A face-lift (rhytidectomy) is a cosmetic surgical procedure to create a younger appearance in your face. The procedure can reduce the sagging or folds of skin on the cheeks and jawline and other changes in the shape of your face that occur with age.
During a face-lift, a flap of skin on each side of the face is pulled back, and tissues below the skin are surgically altered to return the contour of the face to a more youthful shape. Before the flap is sutured closed, excess skin is removed.
A neck lift (platysmaplasty) is often done as part of a face-lift to reduce fat deposits and sagging skin on the neck.
A face-lift won't decrease fine creases or wrinkles in your skin or damage from sun exposure. Other cosmetic procedures can address the appearance or quality of the skin itself.
Risks of Facelift
A face-lift surgery can cause complications. Some can be managed with appropriate care, medication or surgical correction. Long-term or permanent complications, while rare, can cause significant changes in appearance. The risks include:
- Hematoma. A collection of blood (hematoma) under the skin that causes swelling and pressure is the most common complication of face-lift surgery. Hematoma formation, which usually occurs with 24 hours of surgery, is treated promptly with surgery to prevent damage to skin and other tissues.
- Scarring. Incision scars from a face-lift are permanent but typically concealed by the hairline and natural contours of the face and ear. Rarely, incisions can result in raised, red scars. Injections of a corticosteroid medication or other treatments might be used to improve the appearance of scars.
- Nerve injury. Injury to nerves, while rare, can temporarily or permanently affect nerves that control sensation or muscles. Temporary paralysis of a select muscle, resulting in an uneven facial appearance or expression, or temporary loss of sensation can last a few months to a year. Surgical interventions may offer some improvement.
- Hair loss. You might experience temporary or permanent hair loss near the incision sites. Permanent hair loss can be addressed with surgery to transplant skin with hair follicles.
- Skin loss. Rarely, a face-lift can interrupt the blood supply to your facial tissues. This can result in skin loss (sloughing). Sloughing is treated with medications, appropriate wound care and, if necessary, a procedure to minimize scarring.
Like any other type of major surgery, a face-lift poses a risk of bleeding, infection and an adverse reaction to anesthesia. Certain medical conditions or lifestyle habits also can increase your risk of complications. The following factors may present a significant risk or result in unfavorable results, and your doctor may advise against a face-lift.
- Blood-thinning medications or supplements. Medications or supplements that thin the blood can affect your blood's ability to clot and increase the risk of hematomas after surgery. These medications include blood thinners (Coumadin, Plavix, others), aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), ginseng, Ginkgo biloba, fish oil and others.
- Medical conditions. If you have a medical condition that prevents blood clotting, you won't be able to have a face-lift. Other conditions, such as poorly controlled diabetes or high blood pressure, increase the risk of poor wound healing, hematomas and heart complications.
- Smoking. Smoking significantly increases the risk of poor wound healing, hematomas and skin loss after a face-lift.
- Weight fluctuation. If you have a history of repeated weight gain and loss — factors that affect the shape of your face and condition of your skin — the outcome of the surgery may not be satisfactory or may be satisfactory for only a short time.
Types of Facelift
Patients who exhibit a mild degree of jowling and sagging skin are often good candidates for a mini-facelift. This is a less invasive technique that allows a cosmetic surgeon to tighten deep facial tissues through shorter incisions, typically located along the hairline above each ear and/or in the natural creases surrounding the ear. Through these incisions, structural tissues around the cheeks are lifted and tightened to correct jowling, refine the jawline, and rejuvenate a “tired” appearance.
Depending on the case, a mini-facelift may be performed using local anesthesia with sedation or general anesthesia; your cosmetic surgeon will recommend the best option for your individual needs. A mini-facelift can help you address unwelcome signs of aging before they become too pronounced, postponing the need for more extensive surgery for many years.
A standard or “traditional” facelift will more fully address moderate to advanced aging around the mid-face and neck. While the surgery is more extensive than those for a mini-facelift, and thus more recovery time is required, the results are more dramatic. Through incisions located just behind the hairline, starting near the temples, and around the front of the ear, hidden in the natural folds, a cosmetic surgeon can reposition the deeper tissues beneath the skin and remove excess skin to smooth creases, eliminate jowling and sagging skin under the chin, and restore a naturally youthful contour to the face and neck.