OVERVIEW
Facial aging is to a great extent genetically determined. It is also influenced by other factors such as sun
exposure, smoking, weight fluctuations, and the stresses of daily life. A facelift does not alter this
ongoing process. However, by removing excess fat, tightening underlying muscles, and redraping the
skin of your face and neck, a facelift can restore a younger appearance to your face.
INDICATIONS
A facelift is designed to correct the common signs of aging such as a sagging neck line, the appearance
of jowls, the deposit of fat along the jawline and neck, and a deepening of the lines between the nose
and the corners of the mouth (nasolabial folds). Consideration must be given to facial bone structure
and skin elasticity in planning and performing a facelift.
Most of the men and women who are candidates for a facelift are between the ages of forty-five and
seventy. However, there are exceptions. Some people age prematurely and consider the surgery at an
earlier age. Other age more slowly and can successfully have the surgery in their seventies and eighties.
More consideration is given to the patients’ actual appearance than their chronological age.
All facelift patients must be in good health, physically and emotionally.
PRIOR TO SURGERY
At your initial consultation, Dr. Glassman will ask you to express your concerns about your appearance.
Your medical history will be reviewed and a physical examination will be conducted to determine if a
surgical procedure is best for you. If you are a good candidate for surgery, Dr. Glassman will explain how
the procedure is designed to correct your areas of concern.
Dr. Glassman may request that you visit your private medical doctor for a check-up and for any
necessary lab work and x-rays. Precise preoperative instructions are provided, and all necessary
prescriptions are given to you in advance of the surgery. All aspirin, aspirin-containing products, and
anti-inflammatory products must be stopped at least ten days before and for ten days after surgery. You
will be provided with a complete list of which medications to avoid. Tylenol may be taken during this
time. Also, you will be given a list of vitamins and homeopathic preparations to take prior to and after
the surgery. This is done to promote healing and limit bruising.
ANESTHESIA
In the vast majority of facelifts, general anesthesia is used. However, in some cases, local anesthesia
with intravenous sedation may be used. Dr. Glassman and our anesthesiologist will help you make this
decision based on what type of anesthesia is best for you.
THE PROCEDURE
As recently as the early 1980s, the only operation that the plastic surgeon had to offer was the
“standard” facelift. This was a one dimensional operations – a simple tightening the skin by removing the
excess skin. Today, more attention is given to the deeper layers of the face which, like the skin, are
affected by age and gravity. These multi-level procedures require less pulling on the skin, providing
natural, less “surgical” and more long-lasting results.
A facelift is generally performed as an outpatient in a private facility. It may be combined with other
procedures, such as cosmetic eyelid surgery and/or a brow lift.
Before anesthesia is given, a detailed “map” of the skin and/or fat to be removed is drawn on your skin
using a special marking pen.
After anesthesia is given, incisions are made in concealed areas of the scalp and inside the cartilages of
the ear. A small incision may also be made under the chin. The skin is elevated from the fat and muscle
below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The
underlying muscles are tightened. The skin is pulled back, and the excess is removed. Great care is taken
to avoid a “pulled” appearance or a change in your natural expression. The incisions are then closed with
fine stitches.
At the completion of the surgery, a bandage of cotton and linen is applied to your face and neck.You are
awakened and taken to the recovery room. The operation takes between two and three hours.
THE POST OPERATIVE PERIOD
The first one to two hours after surgery are spent in the recovery room. When you are fully alert and
ready for discharge, we recommend that you stay in an aftercare facility for a two night stay. Care is
provided around the clock by licensed nurses. Some of our patients prefer to be cared for at home. If so,
we can arrange for a private nurse.
The following morning, all bandages are removed in our office. The surgical sites are inspected and
cleansed, and a lighter bandage is placed. Instructions are given on how to care for the incisions until the
stitches are removed in seven to ten days.
Most patients have no pain after a facelift. Some describe the pain as minimal. Pain medication is
prescribed, although this is usually unnecessary after the first day. Sleeping with your head elevated can
significantly reduce any discomfort.
There may be mild to moderate bruising and swelling which last for approximately one week. Makeup
may be applied after one week. Most patients return to work and social activities after two weeks.
Strenuous physical exercise is avoided for two to three weeks following a facelift.
RISKS AND COMPLICATIONS
As with any operation, a facelift has minimal risks and potential complications. However, with highly
trained doctors and nurses making up the surgical team, complications are extremely rare. Like all
surgery, the risk of bleeding, infection, scarring or an anesthetic problem is present. Numbness caused
by injury to the sensory nerves is also unlikely. And, injury to the motor nerves that move the face is
extremely rare.
RESULTS
The goal and the result of a facelift are a more youthful looking face. The improvement can be expected
to last many years. The results don’t “wear off” but rather, the aging process will continue starting with
your new, younger appearance. When further aging occurs, you could choose to have a secondary
facelift which can be performed safely and easily.
ADVANTAGES OF THE MULT-LEVEL TECHNIQUE
The multi-level procedure involves not only tightening the loose skin, but also repairing the sagging of
the deeper layers of the face. In doing so, less tension is applied to the skin which avoids a “pulled” or
“unnatural” appearance. Almost every patient who contemplates facial surgery, expresses concern that
they not look “done” or “artificial.” The multi-level approach is an effective way to prevent and avoid
this.