Facelift
A facelift is a cosmetic surgery to rejuvenate the lower face and neck. With aging, a myriad of changes occur in the face. These include:
- Sagging and drooping of the soft tissues and loose skin due to gravity and loss of elasticity
- Volume loss and hollowing of the fat compartments, and
- Changes to the skin, including thinning, texture, and color irregularities, and wrinkles.
Genetics and lifestyle play a role in the extent of these changes. These changes can initially be treated nonsurgically, but surgery eventually provides the optimal outcome.
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Facelift Overview
In plastic surgery, a facelift is the gold standard for facial rejuvenation and can dramatically improve aging in the lower face and neck.
WHAT IS A FACELIFT? (RHYTIDECTOMY)
A facelift, otherwise known as rhytidectomy, is a cosmetic surgery to address the lower face to restore the youthful contours of the cheeks, jawline, and neck. It is often combined with a neck lift to provide comprehensive correction of the face and neck.
WHAT FACELIFT SURGERY CAN’T DO
A facelift surgery cannot treat age-related changes in the skin. Any sunspots, superficial wrinkles, or other irregularities in skin texture or color will not be corrected. A facelift will also not stop the aging process.
CAN A FACELIFT SURGERY IMPROVE MY EYELIDS TOO?
A facelift surgery will only treat the lower face and neck and will not improve the eyelids. Eyelid lift (blepharoplasty) and brow lift are frequently performed at the same time as a facelift to address these different areas for more comprehensive facial rejuvenation.
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What Are The Different
KINDS OF FACELIFTS?
There are many different kinds of facelift surgeries. The best technique for each patient will depend on their goals, anatomy, and discussion with their plastic surgeon.
MINI-FACELIFT
Mini-facelifts are reserved for patients with early age-related changes along the jaw and neck. These patients are younger, typically in their 40s. This surgery is usually less invasive and faster than a standard facelift, and oftentimes, the incisions are shorter.
STANDARD FACELIFT
For patients with more significant age-related changes, a standard facelift is more appropriate. This surgery takes longer than a mini-facelift, and the recovery is longer. Incisions are made in the hair near the temple, follow natural creases in front of the ear, and continue behind the ear into the posterior hairline allowing them to be maximally hidden. The tissues underneath the skin are repositioned and tightened, and excess skin is removed. This is often combined with a neck lift to address any issues in the midline neck.
DEEP PLANE FACELIFT
The modern deep plane facelift is a dramatic advancement in facelifting. In this technique, the deeper tissues and muscles in the face are released from their underlying ligaments to allow these structures to be repositioned back to where they were when the patient was young without tension. As part of this procedure, the cheek fat pads are also repositioned, leading to improvement in the midface. The skin then simply redrapes over the new framework, and any excess is conservatively trimmed. This leads to longer lasting and more natural results.
What Type Of Facelift Is Right For Me?
The type of facelift that is right for you depends on your individual anatomy and surgical goals. Your plastic surgeon will be able to help guide you in this regard. In general, a mini-facelift is recommended for younger patients with early signs of aging. The standard and deep plane facelifts are better options for patients who are older and have more age-related changes and seeking a more dramatic improvement.
What Happens At A Facelift Consultation?
At your consultation, you will meet your surgeon and discuss your goals. Your surgeon will take a comprehensive history, perform a physical exam, and take photographs. Your surgeon will discuss your options and make a recommendation regarding the best approach to achieve your goals. You should ask questions and thoroughly discuss recovery, risks, and complications of the procedure, as well as expected outcomes.
How Do I Prepare For Facelift (Rhytidectomy) Surgery?
Patients should optimize their lifestyle and be as healthy as possible before surgery. This includes stopping smoking at least 6-8 weeks before the surgery and limiting alcohol. Patients should also avoid aspirin, anti-inflammatory medications, herbal supplements, and any other medications that thin the blood as they can increase the risk of bleeding. Every patient undergoing anesthesia should have a preoperative medical clearance by their primary care physician which may include lab tests, EKG, and chest x-ray.
What Happens During
FACELIFT (RHYTIDECTOMY) SURGERY?
There are several steps during surgery.
Anesthesia
In general, facelifts are performed under anesthesia for maximum patient comfort. They can be performed under intravenous sedation or general anesthesia.
The Incision
The length and location of your incision will depend on the type of facelift to be performed.
- Traditional Facelift
Incisions are made in the hair near the temple, follow natural creases in front of the ear, and continue behind the ear into the posterior hairline. The deeper tissues of the face are lifted and repositioned to a more youthful position. The skin is redraped over the deeper tissues, and excess is trimmed. An incision is made under the chin to allow recontouring of the anterior neck.
- Limited Incision
In younger patients with less age-related changes, a shorter incision is used than the traditional facelift to achieve improvements in the neck and jaw.
Closing The Incisions
The incisions are closed with sutures. Drains may be placed to prevent fluid collections from accumulating.
See The Results
Improvements in the face and neck can be seen immediately after surgery but can be hidden due to swelling and bruising. As swelling and bruising subside, a more youthful and refreshed appearance emerges. Most patients are presentable to the public in 10-14 days after surgery, but around 6-8 weeks is when they begin to fall in love with their results.
What Happens After
FACELIFT (RHYTIDECTOMY) SURGERY?
After the procedure, you will go to the recovery area to be monitored as you wake. This is to ensure you do not develop any complications from the surgery or anesthesia. Once you are awake, you’ll be discharged from the surgical facility.
After anesthesia, you will not be able to drive, so someone needs to drive you. Many patients go home, but some choose to go to an aftercare recovery center for the first night or two.
What Should I Expect During
RECOVERY FROM A FACELIFT (RHYTIDECTOMY)?
You should have a relatively smooth recovery. The effects of anesthesia wear off within a few hours, and after a few days, you should feel pretty good.
You will see your surgeon the following day after surgery. Your dressing will be removed to make sure there are no fluid collections, and your drains, if present, may be removed. A new dressing will be applied.
You should rest and take it easy as much as possible in the first two weeks after surgery. You should apply ice to the face frequently to minimize bruising and swelling, and ideally, you should sleep with your head elevated. Most pain and discomfort can be controlled with over-the-counter medications such as Advil and Tylenol. Your surgeon may also prescribe a pain medication for you to take as needed.
- WHAT IS THE RECOVERY TIME FOR A FACELIFT?
Most patients feel pretty good within the first few days after surgery. Bruising usually resolves by two weeks after surgery, and patients are presentable to the public by then. Swelling continues to improve week by week, and most patients hit a sweet spot with how much they love their new appearance around 6-8 weeks after surgery. Those having a mini-facelift will recover even faster.
- WHEN CAN I RETURN TO WORK OR OTHER ACTIVITIES AFTER A FACELIFT?
If you work from home, you should be able to resume work within 3-5 days after surgery. Most patients can return to work in person after 10-14 days. Patients should avoid exercise, straining, or lifting until at least three weeks after surgery.
How Can You Care For
YOURSELF AT HOME?
Resting as much as possible and taking it easy are very important. Doing too much will increase blood pressure and increase the risk of bleeding and bruising. Applying ice to the face frequently is one of the most effective ways to minimize bruising and swelling after surgery. Taking arnica orally and applying it topically to the forehead can also reduce bruising. Gauze is useful for cleaning up any oozing that may occur in the first few days after surgery. Having pain medication readily available is also important. Finally, you should follow your surgeon’s instructions to maximize your recovery
This includes resting, icing, taking and applying arnica, and elevating the head. Avoiding physical activity for at least one week after surgery is important as it decreases the likelihood of bleeding, bruising, and pain.
ACTIVITY
Limiting physical activity will minimize bleeding and bruising. You should rest as much as possible and sleep with your head elevated for the first few days after surgery. You should be able to shower by the second day after surgery. Do not make the water temperature too hot, as this can increase the risk of bleeding. Starting the day after surgery, you should walk every day. This can be inside the house or outside around the neighborhood. You should avoid any exercise or strenuous activity for three weeks.
MEDICINES
You should speak to your surgeon about when you should resume your medications. In general, they can be restarted the following day. Pain can be controlled with over-the-counter medicines such as Tylenol and Advil; your surgeon may also prescribe a narcotic medication; take these as directed by your physician. You may also be prescribed a medicine for nausea to be taken as needed. You may or may not be given antibiotics after surgery.
DIET
You should eat a balanced diet consisting of fruits, vegetables, and proteins. Having good nutrition is critical to healing well. Additionally, it is important to drink plenty of fluids and stay hydrated. If you experience any nausea after anesthesia, it is recommended to start with liquids until your nausea resolves.
INCISION CARE
You may start to clean your incisions when your surgeon tells you it is okay to shower, typically in the first 2-3 days. It is best to use warm water and mild soap to slowly break up any scabs that form. You should let the water gently wash the scabs away as opposed to picking them off. It may take several days for some scabs to slowly fall off. You should apply Vaseline at least three times a day to your incisions. This will also help the scabs to fall off and will help the skin heal as fast as possible.
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PHONE NO.
LOCATION
435 N Roxbury Dr, Ste 200, Beverly Hills, CA 90210
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When Should I See My Healthcare Provider If I’ve Had A Facelift?
You will see your surgeon the day after your facelift. The dressing will be changed, and your drains are usually removed. You will have another appointment one week after surgery to remove sutures. After that, you will be seen regularly to monitor your healing.
Patients should contact their surgeon if they experience signs of infection such as fevers, increased pain, swelling, or drainage, chest pain, shortness of breath, or changes in mental status. They should also call for any persistent bleeding from surgical sites that is not resolved.
How Will Facelift Results Look Over The Long Term?
After surgery, you will look more refreshed and youthful. Many patients look 10-15 years younger. While the normal aging process will continue, you will always look younger than if you never had surgery. Maintaining a healthy lifestyle and using sunscreen daily, as well as a quality facial skin care regimen, are keys to maintaining your results.
Why Consider A Facelift?
With aging, a myriad of changes occur in the face. These include 1) sagging and drooping of the soft tissues and skin due to gravity and loss of elasticity, 2) volume loss and hollowing of the fat compartments, and 3) changes to the skin, including thinning, texture and color irregularities, and wrinkles. These changes may make someone appear younger than they feel and negatively affect self-esteem and confidence. Patients who feel self-conscious or are bothered by the aging process would benefit from surgery.
Who Gets Facelifts?
Patients who are bothered by age-related changes in their face benefit from a facelift. Patients are typically in their 40s to 60s, but these days, even younger and older patients are having surgery to improve their appearance. Most patients are women, but over time, the number of men having this procedure is increasing. The ideal patient is in good health, doesn’t smoke, and has realistic expectations for surgery.
How Common Are Facelifts?
Facelifts are very common. Every year, over 100,000 are performed.
What Is The Best Age For A Facelift?
The best age is when you are bothered enough by the age-related changes in your face that you wish to do something about them. Every patient ages differently and sees themselves differently, so there is no one “best age” that works for everyone. In general, aging of the face starts to occur in the late 30s and early 40s and becomes more pronounced the older you get. As long as you are healthy, you can have a facelift into your late 70s or 80s. When performed at an earlier age, you do get the benefit of enjoying the results and looking much younger for longer.
How Much Does A Facelift Cost?
The cost of a facelift depends on many variables, including the type and extent of the surgery. It can range between $10,000-40,000. The deep plane facelift is more invasive, takes longer than a traditional facelift, and will cost more; however, it yields more natural and longer-lasting results.
Does Insurance Cover Facelift Surgery (Rhytidectomy)?
Typically, a facelift is deemed a cosmetic surgery and is not covered by insurance.
What Are The Benefits Of Facelift (Rhytidectomy) Surgery?
A facelift is the most powerful procedure in plastic surgery to rejuvenate and refresh the aging face. The surgery reduces sagging skin, removes jowls that develop in the cheeks and jaw, and even restores some volume to the midface. The appearance of the cheeks, jawline, and neck are all improved, resulting in a more rested and youthful appearance. Together, the surgery helps improve self-esteem and confidence.
What Are The Possible Complications And Side Effects Of Facelift (Rhytidectomy) Surgery?
The risks associated with all surgeries include pain, bleeding, infection, scarring, need for further procedures, and adverse reactions to anesthesia. Specific to the facelift, a hematoma or collection of blood underneath the skin, numbness of the earlobe, facial nerve injury leading to facial paralysis, hair loss near the incisions, and loss of skin are all possible risks. You should discuss these risks in detail with your surgeon before surgery.
Life After A Facelift
After surgery, most patients feel pretty good within a few days after surgery. Bruising and obvious swelling will subside in 2 weeks, and patients can return to normal daily activities including work by then. Some patients will even look be able to do this within 7-10 days. Patients should wait at least three weeks to return to exercise and strenuous activities. Swelling will continue to improve, and most patients start to really love their new appearance around 6-8 weeks after surgery.
Most patients feel pretty good within the first few days after surgery. Bruising usually resolves by two weeks after surgery, and patients are presentable to the public by then. Swelling continues to improve week by week, and most patients hit a sweet spot with how much they love their new appearance around 6-8 weeks after surgery. Those having a mini-facelift will recover even faster.
Can I Have A
NONSURGICAL FACELIFT?
Nonsurgical options can be very beneficial to maintain results after a facelift and in younger patients with more limited age-related changes, may offer improvements without having to have surgery.
WHAT IS A NONSURGICAL FACELIFT?
Nonsurgical facelifts refer to multiple nonsurgical or minimally invasive treatments to improve facial appearance without having surgery.
WHAT’S THE DIFFERENCE BETWEEN A NONSURGICAL AND A SURGICAL FACELIFT?
A surgical facelift involves making incisions in the face and elevating and resuspending deeper tissues to correct age-related changes. This requires going to sleep under anesthesia, postoperative care, and downtime to recover but delivers the most dramatic and longest-lasting results.
A non-surgical facelift does not involve large incisions, does not require going to sleep, and there is minimal downtime. In general, the results are also shorter-lived, and the procedures need to be repeated regularly.
WHO GETS NONSURGICAL FACELIFTS?
Patients who are hesitant to have a surgical facelift but are still bothered by aging in the face can benefit from nonsurgical facelifts. Younger patients with early age-related changes can also see good improvements with nonsurgical facelifts. Nonsurgical facelifts can improve sagging skin, wrinkles, and volume loss to a certain degree.
WHO SHOULDN’T GET A NONSURGICAL FACELIFT?
Because many nonsurgical facelift treatments target the skin and require an intact and healthy skin barrier, those with eczema, psoriasis, active acne, active cold sores, dermatitis, or burns are not good candidates, additionally, if the age-related changes are severe, nonsurgical treatments would be less than ideal. For example, nonsurgical facelift treatments would be ineffective at removing excess skin that develops from aging.
NEUROMODULATORS
Injections of these medications will temporarily weaken or relax muscles in the face, leading to wrinkles. Results usually last three months.
FILLERS
These injectable products, usually made of hyaluronic acid, help restore volume to areas that have become deflated over time due to aging. These are especially effective for the under-eyes, cheeks, and lips and also help correct deep wrinkles. Results can last from 6 months to 2 years.
FAT INJECTIONS/TRANSFER
Fat is harvested from other parts of the body and injected in areas of volume loss. This is more invasive as it involves liposuction, but the results last longer.
SKIN RESURFACING
A variety of options are available to improve aged and sun-damaged skin. Microdermabrasion is a minimally invasive procedure that only removes the most superficial layers of the skin. This can be combined with microneedling which uses small needles to make tiny puncture wounds in the face which stimulates collage growth and can improve the appearance of skin. For even more improvement, chemical peels and lasers allow more aggressive treatment of the skin and collagen formation. This leads to newer, smoother, and firmer skin.
ENERGY-BASED TREATMENT
Using radiofrequency or ultrasound energy, the dermis of the skin is heated which causes tightening and collagen formation. Because the outer layer of skin, the epidermis, rests on the dermis, it in turn will tighten, and fine wrinkles and texture irregularities will improve.
THREAD LIFT
In this procedure, barbed sutures are placed underneath the skin to pull it back and tighten it. This allows temporary repositioning of descended tissues. The advantage of this procedure is that it can be done quickly under local anesthesia, but the major disadvantage is that the results go away very quickly within a few months.
HOW COMMON ARE NONSURGICAL FACELIFTS?
The growth of nonsurgical treatments for facial rejuvenation has been extraordinary, far outpacing the growth of surgical procedures.
HOW IS A NONSURGICAL FACELIFT PERFORMED?
Depending on what is done, nonsurgical facelift procedures are typically performed under local anesthesia with the patient awake. Numbing cream and numbing injections may be used to minimize pain with the procedure. For fat harvest and energy-based treatments, the patient is usually asleep for maximum comfort.
WHAT ARE THE RISKS OF A NONSURGICAL FACELIFT?
With neuromodulators, asymmetry or a droopy eyelid can develop. With fillers, asymmetry or irregularities may occur. Very rarely, loss of skin and loss of vision may result. With any skin resurfacing or energy-based treatment, scars and burns may result. With even minimally invasive procedures, there is always a risk of infection, bleeding, and pain.
WHAT ARE THE BENEFITS OF A NONSURGICAL FACELIFT?
A nonsurgical facelift can help improve the appearance of your face without surgery. The recovery after these procedures is faster, and there can usually be very little downtime. You can also avoid the risk of anesthesia. Nonsurgical facelifts tend to be less expensive than surgical facelifts, but they do need to be repeated usually. Over time, the cost may be equivalent to surgery if these are performed long enough.
WHAT CAN I EXPECT DURING RECOVERY?
After most injections, there is usually very little pain or discomfort, but there can be temporary bruising and swelling. For skin resurfacing, your skin will be red and swollen and then start to peel after a few days. The length of peeling depends on how deep the resurfacing went.
HOW LONG DO THE RESULTS OF A NONSURGICAL FACELIFT LAST?
The results vary depending on what nonsurgical treatment was performed. In general, neuromodulators last 3 months while fillers can last anywhere from 6 months to over 2 years. Fat transfer tends to last 5-8 years. Skin resurfacing procedures can last months to years depending on what was performed. Thread lifts tend to last a few months.
HOW CAN I MAINTAIN THE RESULTS OF A NONSURGICAL FACELIFT?
The best way to maintain results is to live a healthy lifestyle, avoid smoking, and use sunscreen and a quality skin care regimen daily.
WHEN SHOULD I SEE MY HEALTHCARE PROVIDER?
You should contact your healthcare provider if you experience signs of infection such as fevers, increased pain, swelling, or drainage, as well as any visual changes or if any area of the skin starts to become dark.
Julie Universe
Choosing A
COSMETIC SURGEON
A facelift is a complex surgical procedure that involves repositioning the deeper tissues of the face. To do this well, expert knowledge of facial anatomy and understanding of facial aesthetics is required. The deep plane facelift technique offers longer-lasting and more natural results; however, it is relatively new, and not all surgeons perform it. It is important to discuss their training and experience with your surgeon and review before and after photos to get a sense of their skill and aesthetic eye.
- Prioritize Patient Safety
Any surgery involves risk. It is critical to trust your care to a surgeon who is specifically trained and board-certified in facial plastic surgery and that your procedure is performed at an accredited surgical facility. Board certification ensures your surgeon has met stringent educational and training standards and has passed strenuous written and oral testing to ensure mastery in their chosen specialty. An accredited surgical facility means the facility meets the highest standards for patient safety.
- Look At Their Results
Looking at before and after photos will give you a sense of the surgeon’s skills and outcomes. Pay attention to how natural the patients appear after surgery and how inconspicuous the scars are. It is also helpful to pay attention to patients of a similar age to you to get an idea of how your results may turn out.
A Note From
HENRY CHEN
A facelift is the most powerful procedure available to correct the signs of aging in the face. The modern-day deep plane facelift technique has incrementally improved surgical outcomes by giving more natural and longer-lasting results. It is important to choose a surgeon with the skills, expertise, and artistic eye to help you achieve the best results. Dr. Chen is double board-certified in facial plastic and reconstructive surgery and otolaryngology, which includes head and neck surgery. He has only trained and operated on the head and neck and has performed thousands of procedures. He performs all his cosmetic procedures at his in-house AAAASF-certified surgical center to ensure the highest level of patient safety and the best outcome. Patients undergoing a facelift go to sleep with intravenous sedation as the recovery is faster and better than with general anesthesia.
Choosing to have a facelift is a deeply personal decision, and Dr. Chen wants you to feel confident and supported throughout the process. Dr. Chen will listen to your concerns and recommend a surgical plan to address them. He will make sure you are fully prepared for surgery and recovery and that all your questions are answered. After surgery, he will be there step-by-step through the recovery process to make sure you heal as well as possible.
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PHONE NO.
LOCATION
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Get In TOUCH WITH US
Dr. Chen is double board-certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head and Neck Surgery.
Call (310) 997-0280 or fill out the form below for a consultation.
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