Facelift Surgery and Recovery
Technically, the face lift operation consists of repositioning and supporting the sagging skin and the underlying tissues of the face and removing the excess skin and fat.
There are several locations where the incisions can be placed during a face lift based on your anatomy. The scars in the hair and around the ear may be camouflaged with the adjacent hair or by the natural creases and folds of the ears. Incisions that are next to hair lines are beveled to allow the hairs to grow through the scar and camouflage it even better. The incisions within the hairline are made in such a way to minimize trauma to the surrounding hair. On rare occasions, there may be some thinning of the hair around these incision lines. If this were to occur, the area can be covered by combing adjacent hair over it, or by a minor “touch-up” procedure. However, I employ techniques designed to protect and preserve hair and to minimize this risk.
If a temporal or forehead lift is performed, the hairline may be altered. If the hairline is high, the pretrichial (in front of the hairline) can help to lower the hairline. If the hairline is low, the coronal incision (behind the hairline) can help to raise it and create more of a forehead. For the temporal extension approach, the incisions are tailored to minimize hairline alterations and avoid the telltale sign of a facelift with a loss of hair above the side burns. Essentially, the operation is “customized” to fit the needs and desires of each patient seeking surgery as discussed in the brow lift section.
During preparation for surgery, we do not shave any hair as we fell it does not assist us and only creates concerns for the patients. Instead, the hair is placed into tiny pigtails to allow me to be able to work around it. Because I close those incisions made in the scalp with small metal clips, it is not necessary to shave the hair. Obviously the fact that one has had surgery is easier to camouflage when hair shaving is avoided. Another distinct advantage of the metal clip closure is that patients may wash their hair the next day after surgery. As a matter of fact, we recommend daily shampoos following face lift surgery starting on day number two (2) after surgery.
Some degree of tightness, numbness or weakness of surrounding tissues is expected following surgery. It is usually temporary, disappearing as healing progresses. The tightness will increase for the first few days as the swelling increases. This is not an “overdone” surgery but merely the body’s response to any surgery. As the swelling dissipates the tightness will improve. The numbness is most common in front of and below/behind the ears. If a brow lift was performed, depending on the technique then the scalp may also be numb. As the nerves regenerate it is normal to feel little pings, zings, and itches. This is the body healing and it is important not to itch these areas.
The operation may be done either under “twilight” anesthesia or general anesthesia. I am trained and have operated under both conditions. Certain candidates are better for one type over the other. The final decision as to what type is used will rest with the anesthesia team, although we can provide our preferences to him or her. More than 90% of the face-lifts we perform are done in outpatient facilities, but even if the surgery is performed in the hospital, patients are usually discharged the following day. If the surgery is performed in an outpatient facility instead of the hospital, the total cost is usually considerably less. These arrangements will be discussed during the consultation and depend on your overall health.
A head bandage is worn the night following surgery. I do not leave drains in place as they can be uncomfortable to remove and can stimulate bleeding when they come out. As a result, the head bandages is kept snug for your safety, but it is generally removed the next morning when a much more loose fitting supportive garment is used to help with cold compresses. The face may be swollen and some discoloration may be present. This discoloration usually fades away within about 10-14 days but not before it increases for the first two to three days. Patients can return to most of their “normal routine” within two (2) weeks. But the face and neck may feel “tight” and movement will be restricted. This is to be expected as long as the tissues are swollen.
The patient returns to the Clinic in about a week to have the sutures and clips removed. Makeup may be worn by ten (10) days and he/she should be able to return to work and carefully drive an automobile in fourteen (14) days if work was performed on the neck or in seven (7) days if a neck lift was not performed. Patients must not pull against tightness, lie on their sides or engage in heavy lifting during this time. Doing so can interfere with healing and lead to less than favorable results. Specifically, scars will defend themselves and if you pull against them with the above activities then the scar will likely widen. For best results and better scars these activities (other than driving) should be avoided for at least 6 weeks following surgery.
Dr. Guy has been trained extensively in the various surgical approaches for rejuvenating the face to give you the best aesthetic outcome which can be discussed with Dr. Guy in consultation.