Facelift What to Expect: Everything You Need to Know

As we age, our skin loses elasticity, crow lines and wrinkles eventually appear, and facial skin gradually loses its suppleness. While hydrating, moisturizing, and staying out of the sun will certainly help, you may want to consider other cosmetic surgery options over time.

Data from the American Society of Plastic Surgeons shows that 234,374 Americans underwent a facelift procedure in 2020. The facelift is the third most sought-after cosmetic procedure after facial cosmetic surgery. If you are thinking of undergoing facelift surgery to refresh your appearance, here is a comprehensive guide of what you need to know about the procedure.

What Is a Facelift?

A facelift or rhytidectomy removes the excess facial skin that has been adding years to your appearance. Specifically, this procedure tightens loose skin around your jawline and eliminates deep creases around your nose and mouth. Depending on your treatment plan, your surgeon may also remove excess fat and skin in your neck and under your chin. Facelifts are typically outpatient procedures performed under local or general anesthesia. While the entire process can take up to five hours, it is done as an outpatient with the patient either going home or to a recovery center for the first night.

What a Facelift Can Do for You

A facelift can help you achieve a more youthful and smoother facial appearance.  The procedure can help with the following:

• Removes and tightens sagging skin
• Reduces your droopy cheeks near the jawline
• Lifts the corners of your mouth
• Lessens the creases between your lips and cheeks
• Creates what are usually minimally detectable incisions in the front and behind your ears

Types of Facelifts

Full Facelift

During a full facelift, three incisions need to be made: one behind the ear, one inside the front edge of the ear and extending into the hairline in the temple area, and one beneath the chin. During a facelift, the underlying layers of tissues and muscles of the face are lifted, and the fat is removed and shifted around. The excess skin is removed, and the remaining skin is sutured into place. In many cases, your plastic surgeon may include other procedures apart from a facelift to enhance your eyelids, brows, cheeks, and forehead for more noticeable results.

Full Neck Lift

A full neck lift involves an incision that begins beneath the sideburn, extends inside the front edge of the ear, and then moves behind your ear before ending in your lower scalp to correct aging signs in your lower face, neck, and chin. Skin and muscle are both tightened, and excess fat is removed to achieve maximal improvement.

Limited Neck Lift

A limited neck lift is for patients who do not have vertical muscle bands or as much loose skin in the neck region. The procedure addresses the neck and jawline by tightening the neck muscle from the side. The skin of the front of the neck is still attached to the muscle and is tightened via this process. The muscle over the lower face is also tightened, improving the jawline as well. One benefit of this procedure is that it uses local anesthesia and does not require drains or an overnight stay.

Cheek Lift

A cheek lift is ideal for people with sagging skin in the jowl and cheek areas that do not have vertical muscle bands or excess skin on the neck. The incision for this procedure will begin within the hairline at the temple and extends inside the front edge of the ear. Cheek lifts are a popular procedure among younger patients who do not require significant work on their faces to achieve their desired results.

Other Procedures Your Surgeon May Combine with Your Facelift

When evaluating your skin elasticity and your facial structure, your surgeon may decide that you will need to get some additional procedures to achieve the best results. Here are some of what your surgeon may suggest:

• A brow lift or forehead lift to tighten the skin in your forehead
• Eyelid surgery to enhance the look of your upper and lower eyelids
• Facial implants to amplify your cheekbones, jaw, or chin
• Facial liposuction to eliminate fatty deposits
• Resurfacing to boost the tone and texture of your skin
• Rhinoplasty to reshape or repair your nose
• Soft tissue augmentation to improve the silhouette of your facial structure
• Wrinkle reduction using injections to smoothen fine wrinkles

Talk to your plastic surgeon about what is best for you based on your age, diagnosis, health, medical history, and personal preference.

Types of Anesthesia Used for Facelifts

Local Anesthesia

Local anesthesia is performed through an injection that will numb regions of the face. Typically, this is combined with a mild oral sedative to make you feel sleepy and help you feel less anxious. You can expect to feel some short-term stinging during the injection itself, which will end once the medication takes effect. Keep in mind that you will feel some slight discomfort when the surgeon pulls on your face. After the procedure is over, you may have a slight headache or muscle discomfort. Tylenol or other mild medication will relieve this. 

Deep Sedation

Deep sedation is another widely used type of anesthesia for facial, cheek, and neck lifting procedures. You are given intravenous and inhalational anesthesia that allows you to sleep while still breathing on your own. Intubation is generally not necessary. When you wake up, you will feel a bit sleepy and will not remember what happened in the operating room.

Are You the Right Candidate for a Facelift?

If you are in good physical and mental health, have realistic expectations, and are ready for a 10 to 14 day recovery process, then you may be an excellent candidate for a facelift. Good candidates for a facelift should:

• Bring your diabetes and high blood pressure under control prior to surgery.
• Avoid smoking cigarettes or tobacco because nicotine interferes with the healing process.
• Avoid medication like blood thinners or aspirin because it can cause an excessive amount of bleeding.

If you have or do any of these, the next step is to consult with your surgeon to see if there are things that you can do to qualify for the procedure.

Preparing for Your First Consultation

What Your Doctor Will Ask You

As expected, surgeons will review your medical history and ask questions to assess your ability to handle this type of operation. Here are some of the topics that will be discussed during your first consultation.

• Blood pressure
• Medications
• Blood clotting
• Cigarette smoking
• Allergies
• Drug use
• Skin condition
• Scarring

What You Should Ask Your Doctor

Make sure to spend your time with your doctor wisely and research beforehand to ensure you ask the right questions. You can check the list of questions prepared by the American Society of Plastic Surgeons to guide you.

At the end of the day, your surgeon must be able to provide you with a detailed explanation of the procedure, the process, and the potential risks. Make sure that your chosen surgeon is up-to-date on the latest facelift technology and techniques.

Your 30-Day Recovery Guide

After having a facelift, you will need to take it easy for the first 14 days and give yourself plenty of time to recover. You will be able to resume your normal activities beginning 14 days after surgery. Here is our 30-day facelift recovery guide, so you know what to expect.

Week 1

Post-surgery, you will need to take it easy. You may have drains for several days and will need help traveling to the office. You will not be driving for about two weeks, so transportation to and from the office will need to be arranged with a friend, family, or shared ride service such as Uber. Follow your surgeon’s instructions concerning blood pressure checks and take your prescribed medication.

Your plastic surgeon will see you on the day after surgery to change your surgical dressings and evaluate your swelling and incision. Your doctor will remind you of the basics of wound care, so do not hesitate to ask any questions you might have.

Your sutures will be removed one week after surgery and you will be showering by then.

Week 2

You are encouraged to continue with minimal activities and to continue to monitor your blood pressure. By the end of the second week, most patients will look virtually normal with a bit of makeup.

Weeks 3 and 4

You may begin to drive 14 days after surgery. You may also begin to walk around and participate in light exercises. You may increase your activity over the next two weeks to near normal by 4 weeks after surgery.

After 30 Days

One month after a facelift, you should be back to your usual self. Do not be alarmed by minor swelling, numbness, tightness, and bruising, as that may take up to a year to subside.

The amount of time it takes for recovery is unique to you. Make sure to follow your plastic surgeon’s instructions to gain the best outcomes. It is also vital that you communicate with your doctor throughout the entire recovery process and let them know what you are feeling.

Finding the Right Plastic Surgeon

A facelift is a great way to revitalize your appearance and give a firm, bright look to your face. If you are considering getting one, doing your research, asking the right questions, and setting attainable expectations are the first steps to finding the right doctor for your needs.  Dr. George Sanders is a board-certified plastic surgeon in Los Angeles and San Fernando Valley specializing in facelift surgery. Contact him for a consultation today or search for a plastic surgeon near you.