How is this procedure done?

There are different techniques and approaches to a facelift. The specifics will be discussed with you prior to your procedure. The exact placement of the incisions and the sequence of events depend on your facial structure and your surgeon's preference. Generally, incisions usually begin at the temples above the hairline, flow along the natural line inside of the ear, curve around the earlobe into the crease behind the ear, then into or along the lower scalp. If your neck needs attention, a small incision may also be made under the chin.

The facial skin is lifted, the fat is trimmed or suctioned and underlying muscle may be tightened. After deep tissues are tightened, the excess skin is pulled up and back, trimmed and stitched (sutured) into place. Stitches secure the layers of tissue and close the incision; metal clips may be used on the scalp. Some surgeons use a tiny thin tube placed temporarily under the skin behind your ear to drain any fluid that could collect there. Your surgeon may also wrap your head loosely in bandages to minimize bruising and swelling.

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How do I prepare for my facelift?

During your initial preoperative visit with your surgeon, be prepared to give a complete medical history including all your medications, allergies and previous surgeries. You will undergo a thorough physical examination and blood tests. If you are over age 50, an electrocardiogram may be taken. Photographs are important aids in planning and performing your facelift. They become a permanent part of your patient record and are taken before and several months after your procedure.

During your consultation, you will be given specific directions to help you prepare for your procedure. Instructions generally include taking vitamins, cautions about taking certain medication and drinking alcohol, and instructions on hair coloring and use of antibacterial soap.

It is very important to note that smoking reduces the blood supply to the face and may increase scarring and compromise the good results of a facelift. Therefore, you must stop smoking completely for three weeks before and two weeks after your procedure. "Cutting down" will not help. Complete elimination of smoking is necessary to improve facial blood supply.

You must not eat or drink anything eight hours before your procedure. If you take daily medication, ask your surgeon if it is safe to take before your procedure. If you have any sores on your body, if you have a cold, sore throat or allergic condition, inform your surgeon so you may be examined again prior to your procedure.

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How long does the procedure take?

Operating time varies depending on the extent of your procedure(s). The facelift generally requires two hours; upper and lower eyelids together one hour and the brow lift one hour.

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What form of anesthesia is used?

You will be given either local anesthesia combined with sedation or general anesthesia, given by an expert anesthesiologist M.D. (medical doctor). Discuss your needs and comfort level specifically with your surgeon to create the best possible experience.

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Can I return home the same day?

No. Facelifts and brow lifts require an overnight stay for observation purposes. Be sure to arrange for someone to pick you up the next day, take you home, and stay with you for at least 24 hours.

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What precautions should I take during my recovery?

You will have a bandage for the first night. The tiny surgical drains placed in the hair behind your ears will be painlessly removed along with your bandages on the following morning. After an eyelid procedure, ice compresses are applied for 24 hours, but the eyes are not bandaged and lubricating ointment/drops used may cause blurred vision for one to two hours. Immediately after the facelift, you may notice a tight sensation in the neck and under the chin. This feeling may last several weeks and is a normal part of recovery.

You are encouraged to shampoo your hair daily after your procedure with a mild shampoo. A light cover-up may be applied to the eyelids starting four days after your procedure. Eyelid makeup including mascara, eye shadow, eyeliner and artificial eyelashes may also be applied four days after your procedure. However, it is important to remove all makeup thoroughly at the end of the day using an upward motion. You may use oiled eye pads for removal of eye makeup. All sutures will be removed within seven to ten days; eyelid sutures are to be removed in four days. You may wear make-up on the rest of your face the day after the sutures are removed.

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How long before I can return to normal activity?

Most people return to work and their usual activity within ten days. Jogging, aerobics, bicycling and other non-contact sports are permitted three weeks after the procedure.

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What are some of the complications that can occur with a facelift?

The most common complication after a facelift is a collection of blood under the skin (hematoma). In less than 2% of facelift operations, this collection of blood must be removed in the operating room immediately post-procedure. Occasionally, small hematomas are removed in the office several days after the procedure. Other complications such as infection, eye irritation, delayed healing or excessive scarring are uncommon. Facelifts rarely produce serious complications.

With a facelift, the scars are placed either within the hair or in natural folds and lines of the face so that they are inconspicuous or easily hidden by makeup or hair styling. Your scars fade with time and are usually not noticeable. Nevertheless, you should be aware that scars are permanent, and their width, height, and color are not totally predictable.

As with any surgical procedure, small sensory nerves near the surface of the skin are interrupted during a facelift and brow lift, consequently, portions of your scalp, cheeks, and neck will feel numb or have less than full feeling. Sensibility returns over several months, but some diminished feelings may last indefinitely. Facial nerve injury with weakness of a part of the face can occur on a transient or permanent basis. The latter is very rare. Other complications not listed here, can occur but are exceedingly rare. Nonetheless, it is important to enter into your procedure aware not only of the benefits, but also of the possible complications. Talk to your surgeon about every question and concern you may have.

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What can I expect immediately after my procedure as well as later on?

Some swelling and discoloration is expected following your facelift, but usually subsides within 10-14 days. Your surgeon will want to examine you several times during the week or two following your facelift. Your stitches will be removed in stages, usually between the third and tenth postoperative days. Your surgical scars will be permanent, but every effort is made to conceal them and make them inconspicuous. Your hair around your temples may be thin at first and your skin may feel dry for several months. Chances are very strong that you will be even happier with your facelift if you realize that the final results may not be immediately apparent.

Remember that a facelift cannot stop the aging process. Although excess skin is removed and wrinkles are diminished, your skin continues to age. In time you may feel the need to have a second procedure. Pouches beneath the lower eyelids usually do not recur. As you grow older the skin of the upper lids becomes looser and may create additional folds in which case an upper lid "touch-up" can be done. There is rarely any need to repeat the brow lift. Having one facelift does not obligate you to have another. While secondary procedures are done for some, most have only one facelift and remain pleased with their appearance. However, there is no set limit as to how many facelifts you may have.

Your facelift is carefully planned to give you the fresher, more youthful appearance you seek. Be sure to address any questions or concerns about this procedure to your surgeon immediately. Your health and happiness are the most important considerations any time.

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