Last Editorial Review: 2/2/2005


Mother Nature and Father Time have given your face a worn look, so much so that you're considering a facelift, also known as a rhytidectomy. Your skin and soft tissue have lost their elasticity. You look tired, even when you're not. You may have deep lines around the corners of your mouth, jowls or neck laxity (looseness) that increase your aged and tired look.

The good news is that modern facelift techniques have evolved significantly over the past 15 years. Early facelift operations tightened only the skin, while the modern facelift removes excess skin, laxity of facial muscle and excess fat, often found in the lower face and neck. The procedure can improve the contour of your lower jaw and jowls, and soften deep lines from your nose to the corners of your mouth.

But a facelift is only one technique surgeons can use to restore youth and beauty. Once the loose skin, fat and muscle have been tightened, laser and other peeling techniques can improve the quality of the skin. Your surgeon can perform a facelift with other procedures, including surgery on the forehead, eyelids or nose.

Who's a Candidate For a Facelift?

The best candidates for facelift surgery are those patients who demonstrate the above signs of facial aging but still have some skin elasticity. Generally this includes patients who are in their 40's to 70's, although older patients occasionally are candidates.

It's extremely important that you are in good general overall physical and mental health, and it's crucial that you have realistic expectations. A facelift is not meant to completely alter your appearance or make you look like someone else. It's a way to turn back the hands of time and restore your once youthful appearance, but it is not a method to solve personal problems or psychological issues.

It's important to recognize that not every person needs or is willing to undergo a facelift operation. Younger patients may obtain significant benefit from smaller or more minimally invasive procedures. Older patients also may choose one of these smaller procedures to address a particularly bothersome area of the lower face or neck. Facial liposuction, a neck lift or a brow lift are examples of such procedures.

What Is a Weekend Facelift?

The increasingly popular "weekend facelift" is a minor surgical procedure that provides minor improvements to drooping and sagging skin. And while the results are much less impressive than a "real" facelift, the recovery time is also much less.

If you are interested in this procedure, you can discuss with your doctor whether or not it would be a suitable alternative to a regular facelift and whether it will provide the outcome that you desire.

Does Insurance Cover a Facelift?

Insurance carriers generally do not cover surgery that is cosmetic or elective, so you're probably paying for this one out of pocket.

Make sure you receive all of your surgeon's costs in writing, and ask for detailed charges that you will incur for anesthesia, follow up care, any required prescriptions, etc. It's important to note that some insurance carriers will increase your premiums after you've undergone cosmetic surgery and undergoing a facelift may affect future coverage.

Make sure you ask your insurance carrier about its policies and how they will affect you.

Your Consultation

You've selected a surgeon, now it's time for the consultation.

During the consultation, your surgeon will examine your facial proportions and may suggest additional minor changes, such as enhancing the chin with an implant or elevating the eyebrows. He or she can show you how you'll look with these changes via computer imaging and may also take photographs of you to assess your situation. During this time, your surgeon will discuss what type of would be required.

How your facelift is performed is as unique as you are. Everyone ages differently. For instance, environmental factors (such as sun exposure) and certain facial characteristics can make the face age faster. Specific facial characteristics can mean things like a small chin, a low eyebrow position or overactive forehead muscles.

Your surgeon will ask for a detailed medical history, including information on diseases that can cause complications. These include blood pressure problems, diabetes and liver or heart diseases. Your surgeon also will ask questions about your emotional and psychological outlook on the surgery. Your decision to have a facelift is deeply personal, but your surgeon will help in your decision.

The Next Step: Improving Skin Quality

The facelift repositions muscle, skin and fat. Additional procedures such as laser skin resurfacing or chemical peels improve the quality of skin that has been aged by the sun. The severity of the skin's aging or sun damage dictates what type of skin resurfacing agent might be suggested.

How Should I Prepare for my Facelift?

You should wear loose, comfortable clothing on the day of surgery. Ideally, you should wear a button-down blouse or shirt that does not need to be pulled over your face.

Plan to have someone with you who can drive you home afterwards and stay with you the first 48 hours. If possible, you may consider hiring a nurse who can tend to you for the first 24 hours after you've arrived home.

If you are a smoker, follow your surgeon's instructions on smoking cessation. Stopping smoking will promote healing and ensure proper recovery.

If you take aspirin regularly or certain vitamins, your surgeon may instruct you to stop taking these for a certain period before and after your facelift.

Setting Up a Home Recovery Area

Before you undergo facelift surgery, make sure you take the time to establish a recovery area in your home that includes the following:

  • Ice
  • Freezer bags or bags of frozen vegetables
  • Gauze and clean towels and washcloths
  • Telephone within reaching distance of the area where you'll lay or sit most of the time
  • Ointments or creams as recommended by your doctor
  • Magazines or books
  • Supply of loose, comfortable shirts that button down
  • Thermometer to check for fever


Plastic Surgery: Before and After Photos of Cosmetic Surgeries See Slideshow

What Happens During Facelift Surgery?

Your surgeon will make the incisions in the area of natural creases. That is, at the temple in front of your ear, continuing around your ear and behind it. He or she will then access the muscle and connective tissue beneath the skin to make the appropriate manipulations.

Depending on your personal circumstances, the facelift can take anywhere from two to six hours. Excess fat or skin may also be removed during this time.

Your surgeon will close the incision site with sutures and your face will be bandaged. It's extremely important to follow instructions on how to care for and handle the bandage.

What Are The Complications and Side Effects From Facelift Surgery?

Tightness, numbness, and subtle swelling will possibly last several months.

The effects of your new look will last for five to ten years in general. You will continue to age after the facelift operation; however, your aging will not be accelerated as some people may think and the procedure can be repeated at five or ten years or at a later date.

After Your Procedure, You Should Contact Your Doctor Immediately If:

  • You experience a fever of 100 degrees or higher.
  • You have abnormal discharge from incision site, including pus.
  • You feel extreme pain or tenderness.
  • The sutures come out before you're due to have them removed.

What Should I Expect During Recovery From a Facelift?

You will experience bruising and swelling, which lasts about two to three weeks. Of course, some people heal more quickly while others will heal more slowly. Even though you may not wish to go out in public during that time, you should begin to feel well in the first several days after surgery.

Your surgeon will remove your bandages just a few days after facelift surgery. He or she will determine this timeframe.

Your doctor will want to see you several times during the two to three week period to assess your bruising and swelling and to remove sutures. Most people can return to work in two to three weeks, so it's very important that you schedule time off from work accordingly.

Reviewed by the doctors at The Cleveland Clinic, Department of Plastic Surgery.
Edited by Charlotte E. Grayson, MD, WebMD, Sept. 2003.

WebMD Medical Reference

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