What is a Facelift?
A Facelift, also called Rhytidectomy, is a plastic surgery procedure which tightens wrinkles and sagging skin on the face and neck. The goal is a natural, refreshed facial appearance which helps you look younger, not ‘done.’ There are several versions of a Facelift and they generally refer to what part of the face is being rejuvenated by lifting and dissecting of the tissues. In addition, structures of the face can be rejuvenated with fat injection. Types of facelifts include:
- Brow lift
- Mid Facelift
- Lower Facelift
- Full Facelift
- Fat transfer to face
What concerns does the Facelift address?
I feel invisible and want to do something that makes me look more vibrant
-a Baltimore patient
The Facelift procedure can address concerns in the upper, mid face, and lower face. The symptoms include the following:
- chronically tied look, even though you feel rested
- loose hanging skin, and the appearance of a 'thin face' relative to the body
- turkey neck
- hooded upper eyelids
- loss of bone structure and definition of cheek bones, which you had in youthful years
- loss of skin elasticity in the face
How is a Facelift performed?
There are actually many different types of facelifts and the results are heavily dependent on the surgeon's assessment during consultation and techniques during surgery.
"More and more plastic surgery savvy patients come to my office asking for a specific procedure. So which kind of Facelift should you get? The one that fits YOU best, even if it doesn't have a catchy name!" ------ Dr. Ricardo Rodriguez
During your initial Facelift consultation, it is important for you to explain just what looking younger means to you. To help us determine which procedure or combination of procedures might best produce the desired results, there has to be a good understanding between surgeon and patient. Depending on the desired changes you express, your consultation may discuss the following facelift procedures:
1) Brow Lift
The Brow lift will lift the brow and the upper eyelids to give your eyes a refreshed and rested appearance. It will remove wrinkles from the brow, so that you no longer need injectables such as Botox. It is a great alternative to the upper eyelid lift.
2) Mid Facelift
A Mid Facelift is a surgical rejuvenation of the cheekbone and lower eyelid area. This can be done by surgically lifting the structures in the mid face region. This can also be performed along with Fat transfer to the cheek bone and lower eye lid area.
3) Lower Facelift
The Lower Facelift addresses loose skin in the jowl and neck area. This procedure involves tightening the skin of the lower face and neck. Patients interested in the neck only should consider a Neck lift procedure.
4) Full Facelift
A Full facelift is a surgical transformation of the forehead, upper and lower eyelids, mid face, and the lower face and neck. It usually involves a Brow lift, Mid facelift and Neck lift. In the past few years, I have been complimenting these techniques with fat injections to additionally provide volume to the dermis layer. The effect of this is to provide more fullness and youth to thin aging faces. I have found that many facelift patients who undergo a fat transfer during their procedure usually notice an improvement in their skin texture which results in more youthful, glowing skin.
5) Fat grafting
You may be hearing a lot about regenerative fat grafting or the term stem cell facelift. We don't particularly like the marketing term 'stem cell facelift,' but the truth is that your own fat does contain a population of adipose stem cells. This has been known since 2001, when the first isolation of stem cells from adipose tissue was performed by a team from University of Pittsburgh.
Adipose Stem Cells (ASCs) do have regenerative tissue capabilities and they are the New Frontier of plastic surgery. This is not a myth. Thousands of scientific publications have researched this topic over the past decade. It is a fact that adipose stem cells function to provide more blood supply to affected areas, by virtue of the fact that they act as pericytes to increase the density of blood vessels in the tissue.
When the procedure is performed correctly, regenerative fat grafting can provide a new source of blood supply for your existing tissue and skin. Thus, the fat not only adds volume to your face, but it also has these natural regenerative properties to help make your face look more youthful. Those stem cells explain why the skin of the face looks so much better after fat transfer. Learn more about regenerative fat grafting.
Type of anesthesia Used
To reduce the risk of pulmonary embolism seen in General anesthesia, Dr. Rodriguez uses only monitored IV sedation which is a milder form of anesthesia. With this anesthesia type, you are breathing on your own. There are no tubes down your throat or nose used with IV anesthesia. The IV is administered in your wrist. In addition, the anesthesia is administered by a board Certified anesthesiologist, so that you have the most qualified health care provider possible.
What are the preoperative requirements?
During your consultation with a board certified plastic surgeon it's important to discuss the surgical plan and review risks associated with the Facelift procedure. Your surgeon should also provide a copy of the ASPS informed consent so you can read it carefully in advance of your surgery. This document will list all the possible risks and complications. Preparations for this procedure involve the following:
- Quit smoking 3 - 4 weeks before the surgery so that healing is not compromised.
- Read the Informed Consent document which lists the possible risks and complications for the surgery. Make a list of questions.
- Stop taking multivitamins, herbals, and aspirin two weeks prior to surgery.
- Within 30 days of your surgery date, get a medical clearance for surgery with a physical examination (H&P) and CBC (anemia detection).
- Schedule a pre-op office appointment with the surgeon to review the surgical plan and sign the informed consent forms.
- Get all of your prescriptions filled out before your surgery date.
- Do not drink anything (NPO) after midnight the night before surgery.
Your procedure should be performed by a board certified plastic surgeon in an accredited surgery center. The most highly recognized accreditation agencies are Medicare, AAAASF, and JCAHO. Be sure that your facility is accredited by at least one of these organizations! In many cases, a facility will have accreditation from Medicare, and either AAAASF or JCAHO. Our surgery center is accredited by both Medicare and the AAAASF.
What is Facelift Post-Op recovery like?
The Facelift procedure is generally well tolerated with a period of 1 - 3 days of mild pain and discomfort immediately following surgery. Facelift patients will, however, need to be prepared for the swelling and bruising that can be present for up to 4 weeks.
- post op day 1-2 , drain removal in the office
- no driving for the first 4 - 5 days and refrain from heavy lifting or strenuous exercise for at least 4 weeks
- post op follow up: week 1, month 1, month 4
- return to work at week 3
- return to regular exercise week 4
- 90 - 95% of swelling is down by end of month 4, but final results are not obtained until end of 12 months
- majority of numbness will subside by 4 months, but there MAY be some residual numbness for 12+ months - do not be alarmed
What are the risks and possible complications?
The possible risks and complications should be discussed in your initial consultation and your pre-operative appointment with your surgeon. These risks are also part of the ASPS Informed Consent document, which you will be signing prior to your procedure. Be sure you understand the risks and make sure you are comfortable that your surgeon will 'work with you' if your ideal result is not achieved!
- skin necrosis
How much does a Facelift cost?
The cost of a Facelift depends on the areas selected for rejuvenation.
In 2020, a full facelift (Brow lift + Mid + Lower face), with a fat transfer, averages around $17,000 in total cost. This includes the surgeon fee, the operating room fee, the board certified anesthesiologist fee, and all follow-up visits. The Full facelift procedure is typically 7 - 8 hours in the operating room. If the patient concentrates on only the mid face region, this total cost ranges from $5,400 - $8,200, depending on the amount of time required in the operating room.
Price-shopping this procedure can be be quite tricky. Not all Facelifts are created equal and you can expect mini results from mini surgeries. The recent trend is to focus more on Fat grafting and less on dissection .
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Board Certified Plastic Surgery, ASPS Member
Patients depicted in our before and after galleries have provided their written consent to display their photos online. Every patient is unique, and surgical results may vary. Please contact us if you have any questions.