A facelift surgery, or rhytidectomy, is a type of cosmetic surgery to correct or reduce varying degrees of age related changes seen in the face and neck. To better understand what a facelift surgery is, it’s important to understand what happens when we age.
As many of us age, we lose the youthful and full contours of our face. These age related changes that we see in our face are inevitable and can occur at any age depending on a variety of individual factors. Genetics, facial structure, skin type, body weight fluctuations, gravity, medical conditions, and lifestyle habits can all influence the age that our face begins to show undesirable changes.
- Procedure Snapshot
- Why your face ages?
- How can facelift surgery reduce the appearance of aging?
- What does facelift surgery improve?
- What are the limitations of facelift surgery?
- How long does a facelift last?
- Advancements in Facelift Procedures
- Best Age for Facelift Surgery
- Facelift Surgical Approaches
- Facelift Incision Lines
- Pixie Ear Deformity
- Does a Facelift Address Skin Complexion?
- Male Facelift surgery
- Surgical procedures commonly combined with Facelifts
- Possible Facelift complications
- Revision Facelift
- Liquid Facelift
- Philosophy and approach
- Healing time and recovery
- Facelift FAQs
|What is the pain level after the surgery?||Minor discomfort|
|Anesthesia type (if applicable)||General anesthesia|
|Duration of Surgery||Up to 4 hours|
|Where will scaring for this procedure be?||Hidden incisions are camouflaged along the hairline and inside of the ear for women or in front of the ear for men|
|Timeframe to begin showing final results||1 to 6 months healing improves|
|When is the patient able to return to regular activities?||2 weeks|
|When is the patient able to resume exercise?||2-3 weeks|
|Cost of surgeon’s fee||$7,000 – $8,000|
Why your face ages?
As we age our skin can lose anywhere from 20-80% of its volume with time. The loss of facial volume is due mainly to reduced production of collagen, elastin, and glycosaminoglycans (GAG) in the dermis of our skin. Overtime, the skin on the face loses some of its elasticity and begins to sag. The underlying muscle and soft tissue also lose their tightness, which allows some of the soft tissue in the face to descend leading to jowl formation and loss of a defined jaw line. Without support, excess skin, fat, and soft tissue settles under the chin and neck and blunts the angle of the neckline. Volume loss in the cheeks, and even bone loss in our face and jaw bones diminish the support to our facial tissue. Underlying bony structure becomes more evident with volume loss and descent of soft tissue. A youthful triangle shaped focus of the face inverts over time, as the jowls form and the midface loses volume the face takes on a more square shape.
How can facelift surgery reduce the appearance of aging?
Facelift surgery improves the visible and telltale signs of aging in the face and neck. A facelift tightens and lifts the underlying muscle and soft tissue to restore the cheeks, jawline, and neck area to a more healthy and youthful position and contour. The excess loose skin that develops over the years is also excised during the facelift procedure.
The goal of a facelift surgery is not to make everything tight, but to return the face to a natural, refreshed, more youthful, and overall better look.” —Dr. Jessica Kulak, Aging Face Surgeon
What does facelift surgery improve?
- Excess loose skin on the lower face causing jowl formation
- Sagging skin of the neck, giving the appearance of a double chin
- Sagging facial muscles
- Loss of youthful facial contours
- Appearance of deep wrinkles
- Self-esteem and confidence
What are the limitations of facelift surgery?
A facelift does not change the appearance of the skin. Fine lines, fine wrinkles, hyperpigmentation, age spots and skin texture will not improve with a facelift. Improving the overall skin quality and wrinkles typically requires a resurfacing procedure such as a chemical peel or laser resurfacing. The facelift procedure mainly addresses the lower portion of the face and neck. To significantly improve the upper portion of the face and eyes, adjunctive procedures such as a forehead lift or eyelid surgery may also be beneficial.
Often times a facelift is combined with other facial surgical procedures as well as skin resurfacing to overall give the most youthful and rejuvenated results to a patient.
How long does a facelift last?
A facelift can “turn back the clock” on aging and may take 10 years off your appearance, but unfortunately it does not halt the aging process. Most patients will find that their rejuvenated appearance will last somewhere between 8-10 years. Additionally, although the result of a facelift are not forever permanent, patient’s by taking good care of their skin and staying out of the sun can prolong the longevity of their surgical results.
Advancements in Facelift Procedures
In the past few decades the world has seen major advancements in facial plastic surgery. These advancements have come from a better understanding of overall facial aesthetics, anatomy, the natural aging process, and what truly characterizes a youthful facial contour.
Originally, facelift surgery consisted of “skin-only lifts” where surgeons were simply excising the extra and lax facial skin. This “skin-only” technique did not have very long lasting results and often times gave the patient a “pulled back” or “wind tunnel” look. Nowadays, surgeons have modernized their facelift techniques by not only correcting skin laxity, but also repositioning the underlying muscle and soft tissues of the face and neck. Elevating the muscles in addition to the skin enables surgeons to tighten the connective tissues of the face and neck without overstretching the facial skin, creating a very natural lift for the patient.
Best Age for Facelift Surgery
The most common age group is 40s- 70s for facelift surgery, however facelifts can be performed on individuals outside of this typical age group depending. Noticeable facial aging changes may begin in the mid to late thirties and continue to progress once they have begun. Aging is a process that relies both on genetic factors as well as external factors.
External factors such as stress, sun exposure and dramatic and rapid weight loss can all contribute to loose and sagging facial tissue. Regardless of age, if a patient has experienced a descent of facial tissues, loss of skin buoyancy, and is bothered by the changes seen in the jowls, cheeks, and neckline then they are an ideal candidate for a facelift.
Traditionally, the thought has been to hold out on facelift surgery for as long as possible and then to dramatically change their appearance with surgery. The current trend in cosmetic surgery is not to wait, but to make subtle changes as one ages in order to slow down the aging process and continue to maintain a natural and rejuvenated appearance. Mini-facelifts, thread lifts, non-invasive modalities to build collagen and lift muscle (such as Ultherapy™, SkinTyte™) are some of the ways to maintain a youthful contour before needing an invasive surgery.
Facelift Surgical Approaches
There are many ways a facelift, or rhytidectomy, may be performed. Most plastic surgeons are trained on different rhytidectomy techniques to achieve optimal results. The differences come from incision approaches, facial areas needing improvement, and level of invasiveness.
Traditionally, a facelift will consist of incisions made along the front and back of the ears, which extend through to the hairline. The incisions are precisely placed to blend with natural contours and creases of the ear and hidden within the hairline. Once these incisions are made surgical tools are used to undermine, or separate the skin from underlying fascia, in the appropriate areas. Once these areas (typically the cheeks, jawline, and neck) are undermined, the surgeon is then able to tighten the area with sutures, redrape the skin in its new position, and discard any excess skin.
A cutaneous or “skin-only” lift consists of only lifting and tightening the skin of the face, while leaving the underlying muscles and tissues intact. The skin is separated from underlying tissues, stretched, redraped, and the excess is removed. A cutaneous lift has lower incidence of complications, which may make it a better option for older patients that may suffer from a variety of medical conditions that discourage them from moving forward with more invasive surgical procedures. However, the downside to a cutaneous lift is that the results are not as long lasting and the scars tend to be more evident. With a cutaneous lift you are only correcting skin laxity and not moving other tissue layers underneath the skin. Thicker scarring may occur with a cutaneous lift since the entire incision is being held together with just the skin layer. Furthermore, due to the skins’ nature to re-sag with the loss of collagen and elasticity, the longevity of a cutaneous lift is the least when compared against the other facelift surgical techniques.
Although a cutaneous lift or what most people know these days as a Thread Lift has gained in popularity because of less cost as well as less downtime, I am personally not a fan because the results are not as impressive and long lasting as I would like them to be for my patients.” —Dr. Jessica Kulak, Aging Face Specialist
The word “Plication” means to fold or the action of folding. The “SMAS”, or “superficial muscular aponeurotic system”, is comprised of deeper tissues of the face including the ligaments, fat, and musculature of the cheek. Unlike a skin-only facelift, SMAS plication consists of tightening the skin as well as its underlying tissues. The SMAS and platysma muscle are often elevated and repositioned to restore the youthful contours of the face and neck. Once this deeper tissue has been tightened, the overlying skin is redraped and excess is trimmed to close the skin incision with minimal tension. Minimal tension at the closure of the skin is key to a thin and well-healed scar that is barely visible. This technique has longer lasting results, restores the SMAS to a more youthful position on the face, and achieves a better correction to the effects of aging. When done properly, by a qualified Facial Plastic Surgeon, the youthful results may last for 8-10 years.
The composite facelift is an advancement of the SMAS plication technique. It is considered composite because this facelift incorporates several elements of the face to reestablish true youthful characteristics of the face. Composite facelifts reposition the deep tissue layers of the SMAS. However, the key component of the composite facelift, which sets it apart from earlier techniques, is the addition of the orbicularis oculi muscle. This addresses not only the cheeks, jowls, and neck areas but includes a lift and tightening of the eye area as well.
Unlike more traditional facelift techniques which mainly focused on the horizontal repositioning on the facial skin and/or tissues, the composite facelift also takes into account the vertically descending effects that gravity has on the face, and gives an upward and horizontal tightening to facial tissues. The Composite facelift typically has increased downtime and swelling. It is a more invasive and has increased risk of complications.
Deep Plane Facelift
A Deep Plane Facelift is a more developed and invasive form of the traditional facelift. The Deep Plane Facelift is able to better improve the nasolabial folds because it dissects deeper than the SMAS tissues layers, down to the underlying muscles. Since this procedure is dissecting underneath deep tissues of the face, it causes less tension on the more superficial layers of the skin, which can be beneficial in patients with thick skin and a heavier face.
Due to the depth of this procedure it is important to go to a Board Certified Facial Plastic Surgeon who is experienced and regularly performs this technique. A deep plane facelift requires skillful and meticulous dissection of deeper tissue layers, which even in cases where experienced hands are performing the procedure there is a much higher incidence of permanent nerve damage than with other facelift techniques. One commonly seen complication is damage to the mandibular branch of the facial nerve which can lead to permanent one sided or bilateral lower facial droop. Due to the increased risk of complications with deep plane facelifts many experienced surgeons as well educated patients decide to purse a slightly less invasive facelift approach and minimize the incidence of potential complications.
A subperiosteal facelift is considered to be more invasive than a traditional SMAS lift. A subperiosteal lift separates all fat and muscle from the underlying bony structures of the face. A subperiosteal lift is a good choice for patients who also want facial implants; since all facial tissues are lifted from the facial bones and implants may be nicely placed between.
The most profound results of a subperiosteal lift are most noticeable on the upper two thirds of the face, as involves is a vertical lifting process. Since a subperiosteal facelift dissects down to the facial bones, there is typically more involved downtime and lengthier recovery. Swelling can be quite significant lasting weeks to several months.
The midface is commonly known as the area surrounding the nose, eyes, and even the corners of the mouth (the middle areas of the face). As we age and lose skin laxity it is normal to experience sagging or descent of these areas. Some may find sagging of the eye, cheek, and mouth areas only, without experiencing sagging of the neck or jawline. In cases where there is very focused facial saging, a Mid-Facelift could give a more youthful appearance, without the need to undergo a full facelift. The results of a midface lift are often subtle, and often not long lasting and therefore Dr. Kulak rarely performs this procedure on its own. A mid-face lift is usually paired with additional procedures to attain more optimal results. Often an upper and lower blepharoplasty (eyelid lift) compliments the results of a Mid-Facelift by also refreshing the eyes to a more open and well rested appearance.
A mini-facelift surgery is essentially a less intense and less invasive version of a traditional facelift. It is a great option for patients who are experiencing mild signs of aging and facial sagging in the lower areas of the face. A mini facelift is typically done on patients in their 30s to young 50s who are not yet in need of a full facelift but could still receive improvement to their facial contours. Many people know mini-facelifts by other names such as the “s-lift” or the “weekend lift” for its incisional technique and its speedy downtime. Incisions for a mini facelift are typically from the ear around to the hairline, well hidden in natural contours. The term mini-facelift is also often loosely used for partial facelifts such as lower face only, midface only, etc. Some may even refer to a mini-facelift as a procedure that corrects mostly the face with minimal correction to the neck, or it may be referred to as a procedure that corrects sagging of the neck but not as much correction of the face. The way the term is used may vary, so it is important to be very clear about which areas you are hoping to correct when going for a mini-facelift consultation. This will help the surgeon evaluate your specific anatomy and determine which kind of lift will give you optimal results.
Facelift Incision Lines
As in all of plastic surgery, scar placement is crucial for minimizing the “operated on” look. Most patients desire to look more youthful and rejuvenated while hiding the markers or tell-tale signs of having work done. Placing the incision lines in areas that are inconspicuous and well hidden is critical. Incisions are typically made within the natural creases in front of and behind the ear as well as within the hairline. It is important for the ear and hairline positioning to be preserved and remain in the same position after surgery. Our facial plastic surgeon, Dr. Jessica Kulak, elevates the deeper tissues of the face and neck rather than more superficial layers in order to decrease the amount of tension placed on the skin. Reducing tension on the skin allows for a cleaner incision line and leads to better scarring. One concern that patients may have is the possibility of hair loss from the incision line. For this reason our surgeon bevels her incisions to allow for hair to regrow perfectly through the incision line. This hair growth and hairline preservation is important in facelift surgery so that patients are not limited in the ways they can wear their hair. Patients should be able to confidently wear their hair up or back with no worry of having visible scars.
Not every surgeon takes the same approach when it comes to incision line placement for facelifts and necklifts. Dr. Jessica Kulak meticulously places her incisions along the edges of the ear and behind the tragus cartilage. This allows for optimal camouflage rather than placing incisions directly in front of the ear and leaving more evidence of surgery. When closing the back edges of the tragus it is important that the surgeon uses correct techniques to minimize tension so that the tragus is not pulled forwards. Repositioning the newly tightened skin over the tragus requires removal of fat and sometimes the placement of deep sutures under the skin to minimize the potential tension on the cartilage
Dr. Jessica Kulak has an artistic eye for the natural contours and rejuvenation of the face. Patients are always pleased with their natural results that simply restore them to a more youthful appearance without showing signs of any procedures. Below are examples of Dr. Jessica Kulak’s surgical results from two of her many patients who achieved amazing results with no signs of facelift surgery.
Pixie Ear Deformity
A previously common side effect of facelift surgery was an unnatural look of the earlobe, commonly known as the “pixie” ear deformity (pictured on the right). This deformity usually comes about from improper reattachment of the earlobe after repositioning of the skin or too much tension put on the earlobe. This causes the earlobe to stretch and elongate down towards the jawline. The “pixie” ear deformity was a largely known sign of facelift surgery because of its unnatural appearance. A well-experienced facial plastic surgeon is aware of this complication and will perform a facelift properly to reduce the chance of this after effect.
Does a Facelift Address Skin Complexion?
A facelift addresses the laxity and sagging of the skin on the face and neck to create a more youthful contour. However, it cannot correct other skin issues such as fine lines, sun damage, melasma, blemishes, etc without the addition of skin complexion correcting procedures. It is important to not only lift and tighten the skin with a facelift procedure, but to also ensure the quality of the skin tone and texture as well. This is why many of those who undergo a facelift surgery will also opt for a deep laser resurfacing procedure to be done at the same time.
Example of patient who underwent CO2 laser resurfacing. She wanted to improve the appearance of her fine lines, wrinkles, and overall skin complexion.
Our Board Certified Facial Plastic surgeon, Dr. Kulak, will often perform a CO2 laser resurfacing procedure in conjunction with other surgical procedures in the operating room. She uses the Active FX laser that is known to be one of the deepest penetrating ablative lasers on the market. The Active FX laser safely penetrates deep into the skin, below the dermis, stimulating collagen and elastin production. This resurfacing procedure ablates the skin layers, removing all of the previously damaged layers of skin in order to reveal a fresh new complexion.
Male Facelift surgery
A good facial plastic surgeon knows to address gender differences when performing facelift surgery. The aging concerns that males have are different than the ones women look to address. Women tend to be concerned with getting rid of fine lines and wrinkles while men are generally more bothered by the loss of jawline definition. Furthermore, men often look for improvement to the lower face and neck as compared to the full face. Another important difference that surgeons must take into consideration is hiding of incision lines. This is an important aspect of surgery for both men and women, however men tend to wear shorter hairstyles and have more facial hair than woman. Plastic surgeons may have a slightly modified approach for their incisions when performing facelifts on men due to increased importance of hairline preservation.
Additionally, men experience a loss of muscle and skin laxity in the neck, sometimes paired with a fat deposit under the chin. Men with a weaker jaw and chin structure tend to develop these fat deposits at an earlier age, making them a great candidate for additional procedures such as submental liposuction and/or a chin implant.
Surgical procedures commonly combined with Facelifts
The aging process for most individuals affects a variety of different areas of the face at the same time.
Other common effects of facial aging may include:
- Drooping of the eyebrows
- Sagging, puffing, and/or heaviness of the eyelids
- Volume loss in the cheeks and temples
- Laxity of the neck
- Worsening skin texture, tone, and overall quality
- Enlargement of the nose and increase nasal droopiness
If any of these additional effects of aging are a concern, they may be addressed and corrected at the same time as a facelift. Our facial plastic surgeon regularly performs multiple facial procedures during one surgery. She does this to reach a more complete youthfulness of the face so that no major signs of aging are left notable. For example, if a patient needs a facelift but is also experiencing significant heaviness and sagging of the eyelids that is contributing to a tired and aged appearance, it would be beneficial to correct this as well. These are topics that will all be discussed and recommended during a thorough analysis and consultation with our Board Certified Facial Plastic Surgeon.
More specifically, this is a list of procedures Dr. Jessica Kulak will often combine with a facelift in the operating room:
- Upper Blepharoplasty
- Lower Blepharoplasty
- Chin Implant Placement
- Fat Grafting
- Laser Resurfacing
- Neck Liposuction
- Laser Resurfacing
Possible Facelift complications
When undergoing any surgical procedure, there are always risks of complications. Although chances of encountering a complication are low, it is important for patients to be aware of the possible complications that may come from a facelift surgery.
Some possible risks of facelift surgery include:
- Hematoma. A hematoma is blood collection under the skin, which leaks from the blood vessels. This is one of the most common complications of facelift surgery and typically arises in the first 24 hours after surgery. Hematomas require medical attention and most often a surgical drainage of the blood collection.
- Scarring and Hair Loss. Most often scars from a facelift are concealed within the hairline and natural creases or folds of the ear. However, scars may become hypertrophic leading to a thickening and pigmentation of the incision line. Furthermore, this can cause either temporary or permanent hair loss along the incision lines. Routine steroid injections may improve hypertrophic scars and follicle transplantation may improve hair loss.
- Nerve Injury. Damage to underlying structures, such as nerves, may cause numbness, tingling, weakened or even paralyzed movements of the face. Most of these side effects are temporary and resolve as the nerve endings reform. However, in rare cases permanent damage may occur.
- Skin Necrosis. Skin necrosis occurs when there is impaired blood supply to a certain region of tissues, which causes that region of tissues to die. Skin necrosis is a very rare but serious complication that requires medical attention. The risk of this complication is severely increased in smokers.
- Infection. Infection is always a possible complication of surgical procedures, as incision sites may become an entry point for bacteria. Signs of infection may include redness, swelling, drainage from the incision site, and fever. Infections may be treated with a course of antibiotics.
Many of the complications that may come from a facelift surgery can be controlled and treated with proper care, medication, or surgical correction. It is important to speak to your plastic surgeon about all possible complications that can occur before deciding on surgery. Strictly following your surgeons pre and post-operative care is imperative to achieving best results with the lowest risk of complications.
A revision facelift, or secondary facelift, is a surgical facelift procedure performed after one has already undergone a primary facelift. There are many different reasons to choose to undergo a revision facelift. However, the decision is typically very personal and based on ones’ own satisfaction with the results from their first facelift. Longevity of results is a top reason some may undergo another facelift procedure. No matter how successful and satisfied a patient is with their first facelift results, a facelift does not stop time. Facelift results have the ability to last up to 10-15 years. Some patients may be unsatisfied with their facelift results after about 5 years. Aging is a natural process that continues to have effects on our bodies and face and the rate of aging from one person to another is always varied. The natural aging process is largely a reason why some may opt for a secondary facelift. When exactly this time will be for each patient, is up to his or her own personal discretion.
Other reasons to opt for a secondary facelift:
- Noticeable scarring
- Asymmetric results
- Original use of outdated techniques
- Major weight loss after initial surgery
- “Pulled back” look
- Irregular contour with dimpling or ridges
- Not enough lift
A secondary facelift is often more complicated than a primary because underlying tissues have been repositioned in new areas and scar tissue may have formed. Going through with a revision facelift can be worrisome for many patients. This is why it is important to consult with a Board Certified Facial Plastic Surgeon, who is truly an expert in facial anatomy and specializes in facelift procedures, when choosing to opt for a secondary surgery. A skillful and experienced surgeon will be able to correct any previous issues and restore you to a more symmetric, natural, and youthful appearance.
A liquid, or nonsurgical, facelift is the restoration of a more youthful facial contour through the use of injectable dermal fillers and Botox. The injectable fillers can be used to replace volume loss, lessen skin sagging by filling volume from within, and smooth fine lines, wrinkles, and folds. The liquid facelift is the latest trend for a non-surgical, non-invasive procedure with minimal downtime and low risk.
A liquid facelift is an in office-procedure where fillers and Botox will be injected in specific areas to reduce the signs of aging. At the Naderi Center we offer a topical numbing cream, to ensure our patient’s comfort during the procedure. Downtime typically consists of minor swelling and bruising, but with the use of makeup most patients are able to go about their daily routine per usual.
A liquid facelift may seem reasonable due to low downtime, risk, and ability to forgo an invasive procedure. However, it does come with drawbacks. A major drawback is the longevity of results. Although dermal fillers may last 1-2 years depending on the placement and quantity injected, our surgeons suggest routine dermal filler injections every 6-9 months in order to maintain the look. Furthermore, to maintain the results from Botox or Dysport, patients are advised to come in for routine injections every 3-4 months. It is important for patients to be aware of the continued maintenance required when opting for a liquid facelift.
Despite the ability of liquid facelifts to achieve great improvement, if the patients’ degree of skin laxity and facial aging is too severe, one may need more than just fillers and botox to achieve their desired youthful look. An experienced facial plastic surgeon will assess your degree of aging and help determine which procedure will be of most benefit towards your goals.
Surgical Facelift vs. Liquid Facelift
|SURGICAL FACELIFT||LIQUID FACELIFT|
|Longevity of results (~10yrs)||Longevity of results (6-9 months for dermal fillers, 3-4 months for Botox/Dysport)|
|More corrected result||Partially corrected result|
|Higher risk||Low risk|
|Extended downtime||Little to no downtime|
Philosophy and approach
Dr. Kulak approaches each patient as an individual and tries to develop a treatment plan that fits each patient’s goals and lifestyle. Everyone ages in a different way and at a different pace depending on a variety of factors. There is no set age that should guide your decision about when to pursue a facelift surgery. Dr. Kulak specializes in many non-invasive treatment options that she can offer her patients to reverse early signs of an aging face, such as fillers to replace volume loss or skin resurfacing to improve skin texture. However, surgery is only true way to correct loose neck and cheek tissue in the face that cause the formation of jowls and the sagging skin appearance along the jawline.
Dr.Kulak utilizes conservative but effective facelift surgery techniques to achieve a natural, long lasting, and refreshed appearance to the face. Her goal is to restore a more youthful contour to the face without giving an overly tightened or “pulled-back” look. Dr. Kulak works with every patient to understand all of their individual goals and concerns in order to decide which procedures will give them the optimal outcome they hope for.
Dr. Kulak’s facelift technique involves hidden incisions, which are camouflaged along the hairline and inside of the ear for women or in front of the ear for men. The incision then extends behind the ear in a hidden groove and is then extended to the hairline. Incisions placed along the hairline, heal very well and avoid an unnatural shift of the hairline that can lead to a surgical appearance.
Once the incisions are made, excess fat is removed and the underlying tissue is tightened to reshape the jawline and neckline. The skin is then re-draped and the excess skin excised. The incisions are then meticulously closed and a dressing is applied. Dr Kulak does not usually use any drains or require patients to stay overnight in the hospital. Patients go home the same day of surgery and are seen the next day in the office to have the dressing removed.
Typically, Dr. Kulak will perform facelift surgery with twilight anesthesia or general anesthesia in an operating room.
Healing time and recovery
Surgery is performed at INOVA Fair Oaks hospital or ambulatory surgical center in Fairfax, Virginia or Suburban Hospital and surgical center in Bethesda, Maryland. Patients will typically be discharged home from the hospital after a few hours in recovery to rest and relax. Many patients report little pain after facelift surgery. Minor discomfort is easily controlled with pain medication.
On average, recovery after a facelift takes about ten days. The bandages placed after surgery are removed in the office the following day. Sutures will be removed after the first week. Swelling and bruising after a facelift are common and can take around 2 weeks to resolve. While the majority of the swelling will be gone by one month, swelling and incisions will continue to improve over the next 6 months. Most patients return to work after 2 weeks of recovery and can begin light exercise at 3 weeks after surgery.
AQUECOOL RAPID RECOVERY SYSTEM
Post-operative healing and care is of upmost important when it comes to staying comfortable, safe, and ensuring a good result. This is why our surgeon, Dr. Kulak, uses the Aquecool Rapid Recovery System for every one of her facelift/necklift patients. Aqueduct Medical has a top of the line recovery system for patients to use during their post-operative healing to expedite downtime, swelling, bruising, and manage discomfort. It is an advanced FDA-approved device that delivers safe and controlled compression and cooling to the operated areas.
There are two parts to the Aquecool Rapid Recovery System; the Aquecool Masque and the Aquecool Device. The Aquecool Device is a portable and easy-to-use electric water cooling machine which maintains water temperature between 50-65 degrees Fahrenheit (temperature may be specifically adjusted by the user). The Aquecool Device stays at its set temperature and is time-regulated to go on and off at appropriate increments to prevent tissue damage that can occur from over icing. This device is then hooked up to the Aquecool Masque. The Aquecool Masque is a custom fit, splint-like masque that is placed around the patients face and neck. When it is hooked up to the Aqeucool Device, the device is able to circulate the temperature controlled water through the masque to provide compression, comfort, and cooling.
Without this device, the recovering patient would have to rely on ice packs for post-operative facial cooling. Ice packs can be uncomfortably cold, melt quickly, and require routine changing to maintain the cooling affects. Having this cooling system automatically lessens the burden and maintenance of your post-operative facial cooling. No waking up throughout the day or night to change out messy, dripping ice packs. You can sleep comfortably throughout the night knowing that you are getting the proper care that you need.
Am I a good candidate for a facelift?
If you are unsatisfied with the degree of aging in your face and are experiencing significant skin laxity and/or jowling then a facelift is a good procedure for you. We also like our patients to be in good health and at a stable weight. Smokers must be able to quit for at least 2 weeks prior and 2 weeks following surgery.
Would I be able to have a facelift and CO2 Laser all in the same surgery?
Although it is not preferred to have a full face resurfacing and facelift done at the same time, it is not prohibitive when performed by an experienced surgeon. With that in mind, laser resurfacing around the lip lines and around the eyes during a facelift is commonly performed and does not hinder healing. It is the cheeks which surgeons must be extremely careful with when combining a laser resurfacing procedure with facelift surgery. In regards to extra swelling, a CO2 laser resurfacing does not significantly increase swelling when combined with face surgery.
How soon do the scars of a facelift heal and are they hidden?
The facelift scars are typically along the temporal tuft of the hair and a good surgeon will place them such that they are as hidden as possible. Scars can take up to one year to heal, so do not judge their appearance too soon after surgery. Our practice can also offer scar creams, which will aid in decreasing the appearance of the scars.
I just had a lower facelift, is it normal to be numb under my chin, and around my ears. How long will this numb sensation last?
Numbness after a facelift is very common, especially around the incision lines. The numbness near the ear and chin reduces over the first 3-6 months post facelift. Some areas of numbness can be more stubborn and take longer to go away. In addition to numbness, patients may notice other abnormal sensations such as a “tingling” feeling or “pins and needles.”
My biggest fear is my family and friends finding out I have had “work” done. I am worried that the scars from my facelift will be visible.
One of the biggest fears patients have with cosmetic surgery is appearing like they have had “work” performed. Scars should be hidden in the creases and in the hairlines so that they are very difficult to locate. Hiding scars when possible is extremely important in cosmetic surgery.
Should I try to lose weight before my facelift?
Similar to other parts of the body, if you lose weight in your face the skin will become more lax and the appearance of hollowness and jowls will increase. If a facelift is performed and significant weight loss occurs after, it may leave the patient with more excess skin that would require another facelift procedure. For this reason, it is better to lose weight prior to a facelift rather after. Most doctors will typically recommend that patients are within 10 pounds of their ideal or stable weight. However, if there is a small amount of stubborn under chin fat, which a patient cannot get rid of, our facial plastic surgeon will often incorporate submental liposuction to assist with its removal and a better result.