As the face ages, gravity’s effects become more obvious. The earliest apparent change is loss of the cervical mental angle, the angle formed by the neck and lower jaw. As the neck skin becomes lax, it sags and gradually obliterates the youthful sharp angle. This condition generally has three components: a laxity of skin, a laxity of the underlying muscles (particularly the platysma muscles) and an accumulation of fat. Lax platysma muscles cause the bands in the front portion of the neck that often are seen in older persons. In the upper portion of the face along the jaw line, excess skin creates jowls. These jowls may be characterized by fat deposits. The folds that run from the nose to the jaw (nasolabial folds) also become more accentuated with age.
Surgery to improve the appearance of the aging face and neck is called a facelift. This procedure removes accumulated fat, repairs muscles that have stretched and removes excess skin.
While a facelift removes coarse wrinkling and sagging skin, it cannot remove the fine wrinkling associated with sun exposure.
The usual facelift incision is from the temporal hairline in front of the ear, around the earlobe, behind the ear and into the hairline around the back of the neck. Dr. Weisberg uses a “short scar” techniques in order to avoid the noticeable scars behind the ears, and to shorten the recovery time.
There may also be a small incision under the chin. This placement of the incisions restricts any scarring to less obvious areas. There have been recent improvements in the procedure to support the underlying facial structures, resulting in a more successful and longer-lasting outcome.
There is no special age for a facelift. A facelift may be desired whenever changes due to aging become bothersome to the individual. For some people, this occurs as soon as the cervical mental angle begins to fall. Others are not bothered until changes are more advanced and jowl formation or platysmal banding begins.
Patients often ask how long a facelift lasts. The answer is as individual as the patient. While surgery can turn back the clock, it does not stop aging. Facial aging will continue at the normal rate for that person. The average time before people begin to consider a second facelift is usually six to ten years. Many patients never have a second procedure.
In scheduling your surgery, we recommend that you allow four weeks for healing prior to any important function you plan to attend, in case your healing is slow or there is an unexpected complication. We recommend that you have any hair trimming or coloring done during the week before surgery. You should wait four to six weeks after surgery before coloring your hair again.
After surgery you will probably not be wrapped in a dressing. One to two days after, you will return for a checkup. You will see noticeable bruising and swelling. Your surgeon will let you know when you will be able to shower. All sutures are absorbable and placed under the skin surface, so that they don’t have to be removed. Before and after surgery we recommend that you consult with a makeup specialist about techniques to camouflage any remaining bruises. Most bruising will subside by 14 to 21 days after surgery. Swelling may take longer to disappear. Most patients are able to resume a normal level of activity within two to three weeks after surgery.
Possible risks associated with a facelift include skin damage in front of or behind the ear and damage to the nerves that move the face. Complications are rare and usually temporary. Skin damage, however, is more common in cigarette smokers.