Understanding the basics as well as the intricacies of a face lift can mean the difference between a successful surgery with minimal complications and months of regret and frustration. With the increasing number of facelifts being done in recent years, there is a greater need for awareness of what the procedure does and what to consider before committing to it. This essay aims to explain what the actual face lift or rhytidectomy process involves, as well as what one can expect in terms of recovery and aftercare. Many footprints remain from old stereotypes of patients as well as the process of facelifts. We stand at the threshold of a new era in the world of cosmetic surgery; the more the patient knows, the better. The following text is being written in hope that it will help educate on the healing journey after having a face lift. The reader will be given a closer, more detailed look at the process as a whole, both before and after when interested in the healing process.
An Overview of Face Lifts
A face lift is a procedure designed to reduce the apparent signs of aging in the face. There are various forms of facelifts, each making use of different techniques for a range of results. Traditional facelifts typically involve standard incisions, while advanced procedures focus on a patient’s individual needs. Facelifts emerged in the 1900s as a method of facial restoration and improvement. They have since become a popular medical procedure.
There are several types of facelifts available. Patients can consult with a qualified professional to determine which facelift may be right for them. These procedures include the standard facelift, short-scar facelift, multidirectional facelift, endoscopic facelift, autologous soft-tissue augmentation, vertical vector lifting, and SMAS plication. A facelift is a procedure that rejuvenates the face by minimizing visible aging signs. A facelift can make you look younger by promoting a natural and more pleasing appearance. A facelift diminishes frown lines, sagging, jowls, and creases between the nose and mouth. The appearance of a “too much” operation may occur as a result of an unqualified surgeon’s work. Qualified professionals can help keep a facelift in line with the patient’s expectations.
Definition and Types
Face lifts, or rhytidectomies, lift and firm areas of the face and neck that show signs of aging. A face lift can help improve overall appearance by sculpting and tightening the infrastructure of the face. Target areas include the cheeks, the jawline, and the neck. Types of face lifts include full face lifts, which provide comprehensive improvement for the entire face and neck. Neck lifts target the neck area, with incisions around the ear. Mini face lifts offer fewer benefits than full face lifts and are preferable for younger people in their 30s or 40s. A nonsurgical face lift uses temporary, firming, and plumping agents to achieve a lifted look. These agents may include dermal fillers, thread lifts, and Botox.
The term ‘face lift’ usually refers to a traditional face lift in which the skin is lifted off the underlying muscles and tissue and rearranged. There are other techniques that aren’t technically lifts, but provide some of the same benefits, at least temporarily. A look at the varieties of face lifts available, what each technique accomplishes, and aftercare. It is common to receive contradictory advice on this, but the best face lift method depends on your needs, goals, and lifestyle. Skin only in this context refers to making incisions and lifting only the skin of the face, and not the underlying tissues. A skin-only face lift has a shorter recovery time, approximately two weeks.
The Face Lift Procedure
Facial rejuvenation, also known as a facelift, can address multiple signs of aging. This section offers an overview of the facelift procedure to help familiarize prospective patients with the process from start to finish. In surgical procedures undertaken for facial rejuvenation, anesthesia will be necessary. Prospective patients should expect to discuss anesthetic options with their surgeon prior to the operation. Once the surgeon has designed an incision pattern, surgical techniques differ according to the extent and area of surgery undertaken. While most facelift procedures typically last 3-4 hours from start to finish, the exact length will depend on the patient’s anatomical characteristics, aspirations for surgery, and the area being addressed. Like all surgical operations, a facelift carries some risks and potential for complications. Patients should be aware of these in advance of the operation.
A facelift can be undertaken at either an outpatient clinic or a hospital. Proximity to the consulting cosmetic surgeon is important, as he or she will be able to guide the patient through the preoperative assessments. Older patients may require further specialist testing before surgery, such as a cardiology assessment, chest X-ray, or ECG. Prospective patients seeking surgical facial rejuvenation should look for a seasoned surgeon. It is paramount that individuals prioritize their own safety by choosing a surgeon who can combine technical skill with their aptitude for facial aesthetics. Patients seeking facial rejuvenation should discuss their preoperative goals with the surgeon. The physical characteristics particular to each patient are unique and should be enhanced to preserve this uniqueness. More critically, instilling confidence and achieving the desired postoperative image is the aim of the operation.
Preoperative Preparation
The first step in a successful facelift is the preoperative consultation. After taking true informed consent, the patient with the facial signs of aging undergoes preoperative consultations. Comprehensive medical and cardiac evaluation helps in the planning of the surgery. Essential blood work, coagulation panel, electrolytes, BUN, creatinine, complete blood count, C-reactive protein, rapid plasma reagin test or the Venereal Disease Research Laboratory tests, hepatitis B surface antigen, anti-hepatitis C, and hepatitis C antibody antigen, blood type, and electrolytes are useful to the surgeons in determining the level of risk and risk factors associated with the surgery and are extremely important for the release of liability in the case of a complication. Preoperative photography should be performed on all patients. Preoperative photographs are taken on the day of the first consultation, a volume of the series of photography days before, which will better adapt to the characteristics and proportions of the patient’s face and to facial aging signs. Almost everyone benefits from a facelift. In some patients, these procedures are sufficient. Due to the nature of the skin and muscles, exercise and diet decrease with age. In others, weight loss makes no difference in the buttocks and thighs. These people might choose to have a facelift. A good candidate for a facelift should be one whose head, neck, and face have some signs of age, and whose medical condition is good. A thorough discussion of medications and their potential effects on the facelift procedure should be discussed with the patient. Smokers should stop smoking approximately two to six weeks prior to surgery. Three to four weeks prior to surgery, avoid all medications and supplements that contain aspirin, aspirin compounds, and nonsteroidal anti-inflammatory drugs either alone or in combination. If pain medication is necessary, one may take acetaminophen. Stop taking the hormones two weeks prior to surgery. In general, vitamins should be taken as directed. Blood thinners and anticoagulants must be discontinued for two weeks prior to surgery with close monitoring by their general practitioner. Psychological counseling is generally not necessary prior to a facelift, but is best for those people whose emotions are directly related to how they feel about being old. Mandible or jaw joint surgery may be performed to enhance facial rejuvenation. A thorough medical history must be taken in order to help identify and eliminate any potentially deadly health conditions. Health problems and drug and alcohol use must be included in the history. Statistically, heavy smokers of long standing have a bad skin blood supply anyway, and often have a greater tendency towards bad scarring, such as the hypertrophic or keloid type. Some medications have been proven to cause bad scarring and may be canceled one to two weeks before surgery. This includes certain fertility drugs, which have the additional disadvantage of putting fat in the cheeks, abdomen, and face. Cortisone-like drugs often cause bad scarring. In most cases, these can be resumed after the operation. The patient should understand the advice to never expect a completely natural look once surgery is completed. Many patients expect complete rejuvenation from the surgery alone. Postoperative instructions, including medications, postoperative limitations, and a 24-hour phone number, are given to the patient. We believe it is important to try to establish realistic expectations in the patient: good, not perfect, in the same proportion as the rest of the face, but not a different person. One of the things covered and especially helpful is the use of various brochures and an extensive discussion with the doctor during the consultation concerning results so that the patient can truly know what to expect as best as one can state it.
Aftercare and Recovery
The importance of proper aftercare should not be underestimated following facial lift surgery. Adhering to postoperative instructions may help minimize potential risks, aid in proper healing, and in turn make recovery as smooth as possible. Not adhering to these instructions may result in complications. As the face heals, it is expected that pain and swelling will be present, although every patient has a different pain threshold and reaction to this type of surgery. Oral pain medications are routinely prescribed by the surgeon postoperatively to help manage discomfort. Patients are able to assess their own level of pain and take their prescribed medication if necessary.
Swelling is also normal following a facial lift. The greatest degree of swelling tends to occur on days 2 and 3 after surgery, and in most situations, will start to subside after 4-5 days postoperatively. Cool packs can help reduce swelling, and resting with the head elevated in a relaxed position may also provide some relief. It is essential for all patients to not only follow the postoperative care instructions provided by their surgeon but to understand the potential complications and know what signs to look for. If a complication occurs, it is expected that patients will call the office for further evaluation or instructions. At the beginning of recovery, most patients should be limited to walking around the house for the first 48 hours, focusing primarily on rest. Sleeping with extra pillows helps reduce the amount of swelling and pressure. After the initial rest period, light activities can be resumed, increasing in intensity as you feel more at ease. Continuing to rest throughout recovery, however, will expedite the healing process. It is normal for patients to take at least 1 week off work. Exercise regimens can usually begin within about 2 weeks. Initial follow-up appointments are essential to ensure postoperative success, assess how healing has taken place over the previous period, and monitor for any potential complications. Alternatively, patients are also provided with postoperative contact details to direct any urgent concerns directly to the office.
It is essential to complete the entire postoperative process to fully appreciate the results. In addition to initial recovery and wound healing, exploring manageable changes to your work schedule or activities may be helpful. Many patients have also found it helpful to have emotional support during the transition period. Some psychological symptoms following any significant cosmetic change have been reported, including mild depression. Many people go through a mild to moderate depression on the road to acceptance. This is a normal and expected symptom. The full impact of the changes does not become apparent until about 3 weeks after surgery, with the vast majority feeling comfortable at around 4 weeks postoperatively. The improvement is exponential week by week after 3 weeks postoperatively. A three-dimensional lift may take 4 months for the final definition. All of these times are average, and individual patients may vary. If you have any questions or are feeling depressed, your plastic surgeon is available and willing to help. Although this is an elective treatment for wrinkles and aging, an appreciative attitude and anticipated end result is extremely relaxing and normal. The entire process should encompass the psychological, medical, and aesthetic attitudes.
Postoperative Instructions
In the immediate postoperative period, patients may experience nausea and sometimes vomiting. Patients should consume plenty of fluids but should not attempt to eat solid food until nausea resolves. It is quite common for patients to display a range of physical and emotional symptoms in the early postoperative period. These may include weepiness, restlessness, and a decreased tolerance for pain. These symptoms typically resolve within the first few days postoperatively. This is especially true if a narcotic analgesic is prescribed. If symptoms are persistent or cause concern, the patient should contact the surgeon’s office for advice.
Patients will be given specific postoperative instructions regarding the management of their incisions. Patients should consult this document for specific details. Surgical sutures will be removed 7–10 days postoperatively. Swelling is normal and expected but should be reported to our office if it is a cause for concern. Patients may bathe upon removal of the head wrap. Do not soak the hair or incision when washing. Normal hair washing may resume at 48 hours postoperatively. Hair color and perms may resume in 4 weeks. Styling with heat is discouraged at 4 weeks. Hair dyes and styling chemicals can cause skin reactions if there are surgical sutures with residual scabs; therefore, do not dye or chemically treat hair unless sutures are completely removed. Makeup may be applied once one scouring is stopped, typically 4–5 days postoperatively. If dressings were placed in or over the ears, these will be removed 7–10 days postoperatively. Sun exposure should be limited for 3 weeks following this procedure given the potential for scarring to darken. Heat, sun, and sun tanning beds all result in blood vessel dilation and the potential for redder and thicker scarring. Heavy sweating (through exercise) is not advised until 3–4 weeks postoperative due to an increased risk of wound healing complications. Patients may feel a sensation of tightness, but numbness of the skin, usually limited to the area around the ears, is temporary. Surgery-related pain is controlled with medication. Initially, a strong pain medication is used, and later a non-steroidal anti-inflammatory agent is most effective. Numbness in front of the ear is normal early on and should improve in weeks to months. Temporary firmness and stiffness in the face and neck is normal. Head elevation with a sleep pillow is recommended for a minimum of two weeks. Lifting, bending, and straining should be avoided until cleared at the first postoperative visit. Walking and deep breathing to prevent pneumonia are encouraged. Care should be taken when blowing the nose or sneezing as this may cause pain, especially if the nasal airways are obstructed. Ideally, sneezing should be performed through a lowered head. Although the decision to return to work is a personal one, most patients with sedentary jobs return to work within a week. Swelling occurs in everyone and varies greatly; if you have a public-facing job, it is important to note that significant swelling can be present, especially in the early weeks. Exercising may be resumed at a minimum two-week visit. Patients are encouraged to walk from the first postoperative date onward to reduce the risk of pulmonary embolisms. Swimming is usually safe by two weeks as long as the incisions are sealed and dry. Additional instructions will be provided if there are any wound or incision issues. Protect your suture lines and observations from sun exposure, and wear a hat outside if you have color changes on the face or neck. Follow-up appointments are made in advance and should be confirmed or rescheduled directly as per specific provider request.
Frequently Asked Questions
Is facelift painful?
In actuality, the majority of patients are quite comfortable after their procedure. Pain is quite variable between individuals, but the majority of patients actually need very little narcotic pain medication. Pain management routinely consists of stronger medications for the first 1-2 days, transitioning to Tylenol and Celebrex within roughly a week following surgery. Most patients experience some mild discomfort or a feeling of tightness over the face and neck region without generally experiencing intense or sharp pain.
How will the recovery be?
Following your facelift procedure, you should expect to be out of work and at home for roughly 2-3 weeks. This time period varies based on the scope of the procedure. We recommend taking 2 weeks of absolute downtime for a more intense facelift or facelift with significant fat transfer, with an optional 3rd week off accompanied by a work-at-home week. Scars after a facelift are generally very well hidden and are not visible under normal lighting conditions even at close inspection.
Is there a non-surgical alternative to Face Lift?
There is no non-surgical alternative to a surgical facelift that will provide the same type of result. Other non-surgical alternatives will give improvements in skin tone and quality and will provide mild tightening and lifting effects, but they are mild when compared to the results of the surgical facelift. It is important to remember that any surgical procedure is still surgery necessitating recovery and healing. Everyone heals differently. The scars tend to mature around 6-12 months and have a refractive period of about 1 year before they become only mildly recognized. Reach out to your surgeon prior to the surgery to express your concerns and plans. It is likely that he or she can reassure you based upon your own aesthetics.
