To see photos of patients with face and neck lift, click here

Facelift surgery, or a rhytidectomy, is designed to restore a more youthful appearance by removing major wrinkles and sagging skin. It involves tightening of the facial and neck muscles as well as the removal of any excess skin.

Due to the effects of aging, sun exposure, smoking and genetic predisposition, the skin begins to wrinkle and sag. Children and young adults have smooth, round faces due to evenly distributed fatty tissues in facial contours. Over time, the skin sags and folds of the chin, jawline and neck become prominent. Not only does a facelift improve facial appearance but also has a dramatic effect on the neck, enhancing its contour and profile.  A facelift can make a patient look 5 to 10 years younger.  Dramatic as the end results are, this is not a simple procedure. It requires a week to 10 days of recovery. It is important to remember that while a facelift reduces sagging skin and wrinkling significantly, it does not stop, or even slow down, the aging process. Eventually, you will start to wrinkle again.

The Procedure

Over the past several years, a variety of face and neck lift techniques have been developed, which are less invasive and therefore less risky than a full traditional facelift. Called by a variety of names, such as "MACS lift", "S-lift", "short-scar lift" or "lifesyle lift", each attempts to correct wrinkling and sagging of the face and neck with smaller incisions. A facelift can be done by itself, but it is often performed in conjunction with blepharoplasty (eyelid surgery,)  forehead lift, chin augmentation, laser skin resurfacing, and/or neck and jowl liposuction, to create an overall rejuvenation of the face. The procedure can be repeated as gravity continues its effects after the first surgery.

ENDOTINE® RIBBON LIFT

The ribbon lift is a revolutionary new tool in minimally invasive lifting and sculpting of the lower face and neck. Intended for patients with mild to moderate sagging of the neck and/or jowls of the lower face, this procedure involves placing a bioabsorbable (dissolves by itself in 6-8 months) ribbon with multiple tines (teeth) that grab and lift sagging facial tissues into a more youthful and aesthetic position. It can be performed under local anesthesia, utilizing very small incisions above and/or behind each ear. It provides a quick and long-lasting lift, with minimal discomfort and little down-time. It is safe, and less invasive (and less expensive) than other types of lifts.   Photos courtesy of Dr. John Zimmermann           Photos courtesy of Dr. Miles Graivier

MACS lift

MACS stands for “Minimal Access Cranial Suspension. Minimal access refers to the fact that only a relatively small incision is made. Cranial suspension means the lifted tissues are anchored to part of the temporal bone tissues. Briefly, the incision shown above is made, and the skin and fat are lifted off the muscle layer underneath. Then, using permanent sutures, the sagging muscles are encircled in a “pursestring” fashion, drawn tight (producing the lift) and anchored to the fascia (thick tissue) covering the temporal bone (temple part of the skull). The skin is then drawn snug, excess skin is cut off, and the remaining skin is reattached. The result is a lifting of the mid and lower face and neck, and tighter, less wrinkled skin. Frequently, the MACS lift is combined with another procedure, such as neck liposuction or laser skin resurfacing, depending on the needs of the individual patient.

FULL FACE LIFT

A full face lift is usually indicated in patients who are heavily wrinkled and have significant skin sagging. It is the most aggressive of the facelifts, and therefore has the greatest risk and longest recovery time. Most patients do not require this extensive a lift.

The procedure involves making incisions inside the hairline at the temple, (dotted line) in front of the ear, then around the earlobe and behind the ear, ending at the scalp area. Skin is then lifted off the facial muscles (green). (Note these diagrams represent a fairly extensive full face lift. Many people can get by with a much smaller lift.

Sagging muscles and connective tissues are pulled upward and tightened, and in some cases, fatty deposits are removed from beneath the chin.

Excess skin is removed.

Incisions are closed with staples and sutures.

We perform face and neck lifts under local anesthesia with conscious sedation ("twilight sleep"). Patients can go home a few hours after surgery. Post-operative pain is minimal, but there will be swelling and some bruising, depending on the extent of surgery done. Recovery is usually 7-14 days. It will be necessary to have someone drive you home and stay with you for the first 24 hours. Initially you will have a large dressing wrapped around your head. Stitches around the ears will be loosened or removed in a few days. The scalp sutures will be removed in 7-10 days.

In the weeks following surgery, the facial skin and area around the ear may be numb. There may also be some temporary discoloration as healing begins, which may take a few months to disappear. Occasionally, the facial nerve is bruised during surgery, resulting in temporary loss of function or sensation. However, actual permanent damage to the facial nerve is rare. Other complications include bleeding, hematoma  (blood collection), infection, numbness  and asymmetry. (Note that this is not a complete list of risks and complications. We will discuss those with you in detail prior to your surgery).

The healing process is gradual, so you will not notice final results for up to 6 months. A single procedure often achieves the desired results. Most patients who have had facelifts are pleased with their new, more youthful appearance.