What is a Facelift?

A facelift is a surgical procedure designed to rejuvenate the face and neck. The operation consists of removing the excess skin and fatty tissue, and then lifting the sagging deeper tissues.

What are the limitations of the procedure?

Facelifts are not effective for correction of generalized face wrinkling. Dermabrasion, chemical peels, laser, or Visage resurfacing are better options for skin rejuvenation in this situation. This is particularly true for the fine wrinkles of the lips. A facelift also cannot remove the wrinkles caused by facial animation when muscles contract. After a facelift, the aging process will still continue at the normal rate; the procedure can be repeated to rejuvenate the effects.

Is there any preparation required?

There is always a possibility of excess bleeding during or after the operation. Therefore it is essential to avoid taking aspirin, anti-inflammatory drugs, or similar medication for two weeks before and after the procedure. No smoking, use of a nicotine patch, or nicotine chewing gum one month prior to surgery or 3 weeks afer surgery is required to prevent those toxic substances from depriving the skin of sufficient blood and oxygen; otherwise these can cause skin tissue death and bad scar formation.

How is a facelift performed?

The basic operation is designed to lift, stretch, and remove excess skin. There are many variations on the basic procedure. The standard incision starts within the temple hair, proceeds down in front of the ear and around the earlobe, then back into the hair at the nape of the neck. The skin of the cheek, upper neck and behind the ear is separated from the underlying tissue and stretched upwards and backwards. Any excess skin is removed, and the muscle in the upper neck is tightened. Any fat beneath the chin may be removed through an incision beneath the chin and liposuction, resulting in a small scar in this area.

The "Short Scar" technique favored by Dr. Horton is an evolution of the standard facelift procedure. This differs from the standard procedure in that there are no incisions behind the ear, so that you can wear your hair up without worrying about scars being revealed. This technique is frequently combined with the endoscopic browlift in which an endoscope (small camera in a tube) is inserted through small incisions in your brow to loosen and lift the eyebrows and smoothen the forehead. The forehead deep tissues can be moved upward and fixed to the bone, and frowning muscles between the eyebrows can be removed. The chief benefit of this procedure is that scars are minimal and sensation at the top of the scalp is maintained more-so than in the traditional facelift procedure.

What's the recovery period like?

There will be some pain or discomfort for a week or two following your surgery, and you will usually be prescribed some medication to manage this for the first few days. Most patients notice a dull, muscular-type ache or a burning sensation. You may experience numbness or discomfort for varying periods of time. You will have some mild bruising for two to three weeks and swelling that usually subsides in six to eight weeks.

Most people return to work in 2-3 weeks, depending on the extent of the surgery and type of work they perform. The majority of our patients are back to their regular activities in 4 to 6 weeks.

What about the scars?

Surgery is not possible without scars, but Dr. Horton carefully plans the incisions so that they lie in normal skin folds or are hidden by the hair or ear, making them as inconspicuous as possible. Your individual genetic healing characteristics will be the main factor in determining your scar appearance. In some patients the scars may widen, particularly behind the ear. Thick, raised, red "keloid" scars can occasionally occur.

What are the more common complications?

A facelift is a low risk procedure, but as with any operation there are certain potential problems. Nerve damage can occur, which may cause varying amounts of facial weakness or paralysis of the muscles that elevate the eyebrow, close the eye, or affect the smile. This can be temporary or permanent. As in all surgery, problems such as infection (requiring antibiotics) or bleeding can occur and require appropriate treatment including possible surgery. At times, fluid or blood may accumulate in the location of the operation which may require aspiration, drainage, or removal by surgery. There may be blistering, crusting, or skin tissue death (necrosis) with delayed healing in areas where the skin has been lifted and pulled tightly. This can result in prolonged recovery and exaggerated scarring.

There may be scattered areas of numbness over the face, forehead, scalp, neck, ears, and face following the surgery which may cause persist for an indefinite period of time. Rarely these sensory nerves may cause persistent pain in the skin or scar. Abnormal earlobe positioning can occur. Temporary or permanent hair loss around incisions may occur. Facial asymmetry can occur. Eyelid malposition may occur. Occasionally the scarring of the lower eyelid can pull the eyelid down and away from the eyeball (ectropian). Dry eye syndrome may occur. Any of these complications may cause permanent disfigurement and/or require subsequent surgical treatment.