1. How is a facelift done?
Facelift surgery is about lifting just one part of the face, the lower face. It is not a complete rejuvenation operation from the forehead down to the neck. Rather it focuses on just the neck and jowl line contrary to what many patients initially think. To define the shape of the neck and smooth out the jowl line, the overlying skin is raised from incisions that run around and into the ear. The main neck muscle, the platysma, is tightened down the middle of the neck and the deeper tissues on the side of the face, known as the SMAS, is also suspended upward towards the cheek bone. Once these are done, the skin is pulled back and the excess is trimmed off around the ears and then closed.
In more limited versions of a facelift, often referred to as a Lifestyle Lift or Quicklift, the procedure is more limited and tissues are only ‘nipped and tucked’ in close proximity to the ears.
2. Can I expect permanent results from a facelift?
A facelift does not create a permanent effect. It treats only the symptoms of the problem and not the cause, facial aging. This begs the question then of how long does a facelift last? That answer depends on numerous factors such as what type of facelift technique was used, how severe was the neck and jowl sagging to start with, does one have a full or thin face, and at what age was the procedure done, to name a few of the most significant. On average, however, one can anticipate full facelift results to last from seven to ten years. For some patients they will return to what they used to look like. For others they will still maintain some of the effect albeit a return of some loose skin.
The lasting effects of more limited facelifts, however, can be less long and most patients will have ‘full relapse’. This is because they often are done in younger patients who will continue to age longer or are done in older patients who want less of a surgery for an aging problem that really needs more of an operation.
3. Who is a good candidate for face lift surgery and at what age?
Anyone who has undesired sagging of the neck and jowls can benefit. The timing of the surgery depends upon when one finds it bothersome. For some it may be when just a little sagging is present. For others, the need is apparent when a more significant neck wattle is present. Like all cosmetic surgery, the need and timing is an emotionally-driven decision. One is never too old to care. I have done facelifts on healthy patients in their 80s and early 90s.
4. Will facelift surgery eliminate improve the wrinkles around my mouth?
It is best to think of facelift surgery as a skin lifting procedure. And it will improve wrinkles and folds of skin that are in the path of tissues that are undermined and lifted. But the mouth is actually beyond the skin that is lifted and no amount of skin pull will significantly affect the mouth area. It is a common misconception that a facelift will soften or eliminate nasolabial folds or vertical upper lip wrinkles. For this reason, many facelifts are accompanied by adjunctive mouth rejuvenation procedures such as laser resurfacing, corner of the mouth lifts, and fat injections to the lips.
5. Will it be obvious that I’ve had a facelift?
One of the most common concerns for potential facelift patients is that they will look like they have had a facelift…that they will look unnatural or pulled too tight.This concern comes from the appearance of some well known celebrities who do have that frozen or ‘wind-blown’ face look. These results are very atypical and are usually reflective of having had more than one facelift and a lot of different facial procedures. In reality, it is more likely than facelifts may not do as much as one wants than it is that they do too much.
6. Are facelifts in men different than in women?
Facelifts are different in men in two ways, how the operation is done and in the results. Because of men’s hairline and beard skin, the incision around the ears must be changed from the way it is done in a woman. To avoid pulling beard skin inside the ear, the incision stays outside the front of the ear in a natural skin crease. Because the incision on the back of the ear has the risk of being more exposed (less hair to hide it), it is often not carried as far back away from the shadow of the ear into the occipital hairline. As a result, the amount of neck lifting that can be achieved is often less. Combined with the heavier and thicker skin of most men, facelift results in men are usually less dramatic and rarely can be overdone. This is fine for most men as they are most concerned about looking too dramatically different. Subtle changes in men are preferred.
7. How long will I look bad after a facelift?
For full or more complete facelifts, think about two to three weeks for a complete recovery. For smaller or limited facelifts, seven to ten days will allow one to look ‘non-surgical’.
Dr. Barry Eppley
Indianapolis, Indiana