What is a face lift and neck lift surgery?

A face lift and/or neck lift (rhytidectomy) are procedures that can be used in isolation or combination to help improve signs of aging in the face and neck and give you a more youthful appearance. In particular, they can diminish the appearance of deep facial lines, jowls, platysmal bands and sagging of the facial and neck skin and fat.

Who is a good candidate for face lift and/or neck lift surgery?

Face lift and neck lift surgery is a highly individualized procedure. Your plastic surgeon will meet with you in consultation and review your concerns and desired changes as well as your medical history to determine whether a face and/or neck lift surgery is the right procedure for you. Physical conditions such as high blood pressure, diabetes, smoking, kidney disease, heart problems, and other serious conditions will be assessed.

What is done during face and/or neck lift surgery?

Face and/or neck lift surgery is performed as an outpatient procedure and you will go home the same day of surgery. The surgery is performed under general anesthesia. Depending on your discussion with your plastic surgeon and desired effect, your procedure may involve a traditional face lift, limited incision face lift, and/or neck lift.

A traditional face lift incision extends from the hairline at the temple, around the ear, to behind the ears. Alternatively, the limited incision face lift starts lower in the temples and continues around the ear. The neck lift incision begins in front of the ear lobe, continues around the ear, and ends in the lower scalp. An additional incision under the chin may be used to enhance the neck lift results.

The skin is then lifted to reveal the underlying tissues. Fat may be removed and/or redistributed from the face and neck. Commonly, the underlying muscle layer is also tightened to lift the sagging tissues. Excess facial and neck skin is then trimmed and redraped to create a more youthful and natural appearance. Finally, the incisions are carefully sutured back together and hidden in the hairline and natural curvature and lines of the face and neck.

Where is the surgery performed?

All surgeries are performed at Women’s College Hospital as day surgery by the plastic surgery senior resident under the supervision of a faculty plastic surgeon.

What to expect in the recovery? How long will I be off work? When can I resume exercise?

After the procedure, a dressing is applied around the face to reduce the amount of swelling. A small plastic drain may be placed under the skin to help remove any excess fluid or blood and prevent accumulation under the skin. This drain is typically removed within 24 hours. The procedure is performed as “day surgery” and patients can expect to return home on the same day as their procedure is performed after a short recovery in the postoperative area.

Most of the bruising and swelling will subside within 10 days. Some residual, minor swelling may be present for 6 to 12 weeks following surgery. As such, some patients choose to take 1 to 2 weeks off from work, after which they may resume work and light activities. Patients are instructed to refrain from heavy lifting and exercise for at least 4 weeks. It may take up to 6 months for scars to mature and decrease in redness. During this time, it is important to be vigilant about sun protection as sun exposure can darken scars. Your surgeon will discuss with you other techniques to lessen the appearance of scars. While the best attempt will be made to hide the incision, a slight scar may be visible in or around the hairline in the temple and/or behind the ear.

Patients typically do not experience significant pain following a face lift but may notice some discomfort and sensation of tightness in the face that will improve with time and as swelling decreases.

What results can I expect from the surgery?

A face lift can help rejuvenate your face by decreasing visible signs of aging in the face and neck which may include deep lines below the eyelids and from around the nose to the corner of the mouth, sagging skin and fat, jowls, and loose skin and fat in the neck. A face lift does not lift the eyebrows or eyelids. These changes can be accomplished by a brow lift and blepharoplasty, respectively. The results of a face lift are permanent. However, a facelift does not stop the aging process.

What are the risks and possible complications of the surgery?

As with any surgery, there are some common complications that may occur. These include bleeding (hematoma formation), infection, poor wound healing, unfavorable scarring, pain (that may persist after the incisions have healed), hair loss at the incisions (scar alopecia), facial asymmetry, facial nerve injury resulting in weakness or asymmetry of the face, skin loss, numbness/skin sensation changes, and the need for revision surgery.

When will I see the final results of the surgery?

Healing after face lift and/or neck lift surgery is a gradual process. The incisions typically heal in 2 weeks and most of the swelling and bruising have resolved by 2 weeks following surgery. Some mild swelling may persist for several months, and it may take up to a year for your results to fully appear.