Face Lift

What Is A Face Lift?

A face lift is a plastic surgery procedure that can remove excess fat, tighten muscles, and redrape the skin of the face, resulting in a more youthful appearance.

As people age, their skin becomes less elastic, particularly on their face. Sometimes, sagging skin around the jaw line or loose skin on the neck becomes particularly noticeable and unflattering. In such circumstances, a face lift, also called a rhytidectomy, can dramatically smooth the skin and improve a person’s appearance.

While other procedures can smooth surface wrinkles, only a face lift can tighten sagging facial skin, jowls, double chins, and loose skin. A facelift reshapes the lower one-third of the face, while eyelid surgery and a brow lift address the eyes and forehead.

Face lifts are becoming more popular. Both men and women (usually aged 40 or older) are having face lifts in record numbers. While such procedures will improve appearances, it’s important for people considering a face lift to have realistic expectations about the surgery, what’s involved, the recovery process, and how they will look afterward.

Why Have A Face Lift?

Nice To Know:

Be Good to Your Skin

Ever wonder how to age gracefully? While genetics plays a role in aging – one that cannot be changed – lifestyle factors also influence how skin will look

Don’t stress your skin with:

  • Prolonged exposure to the sun
  • Smoking cigarettes
  • Air pollutants
  • Rapid weight loss
  • Constant stress

As more and more people over age 40 take control over their health and eat right and exercise, they also want to look good, too.

But years of exposure to sun, stress, gravity, and other factors take their toll on a person’s face. The skin on the face becomes less elastic and is less able to retain moisture. At the same time, the layer of fat that supports the skin becomes thinner.

As a result, the skin develops sags and folds. Around the jaw, skin droops into jowls and double chins. Skin on the neck may fold and become looser.

The face lift or rhytidectomy is a surgical procedure to remove these wrinkles, called rhytids, along with fat deposits from the face, jaw, and neck so people can look their best.

A face lift

  • removes and tightens loose skin
  • removes the sag of the cheeks around the jaw line
  • lifts the corners of the mouth
  • reduces creases between the cheeks and lips.

The end result is a smoother, more youthful appearance. And because a face lift addresses the underlying structure of the face, the results are fairly long-lasting, usually between five to 10 years.

Liposuction, used to remove focal deposits of fat in the face, often in the area between the chin and neck, can be done at the same time as a face lift or separately.

Are You A Good Candidate For A Face Lift?

A face lift will not stop the aging process, but it can make you appear younger by reducing or eliminating sagging skin on the face and neck. You should have realistic expectations about what effect the procedure might have on your life. While your self-esteem will most likely improve, your overall appearance will remain the same.

The best candidates for face lift are

  • In good overall health
  • Psychologically stable
  • Have realistic expectations about the surgery
  • Have good skin elasticity and bone structure

Before surgery, the plastic surgeon will ask you about your medical history. Be honest. The doctor will want to know

  • If you have high blood pressure or problems with blood clotting
  • What medications you take, either prescription or over-the-counter, especially aspirin or other drugs that thin the blood
  • If you smoke cigarettes or use drugs
  • If you have any allergies
  • If your skin scars easily
  • If you have a history or cold sores or blisters on the mouth
  • If you have a history of acne

Nice To Know:

Why skin ages

The skin has two basic layers:

  • Epidermis: this outer layer contains epidermal cells, pigment, and proteins.
  • Dermis: this middle layer contains dermal cells, blood vessels, nerves, hair follicles, and oil glands and provides nutrition to the epidermis.

The layer under the skin (subcutaneous layer) contains blood vessels and fat.

The dermal layer also contains connective tissue, with collagen fibers to provide support and elastin fibers to provide flexibility and strength.

As we age, wrinkles, creases, and furrows occur because

  • The amount of fat in the subcutaneous layer is reduced
  • Sebaceous glands produce less oil
  • Collagen fibers and elastin fibers that support the skin loose their elasticity.


How Do You Choose A Cosmetic Surgeon?

Choosing the right cosmetic surgeon is one of the most important steps in your decision to have a face lift. Here are some ways to go about your search.

  • Look for a physician who specializes in cosmetic surgery.
  • Research the doctor’s qualifications and his or her surgical experience. Ask about training and educational background – the medical school attended, how many years in practice, etc. Many hospitals have this information available to the public through a physician referral service.
  • Ask about which hospital the physician is affiliated with. This means where he or she admits patients, and the level of affiliation (attending physician, courtesy physician, visiting physician). Hospitals also monitor physician qualifications, and your cosmetic surgeon should have privileges for face lift surgery.
  • Ask if the physician has completed a fellowship in a specialty related to cosmetic surgery, and if the doctor is board certified in plastic surgery.
  • Ask friends or family members if they have had certain procedures done. Remember, though, that each person’s circumstances and procedures will be different.
  • Call the doctor’s office and ask about the practice and the physician, office hours, insurance accepted, the type of facility it is, where face lifts are usually performed, and the staff. (For example, ask if there is a full-time anesthetist on staff if procedures are done onsite.)
  • Ask questions that are “procedure specific.” For example, ask how many face lifts the doctor performs each year.

Contact your local medical society or your local hospitals for names of board certified or board eligible plastic surgeons. After obtaining these names, check each doctor’s credentials. You can do this by contacting the local or state medical society or the American Society of Plastic Surgeons at 1-800-766-4955.

How Do You Prepare For Face Lift Surgery (Rhytidectomy)?

Before any surgery is planned, you will have an initial meeting with the surgeon to discuss

  • Your skin type and underlying bone structure
  • Your expectations and goals for the surgery
  • Whether you are a good candidate for surgery
  • What the surgery will involve
  • Where the procedure will take place (outpatient center, doctor’s office or hospital)
  • If an overnight stay in the hospital is required
  • What type of anesthesia will be used
  • What the recovery will be like
  • Any complications you might expect
  • What costs will be involved. Most insurance policies do not cover face lifts.

Ask lots of questions and be sure you fully understand the procedure. Once you have made the decision to have a face lift, your doctor will guide you in preparing for surgery. The doctor usually takes “before” pictures to compare with your appearance after surgery.

You will also want to ask whether any other procedures, such as blepharoplasty (eyelid surgery) or brow lift surgery should be done at the same time.

Before Your Surgery

In general, plan on

  • Stopping certain medications, such as blood thinners, a week or so before the procedure.
  • Stopping smoking before and after the procedure. Smoking inhibits blood flow to the skin and can interfere with healing.
  • Letting your hair grow if it’s very short. Hair can help conceal scars while they heal.
  • Not eating for several hours before the procedure
  • Having someone drive you home after the procedure
  • Resting for several days after the procedure is done
  • Following your doctor’s advice about when you can resume normal activities

What’s Involved In A Face Lift?

The face lift (rhytidectomy) is done to tighten the skin of the face and remove large creases and wrinkles that have formed around the nose and mouth. The face and neck are usually treated at the same time, and the procedure is sometimes called a face-and-neck lift.

Face lift surgery can last from two to five hours. It can be performed in an outpatient facility with local anesthetics and sedatives to relax the patient. Some surgeons, however, prefer patients receive general anesthesia during surgery and stay in the hospital overnight.

The Incision

The procedure begins after the patient is asleep from the anesthesia or comfortably sedated and pain-free from a local anesthesia.

The face lift is performed through a surgical incision on each side of the face. The incision

  • Begins in the hairline
  • Continues down in front of the ear
  • Goes around the earlobe
  • Ends in the hairline behind the ear

Any scarring is usually hidden on the scalp and along natural lines of the face. For men, the incision follows the natural beard line and can be camouflaged by sideburns. Only a thin line of hair will be trimmed along the incision line.

Achieving A Better Shape

After the incision has been made, the skin is freed and raised from the underlying fat and muscle. Excess fat is trimmed or suctioned from the neck and chin. If jowls and drooping neck skin are a problem, fibrous tissue and platysma muscle under the skin may be separated and made tighter.

Sometimes a small incision is also made in the shadow line under the chin to allow for trimming or suctioning of focal areas of fat along the jaw line or under the chin. The skin is pulled tight over the underlying tissue. Excess is trimmed away and the incisions are closed with fine sutures and staples.

Nice To Know:

Submental lipectomy, or liposuction, is a procedure for cutting away (lipectomy) or suctioning (liposuction) the fatty tissue that some people develop between the chin and the neck. The underlying muscles can also be tightened to produce a more defined chin and jaw. Although the submental lipectomy is sometimes done as a separate procedure, it is usually done at the same time as a face lift.

Need To Know:

In some cases, during surgery, a small drainage tube is placed under the skin behind the ear to drain off any excess blood and fluids that may collect there. This tube will be removed a day or two after the procedure.


What Are The Potential Risks And Complications of FaceLift Surgery?

Cosmetic procedures are generally safe, but every surgery carries some risk. These include

  • Hematoma (collection of blood under the skin)
  • Infection and bleeding
  • Complications of anesthesia
  • Injury to nerves that control facial muscles
  • Numbness
  • Scarring

Usually, these conditions improve within days or weeks. Sometimes, however, these conditions are permanent, or more surgery is necessary to correct them.

How Long Does Recovery Take After FaceLift Surgery?

Immediately after surgery:

  • Dressings are placed along the incision lines and the head is wrapped in a bandage, which helps reduce swelling. These bandages are removed a day or two later.
  • Your head will be elevated to reduce swelling.
  • Most patients experience little discomfort after a face lift, but will still appear bruised and swollen for a few days. If you feel discomfort, you will be given medication for pain.

Sutures are removed about five to 10 days after surgery. Incisions and bandages must be kept dry. The surgeon will give you specific instructions about how to bathe and wash your hair. Once the sutures are taken out, you can use make-up. But you may not be allowed to use hair tints and hair dryers for some time.

Complete Recovery

Most people recover in two to three weeks. During this time, bruises heal and swelling goes down. Take it easy and avoid vigorous activity.

It’s normal to feel some numbness and muscle stiffness for some time, and complete return of sensation may take several months. Earrings should not be worn until sensation has returned to the earlobes.

Scars can take nearly a year to fade and soften. The hair should hide most of the scars. Make-up and jewelry can camouflage other scarring.

Need To Know:

Follow your doctor’s instructions carefully after surgery regarding bathing, your activities, use of make-up and more. Doing so will speed the healing process and allow for the best possible result from your face lift. If you develop a fever or other complications, call your doctor right away.


How Effective Is A Face Lift?

The positive effects of a face lift can last for years, but it’s important to realize the limits of the procedure.

  • Face lifts address only the face. Other procedures may have to be done to achieve the desired effect.
  • Face lifts correct deep wrinkling and sagging of the tissues. Fine wrinkling, such as that around the lips, must be corrected by a skin resurfacing technique such as a chemical peel, liposuction, laser resurfacing or dermabrasion.
  • Face lifts do not stop the aging process. Over time, signs of aging may reappear.
  • How long a face lift last depends on
    • Lifestyle choices such as alcohol and tobacco use
    • Environmental factors such as sun exposure
    • Heredity

With a healthy lifestyle, the effects of a face lift may last for 10 years. In some cases, the improvements are permanent.

Nice To Know:

Camouflaging Cosmetics

Bruising can last as long as three weeks after cosmetic surgery and scars can take several months to fade. Skillful use of cosmetics can disguise the bruises and scars and help you return to your normal routine.

Cosmetics can often be applied to hide scar lines as soon as sutures are removed. The cosmetics must be hypoallergenic and fragrance free. They should be bought fresh with fresh clean applicators. They should also be creamy enough so they won’t pull against fragile skin.

Three kinds of cosmetics are recommended for disguising temporary effects of surgery:

  • Concealers: used to hide healed incision lines, scars, and bruises. They go on before the foundation.
  • Color correctors: used to disguise the yellow discoloration of bruises or the redness that follows facial resurfacing. These tints are also applied under the foundation.
  • Contouring colors: ordinary foundations or pressed powders bought in light and dark shades and applied used to create the illusion of depth when tissue is swollen. Contouring can make cheekbones look higher and can minimize a swollen nose or chin.

Liposuction Of The Face

Liposuction of excess fatty tissue of the face can be done through incisions made for other cosmetic procedures such as a face lift. Fat is removed from the face through a narrow tube called a cannula. This allows the skin to lie flatter. Fat suctioning is most often used to remove jowls and double chins.

For more information about liposuction, go to Liposuction.

Laser Resurfacing

Lasers can also be used to treat the entire face or in combination with lift procedures to produce a comprehensive rejuvenation.

Laser resurfacing can be used to treat:

  • fine lines and wrinkles, including crow’s feet around the eyes
  • brown spots and splotchy discoloration
  • scars

Laser resurfacing should not take more than two hours. It is usually done as an outpatient procedure with local anesthetics and an intravenous sedative to relax the patient. A topical anesthetic cream may also be used. Repeat procedures are sometimes required.

How Are New Advances Changing The Face Lift Procedure?

How Are New Advances Changing The Face Lift Procedure?

New surgical techniques are changing the way the face lift is performed. These advances promise that cosmetic procedures in the future will be safer, less painful, and more effective.

  • Lasers: A face-lift procedure called laser neck and jowl liposculpture, and platysma resurfacing, uses lasers and can be done through a one-inch incision under the chin using only a local anesthetic.
  • Endoscopy: Endoscopic techniques are currently being used to do face lifts and brow lifts. This allows for smaller incisions, less trauma to tissues, and a quicker recovery time. Facial structures are raised without cutting away flaps of skin. Currently, endoscopy is an option only for people whose skin is still somewhat tight and elastic.

Face Lift: Frequently Asked Questions

Here are some frequently asked questions related to face lift.

Q: Will my insurance cover the cost of a face lift?

A: In most cases, procedures done for purely cosmetic reasons are not covered by health insurance. Costs may be covered if a procedure is done to for a medical reason, such as to treat precancerous lesions. Always check with the insurance carrier for exact terms of coverage.

Q: How long do the effects of a face lift last?

A: This depends on many factors, such as heredity and your life style. Smoking, alcohol consumption, and long exposure to the sun can all shorten the effectiveness of a face lift. Some people have a repeat procedure in five, 10, or 15 years. Other people never have a second procedure.

Q: How much scarring will be caused by surgery?

A: Scars from a face lift are usually hidden by hair and by the natural contour of the face. These scars usually fade over time until they can barely be seen.

Q: I am in my late 60s. Can I still have a face lift?

A: While most candidates for a face lift are between 40 and 60 years old, many people older than that are enjoying the results of a face lift. Whether you are a good candidate will depend on your overall health, your skin’s elasticity and underlying bone structure, and other factors.

Q: How long will I have to miss work?

A: A face lift is more involved than some other cosmetic procedures, such as fat injections, and as a result requires a longer recovery time. Usually, people spend two or three weeks at home before returning to work.

Q: Can I have more than one procedure done at once?

A: Yes, it may be possible to complete one or more procedures, such as eyelid surgery or liposuction, at the same time as a face lift to achieve the desired result. Discuss this with your surgeon before any procedures are scheduled.

Q: How can I hide scars, swelling, and redness until I return to normal?

A: Both men and women can use makeup techniques to disguise the temporary effects of cosmetic surgery.

Q: Can a face lift correct the excess skin around my eyes?

A: No, a face lift is designed to tighten the areas around the mouth, chin, and neck. A different procedure, called a blepharoplasty is used to improve the appearance of the eyes and eye lids.

Q: Can I tell beforehand how I will look after surgery?

A: Some practitioners have computer imaging programs that can show a person what a face lift procedure might accomplish.

Face Lift: Putting It All Together

Here is a summary of the important facts and information related to face lift.

  • A face lift can improve your appearance but cannot restore youth or guarantee happiness.
  • Find a plastic surgeon who is experienced in performing face lifts and with whom you can have an open and honest relationship.
  • Face lifts can be performed at the same time as other cosmetic surgery procedures to achieve the optimal effect.
  • Be sure you understand exactly what the procedure will involve, how long recovery takes, and the fact that it may take a few weeks to fully realize the benefits of a face lift.
  • Help yourself heal properly by following your doctor’s instructions before and after surgery.
  • A healthy lifestyle, including not smoking or drinking alcohol, can help lengthen the positive effects of your surgery.
  • Both men and women are now undergoing face lifts. While most patients are between aged 40 and 60, it’s possible for healthy people to have the procedure done well after that.

Face Lift – Glossary

Here are definitions of medical terms related to face lift.

Blepharoplasty: A blepharoplasty is a surgical procedure to reshape (plasty) the upper and lower lids of the eyes. A blepharoplasty is performed to correct a sagging upper lid that can sometimes interfere with vision and a puffy, baggy lower lid.

Collagen: Collagen is the fibrous protein found in the white tissue of skin, bone, cartilage, tendon, and other connective tissue. Collagen is made of rodlike molecules that have great tensile strength. Collagen works in partnership with elastin to give our bodies both structure and elasticity.

Cosmetic surgery – Surgery performed primarily to improve the appearance of a part of the body. Cosmetic surgery evolved from reconstructive surgery. Not all insurance policies cover cosmetic surgery.

Dermis: The dermis is the layer of skin immediately under the epidermis. The dermis contains blood vessels, nerves and nerve endings, glands, and hair follicles.

Elastin: Elastin is protein found in yellow elastic connective tissue. Chains of elastin molecules form rubberlike fibers like a bunch of rubber bands. The molecules stretch when pull and recoil when the pull is relaxed. Elastin works in partnership with collagen to give our tissues both structure and elasticity. Normally the body stops making elastin once the body matures.

Epidermis: The epidermis is the most superficial layer of the skin. The epidermis does not contain blood vessels.

General anesthesia: The type of anesthesia where the patient “sleeps” through the surgery. This type of anesthesia takes longer to recover from but is sometimes preferred for more complicated procedures.

Laser: The word “laser” is an acronym for Light Amplification by the Stimulated Emission of Radiation. Lasers produce an intense beam of light in one specific color (wavelength) that can be controlled for intensity and pulse duration. Light is amplified in a laser by bouncing back and forth between optical mirrors and lenses. The light gains strength with each cycle and when it has reached the right power, it is released in a quick burst of energy. The two most common types of lasers are the carbon dioxide (CO2) and the erbium:YAG. The CO2 laser delivers short bursts of high-energy light. The erbium:YAG laser produces a wavelength that is gentler and cooler. Both can be used for skin resurfacing techniques.

Platysma muscle: The platysma is a platelike muscle that runs from the neck to the jaw and the skin around the mouth. It acts to open the jaw.

Rhytidectomy: A rhytidectomy is a surgical procedure to reduce the most visible signs of aging. It eliminates excess fat, tightens muscles in the face and neck, and removes sagging skin.

Rhytid: A skin wrinkle. From the Greek rhytis, meaning wrinkle.

Submental lipectomy: A submental lipectomy is a surgical procedure to cut away excess fat under the chin. Submental liposuction vacuums away the fat under the chin.

Face Lift: Additional Sources Of Information

Here are some reliable sources that can provide more information on face lift.

American Academy of Cosmetic Surgery 

American Society for Dermatologic Surgery 

American Society of Ophthalmic Plastic & Reconstructive Surgery 

American Society of Plastic Surgeons 

Plastic Surgeons – Provides information on plastic and cosmetic surgery, as well as locating plastic surgeons in your area who specialize in all areas of plastic surgery including face lift, breast lift, liposuction, breast augmentation and adominoplasty. 

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