Facelift Cosmetic Surgery – FAQs

Read below commonly asked questions about Facelift surgery (Rhytidectomy).

Facelift Surgery (Rhytidectomy)

Why undergo facial cosmetic surgery?

Facelift surgery (otherwise known medically as a Rhytidectomy) is one of the most common procedures for reducing the signs of aging. Designed to lift and tighten sagging skin, primarily in the lower part of the face, it smoothes the neck area, reduces jowls and refines the jaw line.

At what age should I consider a facelift?

There is no one age that is considered ideal for a facelift. You may be in your late 30’s or your 80’s or anywhere in between and still be a good candidate for surgery as long as you are in good health.

The trend in facelift surgery today is to have surgery at a younger age. Many people are choosing to have corrective procedures done early, before the signs of aging have become very pronounced. In the past, the typical facelift patient was in their late 50’s or early 60’s with a significant amount of sagging and excess tissue in the lower face and neck areas. Today, the typical patient is likely to be in their 40’s or 50’s and may be just beginning to see some signs of aging.

How long does a facelift last?

Although the results of an early facelift are more subtle, they seem to last a long time. This may be because the facelift creates a sheet of scar tissue in the layer of supportive tissue beneath the skin. The scar tissue is firm and stable; it holds the muscles and skin in place and prevents further slipping of the fatty tissue. Thus an early facelift may actually seem to slow down the aging process. It is generally accepted that a facelift sets the clock back 5 – 7 years.

How is a facelift done?

Anesthesia

Generally, facelift surgery is done with local anesthetic and intravenous sedation without the need for a general anesthetic. This eliminates the risk of a general anesthetic. You are in a state of “twilight sleep” throughout the procedure.

Surgery

In essence a skin incision is made as outlined below in blue. Dr Bartlett prefers this incision as the hairline is not altered as it may be with other incisions. Excess skin is removed from the face and neck in combination with tightening a deeper layer of stronger tissue referred to as the SMAS layer.

Facelift Procedure

Blue line indicates skin incision, black stitches are deep to skin and not visible

This deep tightening leads to longer lasting results and a more natural look while eliminating tension on the wound. It also enhances healing and leads to an imperceptible scar.

Facelift is usually combined with liposuction to the neck to improve the definition of the neck profile.

Dr Bartlett no longer places drains at the completion of the surgery but rather uses a tissue glue called Tisseal which seals the tissues and lessens swelling and speeds the recovery process

Tightening muscles in the neck

Correcting problems in the neck area is an important part of the facelift procedure. Although the conventional facelift smoothes and tightens the skin of the neck, it does not address weakness in the underlying muscles. An additional step sometimes is carried out to tighten these muscles.

As we age, the muscles supporting the neck – called the platysma – begin to weaken. The midline of the neck may take on a sunken appearance, with prominent vertical bands visible on either side. In some people, excess skin and fatty tissue may collect under the chin as well, forming loose deposits of hanging tissue that resemble turkey wattles.

To reach the platysmal muscles, Dr Bartlett makes a small incision under the chin. Through this incision, the edges of the platysmal muscles are located and drawn together, then stitched together at the midline. Next, the back portion of these sheet-like muscles is tightened and fixed at the back of the neck on either side. This forms a strong sling of muscle that supports the entire neck and jaw.

Excess fatty tissue and “turkey wattles” may be removed at the same time. If necessary, liposuction can be done through the same incision.

What about my forehead?

Along with facelift, elevating your eyebrows and managing forehead wrinkles may complement the effects of facelift. This can be done a variety of ways. Surgical browlift/forehead lift may be recommended. Many patients however opt for a medical browlift which can be achieved with Botox®. The various approaches can be discussed during your consultation with Dr Bartlett.

What do I do after the procedure?

After the surgery, a firm dressing is placed around your head to protect the incisions. This is replaced with a softer supportive garment that you wear for the next week and are able to take off for short periods of time. Some stitches are removed during the first week, and staples in the hairline are removed within 10 – 12 days.

Some swelling and bruising are to be expected after a facelift, but much of it will diminish within the first week or two.

When can I return to work?

Most people are able to return to work about two weeks after surgery, but I have had many patients who have returned to social activities in less than a week as makeup can be applied early after surgery.

You should not do anything strenuous for at least three weeks.