The facelift (rhytidectomy, facialplasty) procedure rejuvenates the face and neck by removing excess skin, correcting sagging, and uplifting the internal facial structures. The facelift really means face and neck lift. Lifting the facial structures restores the youthful beauty of the face and neck. Modern facelift techniques can help maintain the youthful appearance of the face into later years, which can improve confidence and self esteem. Many patients state that they actually feel younger after a facelift procedure because they look younger.
Facial sagging (ptosis) is a result of the natural aging process and external factors. Aging causes the skin to become less elastic which results in skin sagging. The skin and internal facial structures migrate towards the mouth which results in “jowling” (large deep cheek crease). The facial bone structures shrink with increasing age, especially in women. As the facial bones shrink, there is less support to hold out the facial skin, and this gives the appearance of excess sagging skin. The skin of the neck also changes with age and begins to droop or sag. The neck skin and the internal structures move towards the midline (front) front of the neck resulting in wrinkling. The flat neck muscle (platysma) relaxes and lengthens which gives the “turkey gobbler” appearance and the “banding” (two vertical lines) in the front of the neck.
The incisions for the facelift are concealed around the ear and under the neck. The facelift procedure pulls the facial skin and internal structures towards the ear and also tightens the neck like a corset. In many patients the flat neck muscle is pulled forward and tightened to help support the tissue under the chin. If patients have excess fat in the neck it can be removed by liposuction though a small incision under the chin. After the neck muscle is tightened the extra skin is pulled towards the ear and removed from the front of the ear and behind the ear. This can be simulated by pushing the face and neck skin towards the ear with the fingers. The facelift does not correct skin texture (crepe paper wrinkling). Fine wrinkling (crepe paper wrinkling) is corrected by a different method (see laser resurfacing section). The facelift does not correct extra skin around the eyes or drooping eyebrows. These problems are corrected with different procedures.
The facelift procedure can be performed under general anesthesia or sedation with local anesthesia. Many surgeons prefer to use sedation with local anesthesia for a number of reasons and this is the technique preferred by Dr. Herring. The anesthesia for facelift is performed by an experienced certified anesthesia professional.
The recovery period for facelift takes about two to three weeks, but many patients will go out in public after about one week. For the first few days after surgery a head bandage is placed to absorb any drainage and help hold the flaps in place. Facial make-up can be used after several days. During the first week there will be some facial swelling and bruising. This usually resolves in about a week to ten days. After about three weeks full activity is possible for most patients.