Putting Your 'Best Face Forward' - All About Facelifts

By Thomas Fiala, MD

Published on August 01, 2006

One of the most common cosmetic surgery questions I hear from both men and women is about the facelift procedure, and whether or not "it's time" for one. Usually this question is accompanied by them taking their fingers and pulling back on their cheeks or neck and saying "Doctor, I would really like it if I could look like this." In this article, we'll discuss the facelift, and I'll answer some commonly asked questions.

As people age, the effects of gravity, exposure to the sun, and the stresses of life can be seen in their faces. Creases form between the nose and mouth, jowls form, and fat deposits appear in the area under the chin. While a facelift doesn't stop the aging process, it can "set the clock back," improving the most obvious signs of aging. This is done by artfully removing excess fat, tightening underlying tissues, and re-draping the skin of the face and neck.

Are You a Candidate?

The best candidate for a facelift is a man or woman who has noticed changes related to aging in the face or neck, but whose skin still has reasonable elasticity. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies, provided that their overall state of health is good.

Potential Side Effects

There are some potential complications you should keep in mind before having a facelift. These include infection; damage to structures beneath the skin; negative response to anesthesia; visible scars following surgery; and hematoma (buildup of blood underneath the skin).

Achieving a natural look

In my opinion, the goal of the modern facelift is to restore a youthful appearance in a way that looks pleasing and natural - not tightly pulled or obviously surgical. As surgeons, we strive for a harmonious, natural-looking correction of the aging changes in the cheeks, neckline, and jaw. Following surgery, you should look younger and refreshed, not 'different.' I like to aim for a result that makes the patient think of the change as looking like his or herself, only about 10 years younger.

Because of advancements in surgical methods, it is now possible to perform a facelift that doesn't leave the obvious telltale signs of surgery. For this reason, we can now help men and women in their early to mid-forties, who are beginning to develop some of the early signs of facial aging, but who don't want to look like they've had an old-fashioned facelift. This helps people to continue to look good - certainly better than their peers - and helps them age gracefully.

How it works

After a detailed consultation, an individualized approach is developed for each person's surgery. Some doctors use computerized imaging as a teaching aid for explaining many of the changes potentially achieved through the facelift procedure. The prospective patient can see an image of how his or her face may look following surgery.

For optimum patient care, I prefer operating in an accredited surgical facility, with the use of general anesthesia. With a well-qualified group of anesthesiologists, the patient can expect to sleep through the operation in comfort and safety. The facelift operation takes about four hours to perform, and additional time if work is done on the eyelids or forehead (which is fairly common). The patient is then monitored overnight by a nurse, and is typically ready to go home the next morning.

Following surgery, there usually isn't very much pain - most patients are pleasantly surprised; but there can be a fair bit of swelling of the cheeks, which is temporary. Patients are seen as needed after surgery to monitor their progress and to remove sutures. Most people are ready to resume their normal activities after 10-14 days.

The incisions from your facelift are usually hidden by your hair or in the natural creases of your face and ears. In any case, the scars fade with time and should be scarcely visible after a few months. Although no surgical procedure has a perfect track record, most facelift patients are very pleased with the improvement in their appearance, and recommend the procedure to friends and family.

Comment on this article →