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Face-Lift (Rhytidectomy)

Surgery Overview

A face-lift is the most extensive way to remove or reduce the appearance of wrinkles and sagging of the face caused by age. In a traditional face-lift, the skin is literally lifted off the face so that the skin and the tissues beneath can be tightened and the skin can be repositioned smoothly over the face.

For the procedure, you are either given general anesthesia or a sedative through an intravenous line and local anesthesia to numb your skin. Next, the surgeon makes an incision that starts in the temple area and circles around the front of the ear. The skin is raised, and the muscle and tissue underneath is tightened. The surgeon may remove some fat and skin. The skin is then redraped over the face and the incision is sutured. The incision usually falls along the hairline or in a place where the skin would naturally crease so that it does not show after the surgery.

Some people are able to have a limited-incision face-lift. This surgery uses shorter incisions at the temple and close to the ear. Sometimes an incision is made within the lower eyelid or under the upper lip.

A neck lift can tighten sagging jowls and loose skin under the chin. The incision starts in front of the ear lobe and goes behind the ear to the lower scalp.

The surgery usually takes several hours. You may be able to go home that day. But people sometimes spend one night in the hospital.

What To Expect After Surgery

Your face will be bandaged after the surgery. The dressings are usually removed 1 to 2 days later. If a drainage tube has been placed (usually behind the ear), it will also be removed 1 to 2 days after the surgery. Your doctor will remove your stitches in 5 to 10 days.

Your doctor may prescribe medicines to relieve pain after the surgery. Expect to have swelling and bruising of the face. Cold compresses can help relieve these side effects. Your doctor may instruct you to keep your head elevated and still as much as possible.

It is important to avoid smoking and even second-hand smoke for 2 to 4 weeks before and after surgery. Tobacco smoke increases the risk for skin and tissue death and will delay your face's healing process and make scarring worse.

Most people can return to their normal activities 2 to 3 weeks after a face-lift.

At first your face will feel stiff and will probably look and feel strange to you. This is normal, but it is important to be prepared for it.

Numbness of the skin may last for months after the surgery. Your skin may feel rough and dry for a few months. Men sometimes have to shave in new places because the skin has been rearranged, but laser hair removal or electrolysis can be used for beard hairs that have shifted to a new position.

Why It Is Done

Face-lifts are done to make an older face look younger by eliminating wrinkles, lifting sagging muscles, and tightening the skin.

How Well It Works

Having a face-lift can make your face appear younger and healthier. Your face will continue to age, but a face-lift does indeed "take years off" your face. For some people, this may increase self-confidence and reduce anxiety over growing older.

A face-lift can reduce signs of aging to a great extent. But it cannot reverse sun damage to the skin or remove all facial wrinkles around the eyes, below the nose, and around the lips. For best results, you may want to have a face-lift and then treat any skin damage.

The effectiveness and safety of your face-lift surgery depends heavily on the skill of your surgeon.

Risks

Problems that may be caused by having a face-lift include:

  • Reactions to the anesthesia.
  • Bleeding under the skin.
  • Infection.
  • Damage to the nerves that supply the muscles of the face. This can cause paralysis or spasm in the face, but the effects are usually temporary.
  • Numbness (in areas of your face) that may last 6 months to a year.
  • Hair loss (alopecia).
  • Tissue loss.
  • Scarring.
  • Blood clots in large veins traveling up to the heart and lungs (pulmonary embolism). This is not common.

As with all cosmetic procedures, there is also the risk that the results will not be what you expected. But an experienced plastic surgeon can usually give you a very clear idea of what to expect after surgery.

What To Think About

As with other cosmetic procedures, you are more likely to be happy with the results of your face-lift if you have clear, realistic expectations about what the surgery can achieve and if you share these with your plastic surgeon.

Insurance companies do not cover the costs of face-lifts. It is important to find out what the total costs of the procedure will be, including fees for the operating facility, the anesthesiologist's and surgeon's fees, medicines, office visits, and other services and materials.

Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.

Credits

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Keith A. Denkler, MD - Plastic Surgery
Last Revised July 31, 2012

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