Facelift

A Facelift can dramatically enhance the overall appearance of the face, giving it a youthful look by removing excess skin and fat. It is very effective in eliminating the jowls and some wrinkles of the mid- and lower-face. Blepharoplasty and forehead lift can also be incorporated to this procedure to achieve total face rejuvenation.

For the deep creases of the cheek and joweling, this is the procedure to tighten face and neck areas. It, however, does not change the forehead or craw's feet areas of the face. It generally will not improve the lip wrinkles either. I usually prefer conscious sedation as the anesthesia of choice for my facial procedures. During surgery, the patient is given sedation and pain medication to reach a "dream state." Additional local anesthesia was then administered to the surgical sites. As the procedure goes on, the patient will gradually wake up more but will not experience pain. The incisions generally follow the crease between the ear and the face in the front and trace along the crease behind the ear. Typically the incisions heal very well and the scars are quite acceptable.

I typically will do some liposuction next for patients with excess fat at their neck area. This, together with tightening of the skin, will improve the neck contour significantly. Some patients may need a small incision under the chin area to remove more fatty tissue. The skin will then be lifted from the underlying fatty tissue of the cheek, neck and behind the ear. Generally very little bleeding occurs. Frequently a second layer of fibrous tissue (SMAS layer) is lifted. This layer of tissue is in continuity with the platysma muscle layer at the neck. Elevating and applying tension to this layer allow us to tighten the face without giving the face a "wind-blown" look.

Excess skin was then removed and multiple layers of small stitches are placed. This is followed by mildly compressive dressing around the face. I generally do not use drain tubes. Patients are seen the next day and the dressings are removed at that time. The sutures are removed about 5-6 days after surgery.

There is usually no significant pain after surgery but some ache and sensation of tightness are common. Antibiotic and pain medication are prescribed before surgery and taken during the first few days after surgery.

Recovery: There will be bruising for 7-10 days for most people, primarily at the lower cheek and neck areas. I recommend warm compress starting the second day to facilitate resolution of bruising. Do not do vigorous exercise, lift, or strain in the first week to avoid bleeding from the surgical sites. Make sure adequate fluid is consumed and stool softener is recommended to avoid constipation, which can occur with use of pain medication.

Facelift Example 1

Age: 54
Notes: This 54-year old woman felt her upper eyelids were heavy, the neck was fatty and her lower face had some jowls. She had upper eyelid blepharoplasty, neck liposuction and facelift. The combined results gave the patient a much more youthful look.

Facelift Example 2

Age: 47
Notes: This middle-aged woman came in for facelift and lower lid blepharoplasty consult. She had rather good quality facial skin. Around the neck area, there was a mild excess of fatty deposits with some jowling. She had a mild descent of cheek fat. Her lower eyelids had thinner and crepe-like skin. She had good elasticity of the lower eyelids. She had lower eyelid blepharoplasty with moderate fat and conservative skin resection. She also had a facelift with SMAS layer tightening. These procedures successfully rejuvenated her facial appearance.

Facelift Example 3

Age: 56
Notes: This patient is a 56-year old woman who desired to have improvements on her neck and lower face. She underwent neck liposuction and single layer facelift with significant improvement of her lower face and neck areas.

Facelift Example 4

Age: 57
Notes: This woman desired to have improvement of her eyes and facial areas. She had upper and lower eyelid blepharoplasty and facelift with improved youthfulness of her face.

Facelift Example 5

Notes: This 58-year old woman had full facelift and upper and lower eyelid surgery with marked rejuvenation of her face.

Facelift Example 6

Age: 52
Notes: This middle-aged woman has moderate blotchy hyperpigmentation skin from sun damage. In addition, she had lost quite a bit of weight and had resulting laxity of the facial skin. She underwent upper and lower eyelid blepharoplasty and facelift and subsequent IPL skin treatment. She was very happy with the dramatic improvement.

Facelift Example 7

Age: 52
Notes: Note in the pre-op pictures that she has deep creases at her forehead due to chronic attempts to raise her eyebrows as well as the deep nasolabial folds (the "parenthesis" lines) and skin folds at her jaw line. After facelift, upper and lower eyelid surgery and browlift, significant improvements occurred

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