Facelift / Necklift Surgery

Facelift and necklift surgery can be one of the most exciting and satisfying surgeries cosmetic surgeons perform. It is the mommy makeover for the face. Common complaints from patients who seek facial rejuvenation surgery include, “ I look tired, I look older than I feel, or I simply want to look younger”. There are three components to the aging face, all of which should be addressed during rejuvenation surgery.

The first component is the underlying structures that support the face. That being the fascia and the muscle commonly known collectively as the SMAS or superficial muscular aponeurotic system. This structure is the main underlying component altered during most commonly performed facelifts. Some surgeons simply tighten the smas while others perform a deeper dissection known as a deep plane facelift which adds additional tightening to these tissues without having a stretched or pulled look. The second component of aging is the skin. The skin is the canvas that we all see, and environmental factors and genetics play a key role in how the skin ages. Also skin types, such as scandinavian, or skin of color, age differently, and will be treated differently during the rejuvenation process. Volume is the third component to restoration of the aging face. Temporal areas hollow out, while jowls, often have more than a desired amount of fat. By performing liposcupture, liposuction, and fat grafting a more natural, pleasing lift can be accomplished.

A facelift-necklift helps improve the most visible signs of aging through removal and redistributing excess fatty deposits, tightening underlying muscles, and removing sagging skin. The standard facelift addresses the lower 2/3 of the face and the neck. Muscle tightening in the neck (the platysma) improves the effects of facelift surgery.

*Photo(s) provided by AACS Member Kevin S. Duplechain, MD, FACS

Who is a Candidate for a Facelift / Necklift?

• Individuals with jowl formation (the lower cheeks and jaw line are saggy)
• Individuals with a poorly defined jaw line
• Individuals with wrinkled saggy and fatty nec

Intended Results of a Facelift / Necklift

• A sharper and better defined jaw line
• Improved neck and chin angle
• Less tired look with more youthful appearance
• This does not treat the lines around the mouth and will not improve skin surface defects and discoloration. This will be addressed by a simultaneous skin treatment such as laser resurfacing or chemical peeling.

Procedure Description for Facelift / Necklift

• Face lifts are performed in an accredited office facility, outpatient surgical facility, or in the hospital.
• They may be performed under local anesthesia with or without oral sedation, conscious sedation, and general anesthesia.
• The surgeon usually makes incisions in front and behind the ear. This should be discussed with your surgeon.
• Sutures and/or staples are used for closure followed by placement of an elastic dressing around the face and neck.

Recovery and Healing for a Facelift / NeckLift

• Recovery may be at home with a responsible adult, in a recovery facility, or overnight in the hospital.
• A compression garment may be worn around the lower face and neck for approximately one week.
• Bruising and swelling are normal and may take several weeks to resolve.
• Stiffness in the neck and some soreness with swallowing and eating is common.
• Sutures and staples are removed within 10 days .
• Drains, if used, are usually removed 1-3 days after the procedure.
• Makeup can usually be applied within 1-2 weeks following surgery. If skin resurfacing has been performed, typically a mineral make up can be worm within 2 weeks as well.

Other Options for Facelift / Necklift

• Chemical peels, laser resurfacing, and microdermabrasion to improve the skin appearance and texture
• Botulinum toxin and fillers
• Lipotransfer and implant insertion to restore lost volume
• Eyelid and forehead rejuvenation
• Rhinoplasty

Notes

The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation with your cosmetic surgeon. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.

Reviewed by J. Kevin Duplechain, MD, FACS