Why it’s done

As you get older, the appearance and shape of your face is altered because of normal age-related changes. Your skin becomes less elastic and looser, and fat deposits decrease in some areas of your face and increase in others. Age-related changes in your face that may be reduced with a face-lift include the following:

• Sagging appearance of your cheeks
• Excess skin at your lower jawline (jowls)
• Deepening of the fold of skin from the side of your nose to the corner of your mouth
• Sagging skin and excess fat in the neck (if the procedure includes a neck lift)

A face-lift isn’t a treatment for superficial wrinkles, sun damage, creases around the nose and upper lip, or irregularities in skin color.

Procedure:

Facelift surgery , clinically known as rhytidectomy, is a procedure used to reduce the appearance of facial wrinkles and other telltale signs of aging, with the goal of improving the overall appearance of the face and jaw. Facelift surgery can help to reverse the harmful effects of time, stress, and exposure to the elements. To perform this procedure, a facial plastic surgeon will lift and tighten the underlying muscles of the face to create more aesthetically pleasing contours appearance and rejuvenate the facial structure. Then he or she will remove excess pockets of fat and skin that can contribute to an aged, tired appearance.

An experienced, skilled plastic surgeon will perform this procedure with an artistic eye and extraordinary attention to detail so that patients will be left with negligible scarring and beautiful, natural-looking results. In addition to traditional full facelifts, there are several other variations of the procedure to address specific areas of the face. Many surgeons use advanced, minimally invasive techniques to minimize discomfort and downtime.

Risks

A face-lift surgery can cause complications. Some can be managed with appropriate care, medication or surgical correction. Long-term or permanent complications, while rare, can cause significant changes in appearance. The risks include:

• Hematoma. A collection of blood (hematoma) under the skin that causes swelling and pressure is the most common complication of face-lift surgery. Hematoma formation, which usually occurs with 24 hours of surgery, is treated promptly with surgery to prevent damage to skin and other tissues.
• Scarring. Incision scars from a face-lift are permanent but typically concealed by the hairline and natural contours of the face and ear. Rarely, incisions can result in raised, red scars. Injections of a corticosteroid medication or other treatments might be used to improve the appearance of scars.
• Nerve injury. Injury to nerves, while rare, can temporarily or permanently affect nerves that control sensation or muscles. Temporary paralysis of a select muscle, resulting in an uneven facial appearance or expression, or temporary loss of sensation can last a few months to a year. Surgical interventions may offer some improvement.
• Hair loss. You might experience temporary or permanent hair loss near the incision sites. Permanent hair loss can be addressed with surgery to transplant skin with hair follicles.
• Skin loss. Rarely, a face-lift can interrupt the blood supply to your facial tissues. This can result in skin loss (sloughing). Sloughing is treated with medications, appropriate wound care and, if necessary, a procedure to minimize scarring.

Like any other type of major surgery, a face-lift poses a risk of bleeding, infection and an adverse reaction to anesthesia. Certain medical conditions or lifestyle habits also can increase your risk of complications. The following factors may present a significant risk or result in unfavorable results, and your doctor may advise against a face-lift.

• Blood-thinning medications or supplements. Medications or supplements that thin the blood can affect your blood’s ability to clot and increase the risk of hematomas after surgery. These medications include blood thinners (Coumadin, Plavix, others), aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), ginseng, Ginkgo biloba, fish oil and others.
• Medical conditions. If you have a medical condition that prevents blood clotting, you won’t be able to have a face-lift. Other conditions, such as poorly controlled diabetes or high blood pressure, increase the risk of poor wound healing, hematomas and heart complications.
• Smoking. Smoking significantly increases the risk of poor wound healing, hematomas and skin loss after a face-lift.
• Weight fluctuation. If you have a history of repeated weight gain and loss — factors that affect the shape of your face and condition of your skin — the outcome of the surgery may not be satisfactory or may be satisfactory for only a short time.

How you prepare

Initially, you’ll talk to a plastic surgeon about a face-lift. The visit will likely include:

• Medical history and exam. Prepare to answer questions about past and current medical conditions, previous surgeries, previous plastic surgeries, complications from previous surgeries, history of smoking, and drug or alcohol use. Your surgeon will do a physical exam, may request recent records from your doctor or order a consultation with a specialist if there are any concerns about your ability to undergo surgery.
• Medication review. Provide the name and dosages of all medications you regularly take, including prescription drugs, over-the-counter drugs, herbal medications, vitamins and other dietary supplements.
• Facial exam. Your plastic surgeon will take photos of your face from different angles and close-up photos of some features. The surgeon will also examine your bone structure, shape of your face, fat distribution and quality of your skin to determine your best options for face-lift surgery.
• Expectations. Your surgeon will ask questions about your expectations for the outcomes of a face-lift. He or she will help you understand how a face-lift will likely change your appearance and what a face-lift doesn’t address, such as fine wrinkles or naturally occurring asymmetry in your face.