Facelift or Face Lift (Rhytidectomy)
Over time, the effects of age, gravity and sun exposure may cause your skin and muscles to sag. This can make the appearance of wrinkles and excess skin on your faces more obvious, making you look older than you are. To counteract these effects and preserve a youthful appearance, many men and women just like you are electing to have a facelift.
Facelift procedures may differ, but their goal is the same: to improve visible signs of facial ageing. A facelift is a surgical procedure that rejuvenates the appearance of the ageing face through the removal of excess fat, tightening of the facial muscles and re-draping of the skin on the face and neck.
In this article, Costhetics invites you to learn more about traditional and leading- edge techniques so that you can make an informed decision about whether a facelift is the right procedure for you.
Facelift BasicsClick to collapse
Doctors call it rhytidectomy, but you know it better as facelift surgery. It lifts and tightens the skin and underlying muscles to rejuvenate facial structure and create aesthetically pleasing contours. Both surgical skills and an artistic eye are required to achieve beautiful, natural-looking results with negligible scarring.
Facelifts are in-demand locally and globally. In Australia, facelifts were ranked among the top five most popular cosmetic surgical procedures in 2009. More recent data from The American Society of Plastic Surgeons (ASPS) demonstrates that the demand for facial rejuvenation procedures remains strong.
“Facial rejuvenation procedures were especially robust last year, with more Americans opting for facelifts, forehead lifts, eyelid surgery, fillers and peels. With new devices and products hitting the market each year, there are more options and choices available to consumers wanting to refresh their look or a little nip and tuck.” ASPS President Robert X. Murphy, MD.
Top 8 Reasons to Have a FaceliftClick to expand
Did you know that more than 90% of facelifts in Australia are performed on women over the age of 50? That statistic is rapidly changing, however, as men discover the restorative value of a facelift.
The trend is reflected in U.S. cosmetic surgery statistics where facelifts are the most popular procedure for both male and female baby boomers aged 51 to 65+. People in this age group accounted for more than 80% of all facelifts in the US in 2010.
The most important factor in determining whether or not to have a facelift, however, is not really your age. The key issue is whether or not you have facial ageing changes that can be corrected with facelift surgery.
What are those changes? Most patients list eight changes as their impetus for choosing facelift surgery. If you’ve been thinking about this rejuvenating procedure, consider whether any or all of these apply to you.
- The skin on the lower part of your face has lost firmness.
- The skin on your neck has lost firmness and elasticity.
- You have developed lots of wrinkles in recent years, and non-surgical treatments don’t entirely fix the problem.
- Your skin has become loose enough to give you the appearance of jowls under the chin.
- Your skin is saggy in the middle of your face.
- You have deep creases under your lower eyelids.
- You have deep creases by the side of your nose, which extend to the corners of your mouth.
- You want to make your face look younger, get rid of some lines, bring back muscle firmness and make your face look rejuvenated and refreshed.
4 Things a Facelift Cannot DoClick to expand
Facelifts cannot correct all signs of facial ageing. The procedure will not improve
- Sagging eyebrows
- Fatty deposits in the upper and lower eyelids
Because facelift surgery is not a cure-all, it is often performed in combination with other procedures such as nose reshaping, neck lift, forehead lift, eyelid surgery and skin treatments. An experienced surgeon can recommend which procedures are best suited to achieving your goals.
Profile of a Good Candidate for Facelift SurgeryClick to expand
Desire is not the only factor that determines whether or not you are a good candidate for facelift surgery. There are physical and emotional considerations as well. A skilled, experienced surgeon will talk with you at length to determine your suitability for facelift surgery, and recommend a specific procedure based on your unique circumstances.
A good candidate for a facelift is a man or woman who
- Has facial ageing issues that cannot be corrected by less invasive treatment options.
- Is in general good health.
- Has no active skin problems, such as acne, psoriasis, or eczema.
- Is willing to follow before-and-after care instructions.
- Has a realistic expectation regarding the outcome.
How to Choose a Facelift SurgeonClick to expand
You and your surgeon are partners in your facelift success, so selecting the right provider is an essential part of the equation. Personal recommendations and online research can provide a rich pool of candidates, but who is the right surgeon for you?
The Australian Society of Plastic Surgeons recommends that you shortlist 2 to 3 surgeons for an initial consultation. Here is a list of key questions you should ask when putting together that list:
- How many procedures like the one I want has this surgeon performed? – A surgeon with specific and lengthy experience with the facelift procedure that is right for you is the best bet.
- What is this surgeon’s approach to facial rejuvenation? – Beauty is in the eye of the beholder, so it is wise to identify a surgeon who shares your aesthetic sensibility. The best way to do this is to look at a surgeon’s before and after photos of patients, which are often available on their website. Look for “before” faces with shape, structure, and ageing issues similar to your own, and then assess the “after” picture to see if it fits your vision.
- Where do you have hospital privileges? – Your safety during a facelift is paramount. Your surgeon should work in accredited operating rooms with a licensed anaesthesiologist and key life support systems on hand in case of an emergency.
6 Different Types of FaceliftsClick to expand
- The area of the face being rejuvenated
- The degree of invasiveness
- The type of incision
- The number of tissue layers being treated
Once you and your surgeon decide that you are an appropriate candidate for facelift surgery, you will then discuss which of the following techniques is best suited to your needs.
The SMAS Lift – When people speak of a “traditional” facelift, this is the procedure they mean. The SMAS lift addresses the superficial musculoaponeurotic system (SMAS), which is one of the deeper layers of facial tissue. The SMAS is a layer of fibrous tissue covering the muscles that control your facial expressions and help you create dynamic facial expressions.
SMAS surgery lifts the superficial layers of skin as well as deeper tissues of the face and neck (known as the SMAS), which tend to grow lax and sag as we age. SMAS facelift surgery is very effective at addressing laxity and loss of volume and troublesome ageing issues including:
- Hollow cheeks
- Nasolabial folds
- Loose neck bands
Incisions are usually made above the hairline at the temple and extend down along the natural creases of the skin, continuing in front of the ear or at the edge of the ear, dipping below the ear lobe to extend behind the ear. Your surgeon will tighten the SMAS layer with sutures, remove excess skin and then stitch up the incision.
Endoscopic Facelift – An endoscopic facelift is a procedure performed with the aid of an endoscope, a small pencil-shaped probe with an attached camera. This high-tech device transmits video images of the facial structures onto a screen. The surgeon uses these images as a guide in performing the surgery.
The endoscope is inserted through a number of small incisions hidden in the hairline. This procedure is effective for younger people without a significant amount of excess skin and no neck sagging.
Endoscopic facelifts can generally be performed on an outpatient basis, under local anaesthesia. This makes them less expensive than traditional facelifts and less risky because they don’t require general anaesthesia or an overnight hospital stay. It should be noted, however, that small incisions limit the scope of this procedure to the lifting of sagging cheeks.
Mid-Face Facelift – This procedure uses small cuts in the hairline and the inside of the mouth to deliver modest, subtle improvements to the face. It is an excellent choice for people between the ages of 40 and 50 whose cheeks are sagging with skin folds and who are experiencing lax skin in the nasolabial area.
In a mid-face lift, the natural fatty layer over the cheekbones is lifted and repositioned. The procedure can be performed endoscopically or through the lower lid, along with eyelid surgery (blepharoplasty).
Short Scar Lift – The short scar lift is an umbrella term that covers a number of facelift techniques involving minimal lengths of incision and hence shorter scars. Usually these incisions do not extend behind the ears.
Short scar lifts are best suited for those in their 40’s and 50’s who have low to moderate levels of excess skin and whose necks show minimal signs of ageing. This technique means a much smaller scar than other techniques.
One short-scar technique requires an S-shaped incision in front of the ear or at the temple. Your surgeon will use this short incision to resuspend facial tissues, improving smile lines and reducing jowls by tightening the skin. Another technique, called a minimal access cranial suspension lift, or MACS, requires an incision that ends at the earlobe.
Thread Lift – Also known as a Feather Lift, this procedure lifts sagging skin, but is considered a non-surgical facelift. It is best suited to people in their 30’s and 40’s whose skin is only minimally loose or sagging.
The doctor uses sutures (threads) with barbs to grab skin layers and pull them upward. No skin is cut away. It can be performed under local anaesthesia and is significantly less expensive than other types of facelift procedures. It should be noted, however, that this is not as effective as other types of facelifts. A thread lift often acts merely as a bridge until a surgical facelift is appropriate.
Deep Plane Lift – During a deep-plane facelift, the surgeon repositions soft facial tissues by lifting the whole face. This technique is suitable for older people with a lot of sagging and loose skin, but surgeons report many clients in their early 40s requesting this procedure.
The deep-plane facelift is currently the gold standard in facelifts. Unlike more superficial procedures, it repositions deep facial soft tissue that lies beneath the SMAS layer, allowing the whole face to be lifted. The deep plane lift
- Accentuates the jaw, neck and cheekbones.
- Avoids the plastic, ‘done look’, which is fast going out of fashion.
- Produces longer lasting results.
Because the deep tissues of the face are more fibrous and less elastic than the more superficial layers and the skin, there is minimal pulling and stretching in the deep plane lift. It also requires less healing time than the SMAS facelift because there is minimal disruption to the skin or tissues of the face.
Anyone who is a candidate for a standard facelift is a candidate for a deep-plane facelift. It is the preferred technique of surgeons for secondary or revision facelift surgeries because most first-time facelifts have been standard facelifts. There is also a limit to how far the face can be ‘pulled.’
To read more about the deep plane facelift technique click here.
What to Expect When You Have Facelift SurgeryClick to expand
If you have short hair, you might want to let it grow out a bit before the surgery to cover your surgical incisions during the recovery period. If you dye, bleach or chemically treat your hair, have this done ahead of the surgery. It will be at least a month before you can safely treat your hair again.
Make arrangements for someone to drive you home after your procedure or hospital stay. It’s also a good idea to have someone stay overnight with you on your first night home.
The technique you and your surgeon choose will also determine the length of time the procedure takes. Usually, a facelift takes several hours—longer if you are having a number of procedures in conjunction with the facelift surgery. In some instances, if a few procedures are to be completed, your surgeon may schedule more than one surgical session.
Facelift surgery is performed in a hospital under general anaesthetic. Even if you are able to go home after the effects of the anaesthesia have worn off, your surgeon may want you to stay overnight to be monitored.
After your surgeon has completed your facelift, and the incisions have been closed with sutures or mini staples, your face will be wrapped in a bandage. This will put pressure on the wound areas and minimise bruising and swelling. A small, thin tube may be placed under the skin to drain the excess fluids that build up after surgery.
Tubes, bandages and sutures are removed a week following surgery.
What to Expect After Facelift SurgeryClick to expand
You should expect some swelling and bruising on the face to last between three and six weeks. During this time your facial muscles may feel stiff and as if they are not working properly, and you may feel that your face looks distorted. Don’t worry. These impressions are only superficial and will go away as the swelling subsides. You can use camouflage makeup to hide bruises after a week.
Scarring is natural following cosmetic surgical procedures. Your scars may take many months or longer to heal. The healing process can go on for as long as two years. During this period, raised, lumpy, itchy or red scars will fade in colour and flatten, making them less obvious.
11 Tips to Improve Facelift Surgery ResultsClick to expand
There are a number of things you can do following any surgery to improve healing and optimise results. Click here to read the full list.
Specific healing-friendly things to do after a facelift:
- You can get back to light activities within a day or two. Avoid strenuous or tiring activities for at least two weeks after full facelift surgery. This rest time is shorter for short-scar facelifts.
- Avoid touching your skin, as it may be tender following surgery. You could also run the risk of causing an infection under the skin.
- Take care in brushing or combing your hair to avoid touching the surgical wounds in or near the hairline and behind the ears.
- Wash your hair as instructed, using a mild shampoo, taking care to avoid the stitched area. You will probably be advised to not wash your hair for 48 hours after surgery.
- Keep your head elevated, using extra pillows as you sleep or when lying down.
- Sleep on your back during the recovery period. Use pillows to prevent yourself from rolling over in your sleep.
- For at least one week after your facelift, avoid excessively turning your head or flexing your neck.
- In general, you should not strain, bend or lift anything for a week after facelift surgery. These activities can induce bleeding.
- Don’t use concealing makeup for at least a week after surgery.
- Avoid smoking as well as second hand exposure to smoke. Both can increase your risk of poor wound healing, skin death, raised and red scars and wound separation.
- Stay out of the sun during the healing process. Exposure to the sun can lead to prolonged swelling and to discolouration of the scars.
Most people can return to work after two weeks. It is important to remember, however, that everyone heals differently. So discuss this with your surgeon, and you will be given the go ahead if your wounds are healing normally.
Possible Risks and Complications Associated with FaceliftsClick to expand
As with any surgical procedures there are risks involved in a facelift. Inform yourself of potential risks and complications involved in any surgical procedure before you elect to have it done. Specific complications that may occur during or after a facelift include:
- Injury to facial nerves that result in numbness or loss of sensation. This usually goes away with time, but for some people it can take many months to return to normal.
- Facial pain, bruising and prolonged swelling are to be expected for one to two weeks. Talk to your surgeon if they last significantly beyond two weeks.
- Facial asymmetry or an irregular or lopsided appearance on the face. Some people experience facial asymmetry during the healing process. This is normal and typically resolves on its own without any intervention. Continuing asymmetry may have to be treated with revision surgery.
- Dissatisfaction with the results.
- Hair loss around the incision sites.
- Skin loss, contour irregularities and discolouration.
- Some people experience depression or other emotional changes after their facelift surgery.
- The need for revision surgery of a minor or major nature.
Just as you would discuss potential benefits before surgery, it is always advisable to ask your surgeon to address the potential risks as they apply to you. Your surgeon can also advise you on how to avoid or minimise some types of risk.
Facelift Cost OverviewClick to expand
Some Australian private health insurers may help pay for the hospital bed and theatre fees. Getting a doctor’s referral will enable you to make a claim on these costs.
Your surgeon will help you estimate potential costs after a consultation. The cost of a facelift will depend on the type of facelift you have. Once that is decided, costs will also vary depending on the surgeon and the hospital used. Your surgeon will help you estimate potential costs after a consultation, but here are some guidelines:
- An endoscopic facelift will cost around $12,000 (AUD). This includes the surgeon’s and assistant surgeon’s fees, fees for the anaesthetist and the hospital costs.
- A short-scar facelift costs around $12,000 (AUD), which includes all associated costs.
- A deep plane facelift cost will vary depending on the surgeon you choose, the hospital used and the exact procedure that is performed. Expect the surgery to cost in the range of $20,000 and $30,000 (AUD) including the surgeon’s and assistant surgeon’s fees, anaesthetist’s fee, hospital facilities and services and the cost of follow up visits.
You should expect the costs to be higher if you are having combined procedures at the same time. For a more detailed look at the costs associated with facelift surgery in Australia, read our article What Does a Facelift Cost in Australia?
This information is correct as of 2016.
If you have more questions, Costhetics recommends that you contact us or a surgeon listed below.