Facelift (Rhytidectomy)

What is a facelift?

A facelift (rhytidectomy) is a procedure in which face and neck skin are removed and the tissues under your skin are tightened. Over time, lifestyle habits such as smoking, sunbathing, outdoor activities, and stress can change the appearance of the face. As we age:

Deep creases form between the nose and mouth.
The jawline grows slack and sags.
Folds and fat deposits appear around the neck.

When is it used?

You are most likely to have good results from a facelift if your bone structure is strong and well-defined and your skin has some elasticity. A facelift can be done by itself, or along with other procedures such as eyelid surgery or nose reshaping. Health insurance usually does not pay for elective cosmetic surgery such as a facelift.

How do I prepare for a facelift?

Tell your surgeon about your medical condition. Certain health problems could cause problems during or after surgery. These include high blood pressure, blood clotting problems, edema, or if you tend to form scars easily.
Be sure to tell your surgeon if you smoke or are taking any drugs or medicines, especially aspirin or other drugs that affect clotting.
If your hair is very short, you might want to let it grow out before surgery, so that it's long enough to hide the scars while they heal.
Arrange for someone to drive you home after your surgery. Follow any other instructions your surgeon may give you.

What happens during the procedure?

A facelift may be performed in an outpatient surgery center or in a hospital. You will probably be given local anesthesia, along with a sedative to make you drowsy. You will be awake but relaxed, and your face will not feel pain. You might have general anesthesia instead, which means that you will sleep through the surgery.

Facelift surgery typically lasts 2 to 5 hours. The surgeon makes a cut from the temple, around the earlobe, to the back of the neck. The cuts are made in the natural creases and lines of the skin to hide scars. After it is separated from muscle and fat, the skin is pulled upwards. Excess skin is then cut away. Muscles are tightened and excess fat is removed. The surgeon will use stitches to close cuts on the face. Metal clips may be used on the scalp.

You may have a small, thin tube temporarily placed under the skin behind your ear to drain any blood that might collect there. The surgeon may also wrap your head loosely in bandages to decrease bruising and swelling.

What happens after the procedure?

Your face will be swollen for awhile. Your facial movements may be slightly stiff and you may feel self-conscious about your scars. You may have some bruising and swelling for 2 or 3 weeks, and you may tire easily. To keep the swelling down, keep your head elevated and as still as possible for a couple of days after surgery.

Bandages are usually removed after 1 to 5 days. Most stitches will be removed after 4 to 7 days. Your scalp may take longer to heal, and the stitches or metal clips in your hairline may be left in a few days longer.

Pain is usually minor and can be controlled with medicine. Avoid strenuous activity, including sex and heavy housework, for at least 2 weeks. Avoid steam baths and saunas for several months. Limit the amount of alcohol you drink.

During the healing process, the skin on your face or neck may feel numb. This usually goes away in a few weeks or months.

What are the risks with this procedure?

Complications that can occur include:

hematoma (a collection of blood under the skin that must be removed by the surgeon)
injury to the nerves that control facial muscles, which is usually temporary
infection
reactions to the anesthesia.

Smoking increases the chance that you will have complications. Many surgeons will not perform facelifts on current smokers. You should stop smoking for at least 2 weeks before and after your surgery.

Having a facelift does not stop the aging process. Your face will continue to age. Results depend on your age, skin elasticity, and future sun exposure.

When should I call the doctor?

Call the doctor immediately if:

You develop a fever.
You have a lot of heat, swelling, or pain near the incisions.

Call the doctor during office hours if:

You have questions about the procedure or its result.
You want to make another appointment.

To find a plastic surgeon who performs this procedure, call the American Society of Plastic Surgeons at 888-4-PLASTIC or visit their Web site: http://www.plasticsurgery.org/find_a_plastic_surgeon/index.cfm.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File SRG5006F.HTM Release 9.0/2006