Facial Plastic and Reconstructive Surgery Handbook

Facelift

Facelift or cheek-neck lift is the operation that pulls up the skin around your mouth, the jowels around your chin and the excess skin of your neck. If there are platysmal bands cording your neck, these are treated at the same time. The incision for facelift begins in the hair of your temple and courses down in front of your ear, around behind your ear, and finally into the hair behind your ear. The skin in this ear is dissected away from the muscles, and other structures of your face. It is then pulled upwards, and sometimes a little bit backwards. The muscles of your face are then tightened with sutures, and the cords in your neck are treated at the same time. Any excess fat in your neck and beneath your jawbone and on your face is trimmed, and then the skin incisions are closed. This operation can be performed under general anesthesia or under local anesthesia.

The most common complication in facelift surgery is bleeding. The local anesthesia reduces the risk. After surgery, a large dressing will be placed around your face. Most patients who have friends or relatives to care for them choose to go home. The dressing is changed the following day, and a much lighter dressing is put on. That dressing comes off three to four days later. The sutures around the ear are all dissolvable and come out by themselves. There are staples used to close the incisions in the temple and behind the ear, and these come out ten days after surgery. Since the skin and muscles of your neck and face have been stretched into a new position, it is important not to stretch them in the first seven to ten days. You should be very careful not to turn your head and pull these muscles. Some patients are more comfortable wearing a cervical collar; others are more comfortable just remembering not to turn the head. You should not drive a car for a week after this surgery, and you should not do any vigorous exercise such as laundry, major housecleaning, dance or other exercises. Exercise can be started again two to three weeks after surgery, and should be started slowly. The swelling and the discoloration from this surgery disappears in seven to fourteen days. One can put on makeup after the second dressing is removed and one can wash one's hair after that dressing is removed as well. Ideally, one would get a hairstyle consultation and a makeup consultation about three weeks after surgery, and if you are not knowledgeable about current ideas in skin care, you should seek this information as well.

Facelift surgery does not stop the aging process, it merely backs it up a little bit. For these reasons, the face continues to age and the sagging can recur. In some people, his happens in a short period of time such as six months to a year and in others, there are no appreciative changes following surgery for the next five to ten years. If properly done, the facelift procedure can be repeated as frequently as an individual desires. Many older movie stars, who wish to maintain their youthful appearance, will have a repeat facelift as often as once a year. Most people who just wish to keep a little ahead of the aging process will have one or two facelifts performed in their life, generally separated by at least five to ten years.

Figure 12A	Figure 13A	Figure 14A
Figure 12B	Figure 13B	Figure 14B