What to think about when considering a facelift

Despite the popularity of noninvasive treatments such as Botox © and fillers, facelifts still make up a sizeable portion of a cosmetic practice. The longer lasting results and improvement in neck tightening are only some of the reasons facelifting is still a highly satisfactory procedure. If you are considering a facelift, or in the beginning stages of researching it, there are many questions that may have popped into your head. Hopefully we can answer some of the more common ones for your today. 

How long is the procedure and what is recovery like? 

Facelifts come in many iterations. A “mini-lift” may only take 11/2-2 hours but a standard lower face and neck lift may take up to 3 or more. Additional time may be necessary if it is a revision case or if other procedures are added, such as blepharoplasty (eyelid lift) or forehead lift.  Recovery usually takes about 10-14 days, though even after that time you may still experience swelling in the facial and neck tissues and some redness around the incisions that requires some cover-up. I caution patients to avoid scheduling important family or business events within the first 6 weeks, especially if photographs are to be taken.

How do I know if I’m a good candidate for a facelift?

Many patients have the misconception that you are a candidate for a facelift based on age alone. This is far from the only criteria that may steer your surgeon towards a recommendation for a facelift. The areas affected by lifting are the jawline and neck. If you have looseness in these areas, favorable anatomy that would allow a significant improvement with tightening, and have no contraindications to a procedure under general anesthesia, your surgeon may recommend a facelift. There are other issues as well, such as skin texture, a history of poor scarring, etc that may arise during your discussion.  A consultation with a Facial Plastic Surgeon or Plastic Surgeon could more clearly elucidate whether or not you are an appropriate candidate.

Can’t I just have a Mini-Lift?

Please see one of our earlier blogs “What is a MiniLift?” for a more in depth discussion, but mini-lifts are appropriate for a small subset of facelift patients: mainly those who have little to no excess skin in the neck and only very early signs of looseness around the jawline.  Because the surgery and recovery are not significantly different between the two, the most important factor is really what your anatomy dictates would be the best result, not the length of the incision itself. 

What if I want to lose weight-should I do it before or after?

If you are planning on losing 10 or more pounds, it would be best to undergo your surgery after your weight loss. This is because looseness in the tissues can develop again soon after surgery if you lose this much weight after you have already been lifted, which can be disappointing to both patient and surgeon. You also do not want to gain significant weight after a facelift, so I advise patients to be at a stable weight regardless, prior to undergoing surgery.

What are the risks of a facelift?

Common expected side effects include bruising, swelling and stiffness in the neck and shoulders for a few days and up to a week. True risks include infection, bleeding under the skin of the cheek or neck, nerve damage (temporary or permanent), and poor scarring. These risks are rare, in most cases less than 2%, but they can occur. The best way to manage this is to feel comfortable with your surgeon prior to any procedure so you know they will stand by you in case there is a problem. 

Will a facelift take the place of fillers?

The short answer is no. Filler are helpful for volume loss and deeper folds or lines in many cases. Facelifting is helpful to reposition loose tissues in the neck and lower face. The two can be quite complementary. Just as fillers cannot take the place of facelifts, facelifts are not mutually exclusive of fillers. The combination can improve the contours of the face quite well using each techniques’ individual areas of strength.

Ultimately, the decision to undergo any type of cosmetic elective facial surgery is a big one that requires homework and possibly multiple visits to multiple surgeons to find one that suits you best. A consultation that addresses your concerns, rather than your surgeons concerns, will likely leave you with the most information to make an educated decision. You will be happy with your results should you choose to undergo this highly effective and successful procedure, I’m sure!