Fillers and injectables can help stop facial aging, but cannot serve as a full substitute for the traditional face lift surgery (rhytidectomy). Unlike the fillers and injectables, which can last typically for several months, a face lift will last up to ten years or more. Just keep in mind that face lift surgery is for major facial problems such as sagging or skin laxity, and is a very involved surgical procedure which takes a long time to heal from.
Here is a list of the five main components of facial aging:
- Wrinkles and fine lines
- Pigment changes in the skin like age spots
- Volume loss like hollow cheeks
- Breakdown of collage reducing elasticity
- The natural effect of gravity
Wrinkles, fine lines and age spots might get better with a skin resurfacing method such as microdermabrasion, a chemical peel or laser skin resurfacing. Wrinkles may also benefit from injectables like Botox or collagen. You could also use injectables for loss of volume and folds (laugh lines), such as Juvederm or Restylane. But the elasticity loss and what gravity can do to your face can only be improved with a face lift surgery.
How do you know if you are a good candidate for face lift surgery? You could be if you have very sagging and loose skin, especially around your jaw line or under your chin. Those people who have a very strong jaw line and a very defined bone structure might also choose a face lift.
Face lift surgery can help to correct many parts of your appearance including:
- Sagging near the middle of your face
- Very deep creases under your lower eyelids
- Very deep creases from your nose to the corners of your mouth
- Fallen or displaced fat pockets
- Fatty deposits or loose skin underneath your jaw and chin, which can make even a skinny person seem to bear a double chin
Preparing to Have Face Lift Surgery
If you’d like to improve the overall look of your face, your first order of business is to have a consultation with a cosmetic surgeon. They will tell you whether or not you are a proper candidate for a face lift surgery. The surgeon will evaluate your medical history. They will then look at your wrinkles, folds, bone structure and skin elasticity, and also your hairline to start thinking about the placement of the incision. The surgeon will discuss your expectations with you, and will take some “before” pictures of you.
When you have made the decision to go ahead with face lift surgery, and you have chosen your surgeon and made the appointment for the procedure, then you will be given some pre-operative instructions.
During the two weeks prior to your face lift surgery, the surgeon will have to stop taking some medications, including blood thinners, anti-inflammatory medications (NSAIDs) and aspirin, as they thin your blood and could increase your risk of bleeding. Some herbal medications might also be a risk (not all products marketed to be all-natural are necessarily safe all of the time). For instance, green tea, gingko biloba, omega-3 fatty acids and vitamin E can all increase your risk of bleeding during and after your procedure.
Be sure to tell the surgeon about all of your medications. But do not quit taking any medications without first consulting the proper physician. Make a “brown bag” appointment with your surgeon. This is where you bring all of your medications in their current packaging so that they can look closely at them all.
Some cosmetic surgeons will suggest that you begin taking certain drugs a few weeks before your surgery, such as bromelain or arnica to help minimize your post-op swelling and bruising.
Your pre-op instructions will also have a list of what to do and not do regarding what you should eat and drink before your procedure.
It is essential that you quit smoking before the procedure. Many surgeons will suggest that you quit for one month before and one month after the face lift surgery. Smoking reduces the amount of blood flow to your face, and 1 in 10 smokers that have a face lift surgery will experience what is called necrosis, or dying skin at their incision sites if they do not stop smoking for the surgery and recovery. The wounds could turn black or red and the edges may come apart. This may result in you needing a skin graft, which is another procedure where a patch of your skin is removed from another place on your body and transplanted to the wound.
There are a number of resources to help you quit smoking. However, common over-the-counter methods such as nicotine gum or nicotine patches cannot be used, because the body is still receiving nicotine, which is the source of the skin problems. Be sure to let your surgeon know if you are using a nicotine replacement method to quit smoking. Your doctor may be able to prescribe a medication such as Zyban or Chantix, which are non-nicotine drugs that can help you quit smoking. You may also consider such alternative methods as acupuncture or hypnotherapy to help you stop smoking.
How Face Lift Surgery has Evolved
Over time, face lift surgery has moved from a very simple to a more complex procedure. There are different types and variations, and you should speak with your doctor about them. They include such procedures as a deep plane lift, a superficial musculoaponeurotic face lift or an endoscopic face lift.
Whichever type of face lift that you and your doctor choose, the basic steps are the same:
The Anesthesia: A face lift is typically done with a blend of some mild sedative drugs, local anesthetic and mild intravenous anesthetic. The less complicated procedures might be performed with only a local anesthetic. From time to time, the procedure may be done with general anesthesia.
The Incision: Incisions are typically made in front of the ear and behind it. These incisions might extend to the scalp, but the incisions are always made in a natural skin crease to help hide the scar. Your surgeon might suggest that you grown longer hair if you have short hair, so that it might hide the incisions while you heal. For men, the incisions are made along natural beard lines.
The Face Lift: When the incisions are made, the skin is manipulated in various ways. Deeper layers of skin are “lifted”. The excess skin is taken away, and a small amount of fat might be taken with a liposuction procedure. Sometimes muscle and skin are reshaped. Muscle may be tightened along with the skin, or perhaps separately. After all of the manipulation has been completed, the skin is stapled or sutured back into place.
After the surgery, the doctor will place on you a dressing which will help to protect the areas where the incisions were made.
Recovering from a Face Lift Surgery
Typically the full face lift surgery procedure will take between two and four hours. It is an outpatient surgery, but occasionally people stay overnight .There will be some discomfort after, but this is easily managed with prescription or over-the-counter pain medication. You may also have some swelling around the eyelids or around other areas of your face. A fluffy dressing is put on right after your surgery. This dressing can usually be removed within 24 hours and in its place will be an elastic wrap dressing. For the first day after the surgery, most patients look bruised, and there may be drainage tubes to help reduce the swelling and drain excess blood. Drainage tubes might be left in for a few days.
Normally people can wash their hair after two days. But all strenuous activity should be avoided until the swelling has gone down, which can take four or up to six weeks. Within just a couple of weeks, you should be recovered enough for some mild social activity. But, you’ll want to stay home for most of the first few weeks home, to allow you to recover. After that, a relaxed activity, such as dinner out, with family or friends would be okay.
Around the three week mark, your new face will likely be mostly ready to show off, but sometimes it can take a little longer to heal. Many surgeons will recommend scheduling your face lift surgery three months prior to any big social events like a wedding or class reunion. The longer you take to heal, the better your face looks.
The skin might feel rough and dry a few months after surgery.
It’s important to remember that a face lift is for serious creases and folds, and not just for wrinkles. Improving the look of your whole face could involve a combination of procedures like eyelid surgery, tissue augmentation, facial implants, resurfacing procedures and injectable procedures for wrinkles. Some patients might also choose to have some unwanted facial hair removed with laser hair removal treatments.
Risks of Face Lift Surgery
Every surgery carries with it some risk, even a face lift surgery. Some risks might include:
- Unsightly scarring
- Hematoma, or blood under the skin
- An infection
- Necrosis or badly healed wounds, which can cause a visible scar near the wound
- Risk of anesthesia complications
- Risk of facial nerve injury and facial weakness
- Risk of facial asymmetry
- Loss of skin
- Facial numbness or other changes in sensation
- Death or loss of fatty tissue from deep in your skin
- Accumulation of fluid
- Bothersome pain
- Irregularities in the contour of your skin
- Discoloration of the skin, swelling or sensitivity
- Problems with the sutures
- Hair loss
- Different results than wanted or expected
- Cardiac complications, pulmonary complications, deep vein thrombosis
- Required revision surgery
Find a Qualified Cosmetic Surgeon
Before you decide that a face lift surgery is the solution for you, you need to speak only with a board-certified cosmetic surgeon. Cosmetic surgeons complete their residency training as general surgeons, and the American Board for Plastic Surgery should have certified them. Being board-certified is a clear indication that the surgeon you choose is properly trained and is up-to-date with the latest technologies in their field. Finding a good, qualified cosmetic surgeon will help to minimize your risks and help you to get the results you desire.