosturizing instructions the doctor provides.
Bandages will cover the patient's face and neck after the surgery. The bandages are removed one to five days after surgery. It is normal for the face to be bruised and swollen after surgery. Swelling and bruising may last from one week or a month, depending upon the patient. Individuals resorb blood into the system at different rates. If a patient tends to bruise easily, and maintains bruises for a long period of time, he or she can expect to be discolored for several weeks.

It is important to keep the head and neck elevated after surgery. Follow the surgeon's instructions regarding the application of cold compresses and ice packs. Some people claimed that it took several months for all swelling to subside, and for the actual results of the operation to become evident. Stitches are removed one to two weeks after surgery. Usually metal clips remain in the scalp longer than stitches because the scalp tends to heal at a slower rate than facial skin.

Numbness of the skin is a common side effect of cosmetic surgery. This could take weeks or months to completely disappear. For several months after the procedure, the skin around the temples may feel dry and may peel, and the hair around the temples may be thin.

Patients will experience some scaring after the operation. The scars may have a pink tint for a few months, but should gradually blend in with the skin tone. After a year or two, the scars should be barely visible. Again, scaring will vary according to the individual and the skill of the surgeon. The scars should be hidden within the natural lines and contours of the face. Smokers tend to heal slower than non-smokers. Sun exposure may impact the healing process.

Note: Men may find that they need to shave behind the neck after the operation. Remember, the skin on the face is repositioned toward the hairline and behind the neck.