A facelift is a procedure used to treat loose and sagging skin around the face and neck. The goal is to providing a more youthful appearance. It is suggested that a facelift may ‘turn back the clock by 10 to 20 years.’
Why does the face age
There are multiple reasons the face ages with time. Aging affects the skin, fat, gristle, muscles and bones of the face.
Skin loses its elasticity causing wrinkles. Fine wrinkles are caused by damage to the skin. Deep wrinkles are caused by skin damage combined with repeated muscle motion.
Fat and gristle is located under the skin of the face. This layer is called the SMAS layer. Over time it drops due to the pull of gravity. Some of the fat disappears. This leads to hollowing around the lower eyelids and upper cheeks and bags around the eyes, mouth and jaw line.
Muscles in the neck cause visible bands.
Bones of the face will shrink slightly, adding to the hollowing of the upper cheeks.
Combined, the changes associated with facial aging are given names such as tear troughs, nasojugular folds, jowls nasolabial folds, and marrionette lines.
A summary of these changes are shown in the diagram below.
What does a facelift do
A facelift is designed to treat some or all of these age related changes. There are many types of facelifts. Dr. Anzarut is a board certified plastic surgeon and is trained in a wide range of face lifting procedures. His training has been with expert plastic surgeons in Canada, the United States and Europe.
Is a Facelift for me?
If you would like to have a more rested and youthful appearance you may be a candidate for a facelift. Patient who have a facelift earlier in life will have a better and longer lasting result. Patients who have a facelift later in life may see a more dramatic change.
Your safety is important to Dr. Anzarut. He will investigate to ensure you do not have a medical condition that may pose a risk. If you have any questions about whether a facelift is right for you, contact Dr. Anzarut to discuss your options. Dr. Anzarut is available for consultation in his office or through an online consultation.
About the procedure
All facelifts involve separating the skin off the SMAS layer of the face and neck. The SMAS layer is just below the skin and made up of fat and gristle. Once the skin is separated from the SMAS, the SMAS layer moved upward and backwards. Moving the SMAS produces a more youthful appearance. The SMAS is then anchored in this more youthful position. Finally, a variable amount of excess skin is removed.
What Procedures are combined with a facelift?
FAT GRAFTING – It is common to combine fat grafting with a facelift procedure. Fat grafting involves injecting fat from the abdomen to replace the fat that has disappeared with age.
FOREHEAD LIFT – In some patient with excessive forehead wrinkles and eyebrow droop a forehead lift is performed at the same time.
Eyelid lift – When patients who have age related changes of the skin and fat in the eyelid region this can be treated at the same time.
Neck lift – A complete neck lift is the most common procedure that is combined with a facelift.
Skin resurfacing – If you have fine lines and wrinkles these may require a skin resurfacing procedure to obtain an optimal outcome.
What is the difference between various facelift procedures?
Facelifts may vary in how the SMAS layer is lifted and repositioned. The fat and gristle that is lifted during a facelift is called the SMAS. Under some circumstances, the SMAS is left attached to the underlying muscles of the face. Examples of these facelifts include SMAS-plication, SMASectomy, and the MAX techniques. In other circumstances, the SMAS layer is lifted off the deeper muscles of the face prior to being repositioned. Examples of these include the sub-SMAS, extended-SMAS, and high-SMAS techniques.
Some surgeons lifting the SMAS off the underlying facial muscles may provide longer lasting results. There is no evidence to support this. Lifting the SMAS off the muscles may be associated with a longer recovery, more bruising, and a higher risk of complications. Dr. Anzarut can review the pros-and-cons of each technique to help decide which may be best for you.
Will I need a neck lift with my face lift?
A standard facelift will provide a modest improvement to the appearance of the neck. The addition of a formal neck lift will allow for more significant improvements in the appearance of the neck. A formal neck lift will treat banding in the neck, improve of the angle of the neck and excess fat and skin.
A formal neck lift involves lifting the skin off neck. The difference between a facelift with and without a neck lift is shown below.
Patients who are in their 40s usually will not need a formal neck lift, while patients in their late 50s often have enough skin laxity to require a formal neck lift.
Will there be scars with a face lift?
Facelift incisions are made along the sideburns, the ear, and the hairline. The extent of the skin incisions depend on the amount of skin laxity and type of face lift. Patients with minimal to moderate laxity may achieve an excellent result with a small incision called a short scar face lift. If there is more laxity a longer incision may be needed to achieve the desired result. A complete neck lift requires a small incision under the chin. Most incisions heal well and can be camouflaged with make-up if desired.
How long does a facelift take?
A Facelift can take three to six hours depending on the complexity of the procedure.
What type of anesthetic is used?
Facelift procedures can be performed using local anesthetic (freezing) and sedation or with general anesthesia.
Recovery from a Facelift
Dr. Anzarut takes special precautions to minimize swelling and bruising. After surgery you will need to have icepacks applied to the face for the first 48 hours, sleep with your head elevated, and you may need to take medications for your blood pressure. Patients usually return home the same day.
Dr. Anzarut will be available through his office or cellular phone to answer any questions or concerns 24 hours a day, seven days a 7 week. You will not be redirected to another surgeon or trainee. Dr. Anzarut takes great pride in always being available to his patients. There will be a drain placed at the time of surgery. This is removed after 24 hours. Five days after surgery your sutures will be removed. You will have some bruising and swelling. This is normal and should subside after the first 7-14 days.
Will I have a drain?
Dr. Anzarut will place a small drain at the time of surgery. This is usually removed after 24 hours. Without drains fluid may build up under the skin and compromise your result. In some patient, tissue sealants may be used instead of drains..
The final result of your facelift will be evident after 3 – 6 months, depending on your skin type and the extent of the surgery. A facelift may allow you to appear 10 – 20 years younger, on average. Facelifts that are done at an earlier age will have a longer lasting effect. However, it won’t stop the clock and you will continue to age.
Risks of a Facelift
The more informed you are about the procedure the happier you will be with the results. There are some side effects and risks of facelift surgery you should be aware of. Side effects include temporary numbness of the face, bruising, swelling, and deep stiches that may be felt. Early on, the incisions will be firm and may be red. With time they will soften and the redness will fade.
Complications of facelift surgery are uncommon. They include areas of permanent numbness over the ear or face, temporary or permanent injury to the nerves that allow the facial muscles to move, thick or wide scars, asymmetry, deformity of the ear lobe or hairline, infections, bleeding or fluid collections. There are also risks associated with anesthesia itself. When performed by a board certified plastic surgeon, complications are usually minor and uncommon.
What Can I do to make sure I get the best result?
Before surgery it is important to avoid medication and foods that may cause bleeding or poor wound healing. Dr. Anzarut will provide you with a list of these (LINK). It is essential to avoid smoking for at least two months before and after surgery.
After surgery you should follow the post-operative instruction. Icing and elevation of the head are important in the first 48 hours. Avoid submersion under water or strenuous activity for the first three weeks.
Over the longer term you should protect the skin and the incision from the sun, avoid smoking and maintain a healthy lifestyle.
The cost of a facelift will vary depending on the complexity of the procedure and the type of anesthesia. The cost of a facelift may include anesthesia fees, medications, facility costs, and fees for medical tests. The price may range from $5,000 to $17,000.