A rhytidectomy (facelift) is perhaps the most well-known of all cosmetic surgeries, and for a good reason. Facelifts are incredibly effective at improving the visible signs of aging on the face and neck. This is done by removing excess skin and wrinkles, repositioning fat, and repositioning the facial skin.
Facelift surgery can take between 3 and 5 hours, depending upon the type and extent of the changes required. There are seemingly as many variations to the facelift procedure as there are surgeons, but most of the variations, while important, remain subtle. Whenever possible, Dr. Rice will make the incisions to preserve a natural appearance and not alter the hairline. Typically the incisions will follow the creases and contours around the ear, making them nearly invisible after healing, yet still enabling important surgical maneuvers. The goal of a well-executed facelift is a natural, more rested you, not a pulled or "windswept" tightness that is too often seen.
The surgery is performed in our on-site surgical suite with anesthesia, by Dr. Rice, a board-certified facial plastic surgeon with thousands of hours of experience and an impeccable record of happy and satisfied patients.
Recovery time is 10-14 days, although it sometimes takes several months for swelling to disappear completely. While we consider surgery the most permanent kind of transformation you can get, nothing can stop the hands of time, and your skin will continue to age as it normally would. This procedure can take years off a patient’s appearance, however, and last for 10-15 years if you are diligent in caring for your skin.
If you have numerous deep wrinkles on your face and sagging skin that causes jowls and even banding of the neck, this procedure is designed to help you. Most of our facelift patients are between the ages of 40 and 70. Still, patients in their 80s may also be eligible, as long as there are no conflicting medical issues and the skin still has an adequate amount of elasticity.
In addition to skin elasticity and overall health, a good facelift candidate is also one who has good bone structure. Having a well-defined facial bone structure is important because it offers support for the facial changes we will make.
Because each person's face is unique, each facelift surgery must be as well. However, there are common maneuvers that are done to accomplish each lift. In most cases, the incision starts beneath the temporal tuft (woman's sideburn) or in the hair of the temple, extending into the crease above the ear and down the front of the ear, hidden in additional creases. It then extends beneath and behind the earlobe, onto the back of the ear, and, as needed, curves into the hair behind the ear. The incision is similar in all of our facelifts as it best hides the scars. Once the incision is made, the deeper layers are approached.
A facelift lasts longer when a layer called the superficial musculoaponeurotic system (SMAS) is repositioned and tightened. The SMAS is like a girdle that smooths the body but is not seen beneath a dress. If it is tightened, the overall contour also improves. The primary difference between a mini-facelift and a full facelift is how the SMAS is treated. In a mini facelift, the SMAS is tucked and held in place with sutures. In a full facelift, the SMAS is lifted, trimmed, and tightened. After the surgery, the skin is adjusted, lifted, and trimmed, and then the incisions are closed with fine silk sutures.
Often, when neck skin is lax, or neckbands are prominent, an incision will be made under the chin to smooth and tighten the neck while the jowls and cheeks are lifted. We nearly always further refine the facial and neck contours using liposuction, which puts the finishing touch on the facelift procedure. When the surgery is complete, the incisions are coated with antibiotic ointment, and the face is dressed with a supportive dressing that encircles the head for the first 1-2 days. Typically patients return the next day, the dressing is removed, the wounds are redressed, and a removable elastic facial garment is put in place and worn for the next few weeks.
A facelift is a significant surgery with at least 10-14 days of recovery. Following the surgery, you should expect swelling, bruising, and some discomfort, but these issues are temporary. Pain is rarely a significant issue —many of our patients comment that there is less pain than expected.
During the first week of recovery, it is important to walk around the house every few hours to prevent blood clots from forming. We recommend avoiding strenuous activities such as jogging, weight lifting, or any other demanding physical activity. We also recommend:
Within two weeks, you should feel more confident venturing out into public and starting to resume normal activities, but individual patient recovery times do vary. We pride ourselves in prepping our patients for what to expect and how best to recover from surgery with minimal discomfort. Rest assured that we will advise you every step along the road to recovery to get you back to normal day-to-day activities as quickly as possible.
It may take several weeks, or even months, for the swelling to fully subside and for you to enjoy the final results of your facelift. But even as you progress toward full recovery, we know you will love what you see!
It should be noted that a facelift is not a permanent solution to aging, but it can make you look 5, 10, or even 15 years younger. With that said, depending on your age and skin health, your facelift results may last for as long as 10-15 years or more!