What is a facelift?
A facelift improves the visible signs of aging on the face and neck by removing excess fat, tightening underlying muscles and redraping the skin. A facelift can be done alone or in conjunction with another procedure such as a brow lift, eyelid surgery or nose reshaping.
Who is the best candidate for a facelift?
The best candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well.
A facelift can make you look younger and fresher, and it may enhance you self-confidence in the process. It cannot give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Appel.
Preparing for your surgery
In your initial consultation, Dr. Appel will evaluate your face including the skin and underlying bone, and discuss your goals for the surgery. Tell Dr. Appel about any 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.
Incisions usually begin above the hairline at the temples, extend in a natural line to 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. If you hair is short, you might want to let it grow before surgery so it's long enough to hide the scars while they heal.
Most facelifts are performed under local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and your face will insensitive to pain. However, you may feel some tugging or occasional discomfort.
Most facelifts are outpatient procedures, but patients might be hospitalized overnight if general anesthesia is used, or if conditions such as diabetes or high blood pressure require extra monitoring. You should arrange for someone to drive you home after your surgery and to help you out for a day or two if needed.
After your surgery
There isn't usually significant discomfort after surgery, but any pain can be lessened with the pain medication. Some numbness of the skin is quite normal; it will disappear in a few weeks or months. Keep your head elevated and as still as possible for a couple of days after surgery, to keep the swelling down.
You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb.
Facelift side effects and risks
Complications after a facelift are infrequent and usually minor. Complications can include hematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles (usually temporary), scar formation, asymmetry, loss of sensation, infection, and reactions to the anesthesia. Poor healing of the skin is most likely to affect smokers.
You can reduce your risks by closely following Dr. Appel's advice both before and after surgery.