WHAT CHANGES CAN BE EXPECTED?
A "facelift" is a lift of the cheeks and neck, although it is commonly combined with treatment
of other parts of the face, such as the brows, upper and lower eyelids, and the area around the mouth.
Read the section about Facial Aging. The main change to be expected is improvement in the jowls,
the sagging fullness out to the sides of the mouth. It should be possible to improve a sagging neck
as well, with an eye to removing excess fat below the chin and tightening the angle between the lower
neck and the below-chin region. Although not routinely necessary, some people with very heavy necks
may require two operations on the neck to achieve the best improvement. It is in general not possible
to eliminate the "nasolabial folds," or "smile lines" that run from the corners of the nose to the
corners of the mouth, although some people can get an improvement here. Sometimes in men with
substantial loose skin here and rough features, these nasolabial folds are directly excised,
leaving in their place a scar that masquerades as a mild nasolabial fold.
Repositioning the cheek tissues upwards can give a nice improved fullness of the area over the jawbones
and diminish excessive hollowness of the central cheekbones.
WHO IS A CANDIDATE
The best candidates for facelift are people who have noticed aging changes in their face but who
have a good bone structure and good remaining elasticity, or springiness, in their cheek skin.
Facelifts are done for people in their 30's to 80's, with most people being in their forties and fifties.
The age at surgery is largely dependent on when the person decides they want to make changes.
Patients should be in good health, and Dr. Cedars always asks patients to see their doctors for
"Medical Clearance" to be sure that surgery will not pose a significant risk to their health.
Smokers virtually guarantee themselves a complication. Stopping NOW will significantly lower your risks,
although not to the risk level of a nonsmoker.
HOW IS THE FACELIFT DONE?
Typically, incisions are made down the front of the ears, then up along the hollow behind the
ears, and finally back along or into the hairline behind the ears. Usually the incision (and
therefore the scar) avoids the skin strip in front of the middle portion of the ear and instead
travels on the edge of the tragus, the cartilage flap that covers the ear canal. The skin of the
outer cheeks is lifted free, exposing the deeper tissues. Often, a second, deeper, layer of cheek
tissue is then lifted up separately, lifting with it the fatty tissue of the jowl so that the jowl
fat can be firmly repositioned higher up on the face. By fixing this cheek fat securely up on the
cheeks, it is not necessary to pull so firmly on the skin, so the result does not look tight but has
a more natural look. Notice that the cheek tissues are moved mostly UP rather than BACK, which is
the best way to avoid a "surgical" look.
Most patients have general anesthesia for a facelift, but it can also be done under intravenous
sedation. In either case, we will have a Board-certified physician anesthesiologist looking after
you for comfort and safety.
Perhaps surprisingly, recovery after facelift is not particularly painful. You will typically
be given a prescription for one of the mild narcotics. Dr. Cedars has long ago abandoned
turban-like wraps of the face and head. Swelling and some bruising are common, but the majority
of people are looking good enough to return to desk work by two weeks. You might want to wait
two months before that high school reunion.
3300 Webster Street 1106
Oakland, CA 94609