A facelift (rhytidectomy) is a type of cosmetic surgery. It tightens and lifts loose, sagging skin in the face. It also helps reduce lines and wrinkles in the face. You may choose to have the surgery to improve your appearance. Discuss your treatment goals with your doctor. He or she can tell you more about what to expect.
Preparing for surgery
Prepare for the surgery as you have been told. In addition:
Tell your doctor about all medications you take. This includes herbs and other supplements. It also includes any blood thinners, such as warfarin, clopidogrel, or daily aspirin. You may need to stop taking some or all of them before surgery.
Tell your doctor if you smoke. Smoking can affect healing after the surgery. For better results, your doctor may ask you to stop smoking in the weeks before and after the surgery.
Do not eat or drink during the 8 hours before your surgery, or as directed by your surgeon. This includes coffee, water, gum, and mints. (If you have been instructed to take medications, take them with a small sip of water.)
The day of surgery
The surgery takes about 2 to 6 hours. You may go home the same day. Or you may stay overnight.
Before surgery begins:
An IV line is put into a vein in your arm or hand. This line supplies fluids and medications.
You’ll be given medication to keep you free of pain during the surgery. You may have general anesthesia, which puts you into a state like deep sleep during the surgery. (A tube may be inserted into your throat to help you breathe.) Or you may have sedation, which makes you relaxed and sleepy. With sedation, local anesthesia will be injected to numb the areas being worked on. The anesthesiologist will discuss your options with you.
During the surgery:
The doctor makes an incision on one side of the face. In most cases, this starts near the hairline at the temple. It travels along the front of the ear, and then behind it. It ends in the scalp. The same incision is made on the other side of the face.
Shorter incisions, or incisions in different locations may also be used.
The skin is lifted to expose the fat and muscle layers beneath.
Excess fat may be removed or repositioned for smoother contouring. The deeper muscle and tissue layers may be tightened and lifted with stitches (sutures).
The skin is pulled back down. Any excess skin is then removed.
The incisions are closed with stitches, staples, or surgical glue.
A small tube (drain) may be placed near the incision. This removes fluid that can build up after the surgery.
Additional procedures may be done at the same time for fat filling, recontouring, or soft tissue augmentation if you choose.
After the surgery
You’re taken to a recovery room to wake up from the anesthesia. You may feel sleepy and nauseated. If a breathing tube was used, your throat may be sore at first. If needed, you’ll be given pain medication to relieve any discomfort. Your face may be bandaged. And you may need to wear a compression garment around your head. An ice pack or cold compress may also be applied to your face. These steps help reduce bruising and swelling.You may go home the same day. Or, you may be moved to a room to stay overnight. When it’s time to go home, have an adult family member or friend ready to drive you.
Recovering at home
For the next few weeks, expect to have some pain, bruising, and swelling. Your doctor will tell you when you can return to your normal routine. Once at home, follow all the instructions you’ve been given. Be sure to:
Take all prescribed medications exactly as directed.
Apply an ice pack or cold compress to your face as directed.
Care for your incisions as instructed. This includes keeping your bandages and incisions dry when bathing or showering.
Wear your compression garment as directed.
For 10 days after surgery, always keep your head higher than your heart. For example, don’t stoop down to tie your shoes.
Walk at least a few times a day, but don’t push yourself too hard.
Avoid heavy lifting and strenuous activities as directed.
Avoid driving until your doctor says it’s okay. Do not drive while taking medications that make you drowsy or sleepy.
When to call the doctor
Call the doctor if you have any of the following:
Chest pain or trouble breathing (call 911 or other emergency service)
Fever of 100.4°F (38.0°C) or higher (or as directed by your doctor)
Symptoms of infection at an incision site, such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage
Increased pain or rapid swelling on one side of the face
Rapid, pounding, or irregular heartbeat
Pain, swelling, redness, or warmth in your leg, calf, or thigh
You’ll have follow-up visits with your doctor. These are needed to check how well you’re healing. These also allow your doctor to monitor the results of your procedure. If you have a drain, it may be removed about 2 days after surgery. If your stitches need to be removed, this is done about 5 to 7 days after surgery. Staples at the hairline are often removed 7 to 10 days after surgery.
Risks and complications
Risks and possible complications include:
Facial nerve injury, causing partial paralysis of the face (usually temporary)
Poor incision healing
Hair loss near the incision sites
Changes in sensation, such as numbness or pain
Death of skin tissue, or of fatty tissue in the skin
Abnormal collection of fluid under the skin
Not happy with cosmetic results
Risks of anesthesia (the anesthesiologist will discuss these with you)