The Basic Facelift Procedure

The Basic Facelift Procedure
Since each face has a unique shape and contour, the surgery will vary from patient to patient. Before the procedure, the doctor will evaluate the patient’s skin consistency and explain the surgery. People who smoke will be asked to stop at least two weeks before the surgery and stay off of cigarettes for a couple of weeks after the surgery, because smoking inhibits blood flow to the skin and can interfere with healing. Patients are also asked to avoid aspirin and other anticoagulants that can increase bleeding.

A facelift can be performed either in a cosmetic surgeon’s office or in a hospital. Most patients are given a local anesthesia combined with a sedative, so that they are awake but unable to feel the procedure. Some doctors may use general anesthesia, which puts the patient to sleep.
During a traditional facelift, the doctor makes an incision that typically begins around the hairline from the temple and curves around the earlobe, ending at the bottom of the hairline. The surgeon may also make a small incision under the chin to specifically tighten the skin of the neck.

The doctor first separates the skin from the fat and muscle underneath. The doctor may make the decision to either use liposuction to remove excess fat, or possible surgical excision to remove excess fat from the underlying tissue. Underneath the skin is a layer of tissue called the superficial musculoaponeurotic system (SMAS). The doctor tightens this layer by folding it, or pulling it back over itself. Tightening the SMAS layer lifts the cheeks, gives the jawline more definition, and firms the neck.

Finally, the doctor pulls the skin back up over the area and removes any excess skin with a knife or laser, similar to the way that you would pull a carpet to tighten it over the floor and trim the excess. The incision is closed with stitches, sutures, or tissue glue. The stitches are usually placed within the hairline so they are hidden by the hair.

The surgery can take between two to four hours, depending on the extent of the tissue and muscle work and the number of procedures being performed.

Other Types of Facelifts
In addition to the traditional facelift, there are a number of other techniques cosmetic surgeons use to give their patients a more youthful appearance.

The mini-lift is term is used to describe less invasive procedures that use a smaller incision and work on a smaller area of the face than a traditional facelift. It is designed to improve the appearance of jowls and loose skin in the neck, but with less dramatic results than a true facelift.

The S-lift works on just the lower third of the face, smoothing out the neck and jowls.
The best candidates for facelifts are people who are experiencing some wrinkling and sagging in the skin of their face and neck, but whose skin still has some elasticity. Facelifts are recommended only for people of normal weight who are in good health. Those with certain conditions, such as blood clotting problems, uncontrolled high blood pressure and the tendency to form large scars should check with their primary care doctor before considering a facelift.