The Face Lift
The face lift both improves wrinkling caused by loose skin and lifts or tightens the fatty face and neck tissues, which tend to sag increasingly with advancing years.
It has become the second most popular cosmetic operation because, as life spans increase due to medical advances combined with better nutrition and exercise, many aging men and women find that they look older than they feel.
The operation may be done for two reasons:
- to slow the advance of aging, helping relatively young individuals, say forty or younger, appear to stay young; or
- to help one who is already well wrinkled to appear younger.
The amount of improvement from surgery depends on the degree of wrinkling. If wrinkling is significant, results may be dramatic. If sagging is just starting and the operation is an attempt to keep the patient looking young, the improvement may be more subtle, causing friends to remark that the patient looks “less tired” and “more alive.”
The greatest benefit of the face lift—one that justifies the procedure being performed on patients in their forties as part of a preventive maintenance program—is that the patient can maintain a youthful appearance for the rest of his or her life simply by having periodic “tuck-ups” every few years, as is done by Hollywood personalities. These relatively minor procedures are usually followed by very little swelling and discoloration. However, they cannot be done without the initial face lift.
In the majority of cases, the face lift result will last from six to ten years. Although no operation can permanently prevent aging, the individual never looks as old as he or she might have if the operation had not been done. The actual duration of improvement cannot be predicted accurately, but depends upon the skin condition of each patient. If the skin’s degenerative process is very rapid (often a result of tobacco, alcohol, or excessive sun exposure), wrinkling and sagging will occur more quickly.
The face lift operation is performed in our office surgical suite under “twilight” anesthetic, supplemented with local anesthesia along the incision lines. Patients generally go home the same day.
Hair is never cut or shaved in the temporal region or behind the ear in preparation for surgery. The procedure consists of redraping and tightening facial tissue and removing excess skin. A pressure dressing is applied after surgery. Hair may be washed two days later. Staples in the hairline are removed seven or eight days after surgery. Stitches along the ear-facial line are removed after four or five days. Hair usually covers the resulting thread-thin scars immediately.
In some people, fat gradually develops below the chin to make a “double chin.” This mound of fat obliterates the ideal chin-neck line and contributes to the appearance of aging. Other people have “turkey gobbler” necks, consisting of fat and loose skin that runs from the chin to the base of the neck.
Most double chins may be effectively improved or eliminated with supplemental liposuction. A short incision is made in the crease below the chin, excess fat is removed, and the skin of the upper neck is tightened. There is negligible postoperative discomfort, and the scar becomes obscured.
When supplemental liposuction alone is insufficient, a face lift may also be performed. This is particularly appropriate for sagging jowls or a “turkey gobbler” neck. The face may seem tight for a while after the bandages are removed, but it softens with time. The face does not, however, appear “stretched” or “plasticized.” In a short time, the scars become inconspicuous except on close scrutiny.
Finally, it should be understood that the face lift operation will not eliminate small vertical creases about the lips, bulging or excess eyelid skin, or horizontal forehead creases. These areas require separate procedures that may be combined with the face lift.