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The facelift continues to be the key procedure of facial rejuvenation for many patients. It counteracts many of the signs of facial aging but is especially effective in combatting the effects of gravity. In particular, a facelift improves the appearance of the midface/cheek area as well as the jowls and the neck by resuspending sagging fat pads, muscle and skin. The faceliftprocedure is designed to re-establish the natural contours of your skin and facial structures, giving a smooth youthful appearance. You, the way you used to look. Dr. Murphy performs a two-layer facelift, suspending and tightening the deep structures and then re-draping the skin, achieving a natural, aesthetically pleasing and long-lasting result. A facelift may be performed alone or, as is more frequently the case, combined with other rejuvenative procedures. The procedure is typically performed under intravenous sedation with local anesthetic. Although most patients prefer to go home following facelift surgery, you may elect to stay the night in the hospital.
Am I a good candidate for a facelift?
The best candidates for a FACELIFT have fairly advanced sagging of the midface and lower face structures, including excess skin of the neck with some banding of the underlying muscle in the neck. You may have noticed some deepening of the folds along your medial cheek or deepening of the marionette lines which radiate down from the corners of your mouth. A lot of patients who have facelifts complain of looseness of the skin of their cheeks.
What if I am a smoker?
Typically smoking is a reason not to have a facelift. Patients definitely will get their best result if they are not smoking. Some of the chemicals in cigarette smoke cause the small blood vessels to shrink up, which leads to compromised blood flow to the skin flaps created during the procedure. This increases the risk of areas of skin loss and scarring with a facelift. You should refrain from smoking for up to six weeks prior to a facelift.
Is it safe to have laser resurfacing of the facial skin at the same time as a facelift?
In some patients judicious use of the laser at the same time as a facelift is acceptable. It is quite common to fairly aggressively laser more central areas of the face, such as lip lines or wrinkles around the eyes at the same time as the facelift. Areas closer to the facelift incisions are lightly treated to feather the edges. Dr. Murphy uses the newest Erbium laser to treat these areas because he can safely determine the depth of the treatment down to the micron.
What won't a facelift improve?
A facelift won't help improve eyelid issues or any low position of the brow. Although deeper nasolabial folds or marionette lines will be greatly improved with a facelift, it is not uncommon to transfer fat into these areas to optimize the look. Lip lines may also require an additional treatment such as resurfacing with the laser or fat transfer to smooth them out.
What other procedures are commonly performed at the same time as a facelift, and is it safe to combine procedures?
The concept of full facial rejuvenation has led to the frequent combination of procedures during one surgery. Procedures commonly performed along with a facelift include brow and eyelid lifts as well as laser resurfacing and fat transfer. Combining these procedures in an educated and experienced fashion is going to lead to the result which best reveals and restores the patient's beauty with a sense of facial harmony. Only surgeons as experienced as Dr. Murphy can safely bring together the combined procedures ideally matched to meet the desires of the patient. |
My dermatologist tells me that I don't need a facelift, and he can get the same result with a procedure done in his office under local anesthesia with no recovery and for a lot less money. What about that?
This brings to mind the idea that if it sounds too good to be true it probably is. Dr. Murphy has spent years scrutinizing each new "non-surgical" facelift that has come out. Certainly some of them have offered a degree of improvement in some patients. You as a patient must also evaluate these offerings. If you are willing to accept a lesser degree of improvement, or in some cases no improvement, then you may want to go ahead. And don't forget some of these procedures aren't particularly inexpensive. Many of them cost thousands of dollars and have not been proven by the test of time. As a plastic surgeon, Dr. Murphy prefers to offer his patients time proven procedures, many with minimal recovery time due to refinements in technique, at reasonable costs. This has led to many happy patients who have returned for additional procedures or have referred family and friends. As a respected surgeon in the community, Dr. Murphy cannot afford to have unhappy patients because they have overpaid for a procedure that didn't work or offered only fleeting improvement in their appearance. Where are the incisions, and will I need to have sutures removed?
Incisions are typically made in the hairline above and behind the ear. Facelift ncisions go around the ear and dip inside the ear in the front to help break up the suture lines. Occasionally incisions are made along the hair line rather than in the scalp to help maintain as much sideburn as possible. This decision is made based on the anatomy and the desires of the patient. Some patients require an incision beneath the chin to allow access to the neck area to tighten up the muscles in front. Stitches in front of the ear are removed after five or six days and skin clips in the scalp are removed in approximately ten days.
When will I be back out in public?
The recovery and return to activity after a facelift is determined by how you look rather than how you feel. There certainly is some discomfort over the first few days, but it is quite easily controlled by the prescribed pain medication. Your return to your normal activities is more determined by swelling and bruising and by your personal feelings about how you want to look as you venture forth. A lot of the swelling will be resolved within eight to ten days, which is when most patients resume more normal activities. Bruising generally resolves in three weeks but it can be fairly easily covered with make-up prior to total resolution. Many patients prefer to wait until the bruising has disappeared before attending any major social events, or if they want to look their best before being seen by their friends.
Will my friends notice I have had a facelift?
Dr. Murphy's frequent answer to this question is, " I hope so." Of course the degree of change in your appearance after facial rejuvenative surgery depends on how aged your face and skin are prior to the surgery. The ultimate goal is that you look like yourself, just more youthful or rested. Patients often report to Dr. Murphy that their friends tell them that they look rested or rejuvenated.
What are the possible complications of a facelift?
Infection or bleeding rarely occur, infection being particularly rare. Numbness over the cheek and neck areas is common after a facelift and usually resolves over a period of months, although it is not uncommon to have some fairly minimal permanent numbness along the areas of the incisions. Permanent numbness of larger areas, in particular of the ears, occurs less that 1% of the time. Other nerves which can be injured during a facelift are those that go to your muscles of facial expression. Dr. Murphy has had a few patients over the years who experienced slight temporary weakness of the facial muscles to the upper lip areas that has taken a couple of weeks to resolve. Dr. Murphy's patients have never had any permanent weakness, although it is reported at 1-2% in the literature. Smokers are at increased risk of areas of poor healing that may lead to poor quality scars after a facelift. It is not uncommon to have areas of temporary hair loss around the incisions as the hair follicles go into a resting phase, but the hair regrows over a period of months. How long will my facelift last?
The length of time that patients enjoy a satisfactory improvement after a facelift depends on many factors such as the quality of their skin when we start, including the degree of sun damage or loss of elasticity. Smokers typically have the worst quality skin. Older patients will see an earlier return of laxity, while younger patients will see more long-lasting improvement. It is unusual for a patient to return less than ten years after a facelift. Are their any differences with men having facelifts?
Definitely. At the time of facelift surgery we need to take into account a number of anatomic differences between women and men to assure the best result. Due to the vascularity of the beard, men are at slight increased risk for bleeding but they also seem to heal a bit more quickly, with less bruising and quicker resolution of swelling. Facelift incisions need to be different to avoid hairy ears. There are issues regarding shaving after facelift surgery due to mobilization and repositioning of the hair-bearing cheek skin. These issues are emphasized during Dr. Murphy's consultations with men who desire the improvements facial plastic surgery can offer. |
