1) “If I have a facelift will I look pulled or too tight?”
Before and After Photos
Will I still look like “me” after cosmetic surgery? Many of our patients report that, upon return to work and routine daily activities, friends and acquaintances make the following remarks: “Gee you look great. Did you change your hairstyle?” or “Have you been on vacation?” Retaining your uniqueness is the sign of a successful procedure. Although the change may be significant to you, it’s not uncommon that friends and family don’t really notice the specific changes unless patients request dramatic changes.
2) Yes, but I want to dramatically change the appearance of my face.
This is an excellent question because it leads to evaluating realistic expectations and, of course, can only be answered on an individual basis. For some patients who “want to look like someone else,” this request can potentially raise a red flag to find out more about their motivation and self esteem. However, the patient in the before-and-after photograph knew from the time of own youth that her mother and aunts appeared older than their age. Her situation was one of genetics, and she knew no matter how well she cared for her skin and body, the signs of premature aging were all around her. As a result, she wanted a dramatic change with her expectations and motivations well thought out and very realistic.
One sign of a good surgeon is one who can tell the difference between realistic and unrealistic expectations and one who will be truthful about meeting each patient’s desires. Our biggest referral source is from satisfied patients – ones who have had realistic expectations and were satisfied with results.
3) Do you tighten the muscles?
We’re always glad to hear this question because it shows that patients are doing their homework. Yes, the relaxed muscles are “tightened” under the skin and the excess skin is removed. Tightening the muscles eliminates the “turkey wattle” (that floppy thing that hangs down on a turkey’s neck) and results in a more youthful appearance. Because of the elasticity of skin, if only the excess skin were removed, the benefits of a facelift would be very short-lived – about six to eight weeks. Successful facial reconstruction involves both muscles and skin.
4) How long will my facelift last?
As with facelifts, the longevity of the benefits is dependent on several factors. For patients who do not smoke, do not abuse the sun, are in good general health and have good genetics, a facelift can last upwards of 10 years. For patients who elect to abuse their skin and body, a facelift will only last up to five years. Don’t forget – attention to your general health plays a significant roll in a younger appearance.
5) Will a facelift help the dark circles and bags under my eyes?
If you have dark circles and bags under your eyes, you are most likely hoping for the benefits of a blepharoplasty (eyelid tuck) which often uncovers hidden beauty of the eyes. A facelift may provide some improvement, however, it will not meet the expectations of most patients whose primary concern is the bags under or dark circles around the eyes. It is most common that patients with these two concerns, have a combination of procedures which may include facelift, blepharoplasty (eye tuck), skin resurfacing. Keep in mind that a facelift does not address the surface or textural changes (such as fine wrinkles) in the skin.
6) Do I need a chin implant?
It is not uncommon for patients who are learning about facelifts to gain an appreciation for the underlying principles of beauty, including symmetry and balance. One of the benefits of computer imaging is the ability for the surgeon to give you a good idea ahead of time about the overall balance of your face, including whether you are a candidate for a chin implant would look. If your chin appears balanced with the forehead and face, you do not need to consider a chin implant.
7) What about my droopy double chin and jowls?
Most patients undergo neck liposuction at the same time as facelift. This has several advantages. It allows us to use the fat in another area for cosmetic enhancement (such as for lip augmentation) while simultaneously reducing the bulky area around the neck. Removing the excess fat under the chin and neck results in a more defined neck line. Tightening the muscles as well as the skin eliminates jowling resulting in a more clearly defined jaw line.
8) Will a facelift get rid of all my wrinkles?
As we age, our skin looses its elasticity. A facelift is most often performed to “lift” and remove sagging skin and as a result eliminate some wrinkles. Some of the deepest lines (such as the frown lines between the eyes that are improved with a Brow Lift) may not completely resolve but they will be significantly improved. Further improvement can be achieved with <Skin Resurfacing> such as CO2 laser. Fillers such as Fat Injections can improve wrinkles and are particularly effective on laugh lines or smile lines.
9) I had a facelift somewhere else and I don’t like my result. Can you “fix” it?
Although patients may want immediate adjustments to the original facelift, patients should wait one full year before undergoing revision facelift.
First of all, final results of facelift are not evaluated until one full year postoperatively. It takes a year for postoperative swelling to subside and healing to be complete. Changes, however subtle, continue throughout the 12-month course following facelift. As time goes by, the face gradually looks different. Features refine as the swelling resolves. These refinements sometimes are enough for a result to be deemed acceptable.
A second consideration is scar formation. Revision facelift is challenging enough without battling through scar tissue that has not matured. Scar tissue is somewhat more compliant in the hands of the surgeon when it has been allowed to soften over time. Even after a year the presence of scar tissue makes revision surgery more complex.
If a surgeon recommends revision facelift at less than one year, at the very least obtain a second opinion. Give your facelift every possible opportunity to “settle” and refine before undergoing another surgery.
10) Why is a revision facelift more difficult than a first-time facelift?
Many reasons. First, after any surgery, scar formation creates a thick, tough layer that is more difficult to work with than original tissue. Second, the original location of (anatomical) landmarks have been altered. Third, the overall skill level required to perform a successful revision facelift is greater. Revision facelifts can take a little longer because of corrections that need to be made as a result of the initial surgery. It is best to provide a patient with a realistic picture of exactly what can be accomplished prior to undergoing another surgery. Revision facelifts have humbled even the most experienced facial plastic surgeon…and at the same time have been the most rewarding.
11) How much pain will I have?
Most patients who have facelift surgery say how surprised they are at how mild the discomfort is that they experience. Patients more typically complain of tightness from swelling or a pulling sensation under the chin. Understandably, after any surgical procedure, some discomfort can be expected. All patients are provided with prescriptions for pain medication. Patients sometimes use the prescription medication two to three days after surgery and then switch to Extra Strength Tylenol. It is uncommon for patients to report unmanageable pain after surgery.
12) Tell me about the numbness associated with a facelift.
Numbness, especially near the incision lines, is most noticeable in the immediate postoperative period. Many patients report resolution of numbness within about six weeks following facelift although patients are told to expect it to lasts up to three months.
13) Will I be awake during surgery?
Using IV sedation (medicine administered through an IV) and a local anesthetic (numbing medication administered in the operating room), patients are asleep during surgery. Patients do not hear or feel anything and are comfortable during the operation. Patients wake up very soon after the surgery is completed. Intravenous sedation is a type of anesthesia; therefore all patients must have a responsible adult to stay with them through the night following surgery. Patients may not drive for 24 hours after their procedure and this time may be longer, depending on the procedure.
14) Do I go home after cosmetic surgery?
Yes, most facelifts are done on an outpatient basis. Because you will go home after receiving sedation, you will need to make arrangements for a responsible adult to drive you home, to stay with you overnight and to drive you to our office for your first postoperative appointment. Your first appointment is usually early in the morning the day after surgery.
15) When can I go back to work?
Restrictions from work are generally two weeks for facelift surgery. Because initial surgery swelling may still be present, some patients take three weeks off to be safe.
16) When can I “work out?”
Aerobic activities should be avoided for three weeks following surgery. Any activity that potentially increases blood pressure will increase the amount of time it takes for postoperative swelling to resolve.
17) How long will bruising and swelling last?
Postoperative bruising and swelling begins to resolve at the end of the first week. Full resolution of bruising or swelling may take two to three weeks. However, you may camouflage bruises fairly easily at seven to ten days with concealer stick.
18) I really want to do this but I’m nervous. What if I get stressed?
It’s ok to be nervous. (Frankly, we would be nervous if you were taking this step lightly!) One of the best ways to deal with nervousness is to see what other patients have gone through. Take a moment to look at Before and After Photos. Check out our board certifications in Selecting a Surgeon. Remember, an educated patient knows when and if the time is right to proceed.