Face-lift (rhytidectomy)

Surgery Overview

A face-lift is the most extensive way to remove or reduce the appearance of wrinkles and sagging of the face caused by age. The skin is literally lifted off the face so that the skin and the tissues beneath can be tightened and the skin can be repositioned smoothly over the face.

During the procedure, you are given general anesthesia. Next, the surgeon makes an incision that starts in the temple area and circles the ear. The skin is raised, and the muscle and tissue underneath is tightened. The surgeon may remove some fat and skin. The skin is then redraped over the face and the incision is sutured. The incision usually falls along the hairline or in a place where the skin would naturally crease so that it does not show after the surgery.

The surgery usually takes several hours. You may be able to go home that day, but people sometimes spend one night in the hospital.

What To Expect After Surgery

Your face will be bandaged after the surgery. The dressings are usually removed 1 to 2 days later. If a drainage tube has been placed (usually behind your ear), it will also be removed 1 to 2 days after the surgery. Your doctor will remove your stitches within 5 to 10 days.

Most people have very little pain after the surgery, but your doctor may prescribe pain medication for you in case you do have pain. Swelling and bruising of the face always occur; cold compresses can help relieve these side effects. Your doctor may instruct you to keep your head elevated and still as much as possible. It is also important to avoid smoking for 2 to 4 weeks before and after surgery. Smoking increases the risk for skin and tissue death and will delay your face's healing process.

Most people can return to their normal activities 2 to 3 weeks after a face-lift.

At first your face will feel stiff and will probably look and feel strange to you. This is normal, but it is important to be prepared for it.

Numbness of the skin may last for weeks or months after the surgery. Your skin may feel rough and dry for a few months. Men sometimes have to shave in new places because the skin has been rearranged, but the surgeon can sometimes avoid this.

Why It Is Done

Face-lifts are done to make an older face look younger by eliminating wrinkles and tightening the skin.

How Well It Works

Having a face-lift can make your face appear younger and healthier. Your face will continue to age, but a face-lift does indeed "take years off" your face. For some people, this may increase self-confidence and reduce anxiety over growing older.

While a face-lift can reduce signs of aging to a great extent, it cannot remove all facial wrinkles—you may need additional treatments (such as laser resurfacing) around your eyes, below your nose, and around your lips. ¹

The effectiveness and safety of your face-lift surgery depends heavily upon the skill of your surgeon. ²

Risks

Problems that may be caused by having a face-lift include:

• Reactions to the anesthesia.
• Bleeding under the skin.
• Infection.
• Damage to the nerves that supply the muscles of the face. This can cause paralysis or spasm in the face, but the effects are usually temporary.
• Hair loss (alopecia).
• Tissue loss.
• Scarring.

As with all cosmetic procedures, there is also the risk that the results will not be what you expected. However, an experienced plastic surgeon can usually give you a very clear idea of what to expect after surgery.

What To Think About

As with other cosmetic procedures, you are more likely to be happy with the results of your face-lift if you have clear, realistic expectations about what the surgery can achieve and you share these with your plastic surgeon.

Insurance companies do not cover the costs of face-lifts. It is important to know what the total costs of the procedure will be, including fees for the operating facility, the anesthesiologist's and surgeon's fees, medications, office visits, and other services and materials.