View Gallery

Face Lift Surgery

Michael C. Fasching, MD

Dr. Michael Fasching performs facelift surgery at his Minneapolis, MN plastic surgery facility. In the paragraphs below, he describes the procedure and how it can be used to help Minneapolis face lift patients develop a more youthful facial profile.

If you’re considering a facelift …

As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck.

A facelift (technically known as rhytidectomy) can’t stop this aging process. What it can do is “set back the clock,” improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and re-draping the skin of your face and neck. A facelift can be performed alone or in conjunction with other procedures such as a forehead lifteyelid surgeryfacial implants or rhinoplasty.

If you’re considering a facelift, this brochure will give you a basic understanding of the procedure when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don’t understand.

The best candidates for a Facelift

The best facelift candidate is a man or woman whose face and neck have begun to sag but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but facelift can be performed successfully on people in their seventies or eighties as well.

A facelift can make you look younger and fresher, and it may enhance your self- confidence in the process. But it can’t give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

All surgery carries some uncertainty and risk

When a facelift is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Still, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable.

Complications that can occur include hematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles (usually temporary), infection, and reactions to the anesthesia. Poor healing of the skin is most likely to affect smokers.

You can reduce your risks by closely following your surgeon’s advice both before and after surgery.

Planning your Face Lift Surgery

Facelift is a very individualized procedure. During your initial consultation, Dr. Fasching will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery.

Dr. Fasching will check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. Be sure to tell Dr. Fasching if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.

If you decide to have a facelift, Dr. Fasching will explain the techniques and anesthesia he will use, the type of facility where the surgery will be performed, and the risks and costs involved. Don’t hesitate to ask him any questions you may have, especially those regarding your expectations and concerns about the results.

Preparing for your surgery

Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it’s especially important to stop at least a week or two before and after surgery; smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas.

If your hair is very short, you might want to let it grow out before surgery, so that it’s long enough to hide the scars while they heal.

Whether your facelift is being done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two if needed.

Where your surgery will be performed

A facelift may be performed in a surgeon’s office-based facility, an outpatient surgery center, or a hospital. It’s usually done on an outpatient basis, but some surgeons may hospitalize patients for a day when using general anesthesia. Certain conditions such as diabetes or high blood pressure should be monitored after surgery, and may also require a short inpatient stay.

Types of anesthesia

Most facelifts are performed under local anesthesia, combined with a sedative to make you drowsy. You’ll be awake but relaxed, and your face will be insensitive to pain. (However, you may feel some tugging or occasional discomfort.)

Some surgeons prefer a general anesthesia. In that case, you’ll sleep through the operation.

The surgery

A facelift usually takes several hours-or somewhat longer if you’re having more than one procedure done. For extensive procedures, some surgeons may schedule two separate sessions.

Every surgeon approaches the procedure in his or her own way. Some complete one side of the face at a time, and others move back and forth between the sides. The exact placement of incisions and the sequence of events depends on your facial structure and your surgeon’s technique.

Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin.

In general, the surgeon separates the skin from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The surgeon then tightens the underlying muscle and membrane, pulls the skin back, and removes the excess. Stitches secure the layers of tissue and close the incisions; metal clips may be used on the scalp.

Following surgery, a small, thin tube may be temporarily placed under the skin behind your ear to drain any blood that might collect there. The surgeon may also wrap your head loosely in bandages to minimize bruising and swelling.

After your surgery

There isn’t usually significant discomfort after surgery; if there is, it can be lessened with the pain medication prescribed by your surgeon. (Severe or persistent pain or a sudden swelling of your face should be reported to your surgeon immediately.) Some numbness of the skin is quite normal; it will disappear in a few weeks or months.

Your doctor may tell you to keep your head elevated and as still as possible for a couple of days after surgery, to keep the swelling down.

If you’ve had a drainage tube inserted, it will be removed one or two days after surgery. Bandages, when used, are usually removed after one to five days. Don’t be surprised at the pale, bruised, and puffy face you see. Just keep in mind that in a few weeks you’ll be looking normal.

Most of your stitches will be removed after about five days. Your scalp may take longer to heal, and the stitches or metal clips in your hairline could be left in a few days longer.

Getting back to normal

You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first.

Your surgeon will give more specific guidelines for gradually resuming your normal activities. They’re likely to include these suggestions: Avoid strenuous activity, including sex and heavy housework, for at least two weeks (walking and mild stretching are fine); avoid alcohol, steam baths, and saunas for several months. Above all, get plenty of rest and allow your body to spend its energy on healing.

At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff and you’ll probably be self-conscious about your scars. Some bruising may persist for two or three weeks, and you may tire easily. It’s not surprising that some patients are disappointed and depressed at first.

By the third week, you’ll look and feel much better. Most of Dr. Fasching’s facelift St. Paul / Minneapolis patients are back at work about ten days to two weeks after surgery. If you need it, special camouflage makeup can mask any remaining bruising.

Your new look

The chances are excellent that you’ll be happy with your facelift-especially if you realize that the results may not be immediately apparent. Even after the swelling and bruises are gone, the hair around your temples may be thin and your skin may feel dry and rough for several months. Men may find they have to shave in new places-behind the neck and ears-where areas of beard- growing skin have been repositioned.

You’ll have some scars from your facelift, but they’re usually hidden by your hair or in the natural creases of your face and ears. In any case, they’ll fade within time and should be scarcely visible.

Having a facelift doesn’t stop the clock. Your face will continue to age with time, and you may want to repeat the procedure one or more times-perhaps five or ten years down the line. But in another sense, the effects of even one facelift are lasting; years later, you’ll continue to look better than if you’d never had a facelift at all.

More on Facelifts

A Facelift (Rhytidectomy) is a surgical procedure designed to smooth and firm the skin, providing a fresh, youthful appearance. Throughout one’s life, the sun’s radiation, stress, gravity, and other factors cause the skin to sag and fit more loosely. Areas of the face and neck, in particular around the jaw line, are especially prone to the aging process. Though these changes are gradual, wrinkles and other signs of aging can make individuals “feel older” than they really are.

Surgery for a facelift involves the contraction and realignment of facial and neck skin, and in some instances the removal of excess fat deposits. A facelift is often performed in combination with other facial cosmetic procedures and can be performed any time signs of aging begin to appear. However, patients are generally in their forties or older when they elect to undergo this procedure.

Reasons for Considering a Facelift:

  • Sagging skin, muscles, and fat in the face and neck.
  • Excess skin and fat on the neck.
  • Sagging jaw line.
  • Crease lines along the nose, mouth, and chin.

General Procedure

The standard procedure for a facelift commonly involves making small incisions just inside the hairline, following the contour in front of the ear, and continuing under the earlobe to the backside of the ear and to the lower scalp. Tissue and fat deposits are separated, the skin is stretched and tightened, and any excess skin is removed. If the neck line requires attention, an additional incision is made under the chin and the same procedure is again followed. Minuscule stitches are used to close the incisions and to reduce any chance of scarring. Metal clips or staples may also be utilized at the hairline.

A face lift may take several hours or longer depending on whether other cosmetic procedures are completed at the same time. Sometimes other procedures may be performed during separate appointments. There are several different facelift techniques that can be employed. We encourage our facelift patients to ask as many questions as possible about the best face lift surgical techniques for them.

Recovery Process

Immediately after surgery, the face will be fitted with bandages in order to decrease the recovery time and to reduce swelling. Generally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing and recovery process. The stitches, clips or staples are normally removed within a week. Patients sometimes report some minor pain associated with surgery. Any discomfort can be treated effectively with oral medication. While complications are rare, our patients can minimize potential problems by carefully following the directions given after the procedure.