By Elizabeth Anthony

A particular line from the movie “Steel Magnolias” has always stuck with me. It is when Truvy, played by Dolly Parton, says “Honey, time marches on, and eventually you realize it’s marching across your face.”

Upon reaching a certain age, who of us has not felt just that way? After a lifetime of cleansing, toning, exfoliating and creaming with all the latest and greatest products, eventually it happens -— looking in the mirror, we see (gasp!) our mother staring back at us and realize that not only did we inherit her winning personality, we inherited her hooded brow as well.

Along with genetic traits, many external factors take their toll on our face. Photo-aging from sun exposure, repetitive facial expressions, the pull of gravity, sleep lines and smoking can all cause premature aging of the skin, leaving us to wonder “What can I do?”

 

WHY A FACELIFT?

“A facelift is the most extensive way to remove or reduce the appearance of wrinkles and sagging of the face caused by age,” says WebMD. “The skin is literally lifted off the face so that the skin and the tissues beneath can be tightened and the skin can be repositioned smoothly over the face.”

Designed to improve the lower two-thirds of the face, a facelift is usually performed in conjunction with a forehead, or brow, lift. A forehead lift can help alleviate deep wrinkles and creases across the forehead. On younger patients, it is also helpful in correcting lowbrow and other related problems.

One reason many people give for wanting a facelift is that their facial features do not reflect their energy level and youthful spirit. A facelift can bring into alignment how you look with how you feel, adding pleasure to daily routines. In today’s youth-oriented culture, it can also add years in the field of your chosen occupation. Keep in mind that while helping to eliminate wrinkles, a facelift will not change your skin’s overall texture.

 

AM I A CANDIDATE?

A facelift is an excellent choice for anyone interested in improving facial contours, tightening skin, removing excess fat, tightening muscles or smoothing lines and wrinkles to create a more youthful appearance. It is important that a patient have good mental and physical health and realistic expectations. A face- lift is not meant to be a method of completely altering the appearance and will not help solve personal or psychological issues.

 

PREPARING FOR SURGERY

The most important aspect, as with any surgery, is good overall health. Keep in mind that certain medications must be either avoided or adjusted before surgery. Smokers should quit before surgery because of possible wound complication issues and delay in healing,  and blood pressure should be well controlled.

 

Pre-Operative Consult

One of the most important decisions leading up to the decision to have a facelift is choosing a surgeon. Always choose a surgeon who is certified by the American Board of Plastic Surgeons. Make sure he or she is trained and experienced in all areas of plastic surgery and has at least five years of surgical experience, no less than two being in plastic surgery.

Your personal consultation is an opportunity to interact one-on-one with your surgeon. This is the time to ask and answer questions, allowing him or her to set up a game plan for the best outcome of your surgical experience. In addition to evaluating general health status including pre-existing conditions and risk factors, he will be examining your face, including skin texture and elasticity.

Photographs will be taken for your medical records, options will be discussed and a course of action will be recommended. Likely outcome, risks and potential complications associated with your surgery will also be addressed at this time. Be ready to discuss any medical conditions you may have or medical treatments you are undergoing as well as drug allergies and previous surgical history.

Make sure to be clear about your surgical expectations and desired outcome.  Your consultation is the time to ask all questions you may have and to have them answered to your satisfaction.

 

THE PROCEDURE ITSELF

The surgeon begins the incision in the area of the temple, just above and in front of the ear, and continues around the earlobe, circling the ear before returning to the point of origin in the scalp. Raising the skin outward, the surgeon will then reposition and tighten underlying muscle and tissue as well as removing excess fat and skin. For men, the incision will align with the natural beard line. In any case, incisions will fall into a natural crease of skin, thereby camouflaging any scars left by the incision. The incision is then closed with fine sutures and/or metal clips, allowing for surgery without the necessity of shaving the patient’s hair.

Taking anywhere from 2 to 4 hours, the patient’s discomfort level is minimal using a combination of sedatives, local anesthesia and a mild intravenous anesthesia. Another option used by surgeons is general anesthesia. After surgery, the affected area is dressed to protect the incisions.

 

Post-Operative Issues

In most cases, a facelift is performed on an outpatient basis with no hospital stay required. Pain is surprisingly minimal and can often be controlled with Tylenol. Most swelling is seen within 24 to 48 hours after surgery and bruising normally resolves within two weeks. You may experience some numbness which should resolve within a few months. Once the dressings are removed, puffiness may be more pronounced in some areas more than others but don’t be alarmed —- this is normal.

Avoid bending, lifting and straining during the early period of recovery. Smoking should also be avoided to prevent delays in healing. Most stitches are removed within a week of surgery and concealing makeup is usually permitted after the first week. Your surgeon will give specific instruction on caring for incision sites, specific concerns to look for and when to follow up. It may take several months for all swelling to resolve and up to six months for scars to fade.

The results may be anywhere from subtle to dramatic and, since the healing process  is gradual, you can expect to wait several weeks to get a clear picture of your new look. Minor changes may occur over the first few months following a facelift. Although results will last for years, you will continue to age. Some people only have one facelift in a lifetime, while others have a second surgery in 7 to 15 years.

 

HOW MUCH DOES IT COST?

Since cosmetic surgery is considered elective and is not covered by insurance, cost is always a consideration. Although prices vary considerably, the average cost nationwide is around $6000. Be sure to ask your surgeon if he offers a finance plan; many do.

 

ADDITIONAL PROCEDURES

Other procedures may be recommended during your facelift consultation. As discussed previously, a facelift is usually done in conjunction with a forehead lift to create a pleasing overall appearance. Other procedures recommended could include facial implants, rhinoplasty (nose surgery), soft tissue augmentation or eyelid surgery. Your surgeon can provide details and help you to decide which procedures might be right for you in putting your best face forward!