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Facelift (rhytidectomy) is a surgical procedure performed to improve visible signs of aging of the face and neck. As individuals age, facial skin and fat becomes loose and begins to sag. A facelift enables repositioning of sagging structures and removal of excessive skin. Most patients appear approximately 7 to 10 years younger, though individual results vary.
A facelift cannot stop the process of aging or remove all facial wrinkles. The best candidates for facelift have some sagging of the face and neck but retain reasonable skin elasticity and bone structure. Most facelift patients are 40 to 65 years old.
A facelift is frequently performed in conjunction with surgery of the upper eyelids, lower eyelids, and/or brows.
Dr. Friedman performs these procedures under general anesthesia. The procedures are performed in his AAAASF-accredited surgical facility, the West Plano Plastic Surgery Center, which is located on the campus of Texas Health Presbyterian Hospital of Plano. He strictly uses physicians—not nurses or technicians—to administer your anesthesia.
There are several types of facelift. Dr. Friedman generally performs a MACS lift (Minimal Access Cranial Suspension), a technique that originated in Europe and is growing increasingly popular within the U.S. The technique involves placement of permanent sutures in the fascia (fibrous tissue just above the muscles) to lift the cheeks, jowls, and neck. Relying on fascia (rather than skin alone) for the lifting tends to improve the longevity of results. The incisions are hidden in front and in back of the ears and within the sideburn. Tightening is done with care to avoid the overdone, "pulled" look. If necessary, excessive fat beneath the chin is removed by liposuction.
Patients are monitored overnight by two medical personnel, a Registered Nurse and her assistant, in Dr. Friedman’s surgery center. Pain is usually mild and well controlled with prescription pain medication. Small, temporary drainage tubes are usually removed within 48 hours. Compressive dressings are removed 3 days after surgery. Most patients return to light activities within 3 to 5 days. Stitches are removed 10 to 14 days after surgery. Bruising resolves in about 2 to 3 weeks. Heavy straining should be avoided for about 4 weeks. The scars are generally well-camouflaged and inconspicuous.
When you visit our office, Dr. Friedman will discuss your specific concerns. He will outline the available procedures and will help you decide which one(s) may be most appropriate for you. We will also show you a variety of "before and after" photos of facelifts performed by Dr. Friedman. If you wish to speak to other patients who have undergone these procedures, we will be happy to provide phone numbers.Back To Top
All facelift patients look swollen and tight immediately after surgery. This gradually improves over the first few weeks after surgery. Dr. Friedman makes every effort to provide natural-appearing results following surgery, since virtually all patients simply want to look better, not different. Most patients feel comfortable in social settings within 2 to 3 weeks of surgery.
You may wish to consider non-surgical procedures to improve facial aging, such as Botox, Restylane, Juvederm, and microdermabrasion. Botox improves frown lines between the eyes, forehead creases, and crows’ feet wrinkles. Injectable fillers (Restylane, Juvederm, and Perlane) improve creases and lines around the mouth, inner cheeks, and chin. Microdermabrasion and skin care products improve skin tone and clarity.
Keep in mind, however, that none of these procedures will tighten a sagging neck or jowls. This is best accomplished by a facelift.
There is no single best facelift procedure. Procedures fall into one of three categories:
Mini-facelift is a great marketing term, but facelifts should be classified based upon the plane of elevation (see previous question) and the length of the scars. Dr. Friedman performs a SMAS lift, generally using a “short-scar” technique. Unlike traditional facelifts, short-scar lifts do not require incisions along the scalp behind the ears. Calling this a mini-lift would be misleading, as the results and recovery time are similar to a traditional lift. Caution: some mini-lifts provide results that last only long enough to allow your check to clear.
Most patients look about 7 to 10 years younger after facelift. You will continue to age at a normal rate following surgery, though you may never “catch up” to your chronological age.
One week before surgery
The evening before surgery
Day of surgery: before you leave home
Day of surgery: at the facility before surgery
Day of surgery: at the facility after surgery
At home after surgery
Instructions for your first postoperative visit (about 3 days after surgery)
1 week after surgery: you may resume casual walking but must not engage in vigorous exercise that increases your blood pressure or heart rate. You may resume driving once you are off of your pain medication. Avoid freeways until you are comfortable with city driving.
3 weeks after surgery: you may gradually resume regular exercise.
Please sleep with your head elevated. You may sleep on your back or part way over (pillow under your shoulder and hip). Do not sleep on your side until about 3 weeks after surgery.
You will use Bacitracin (over-the-counter) antibiotic ointment over your stitches twice daily after washing your face with a gentle soap and water. We will remove your stitches about 10 to 14 days after surgery. A few days later, you may begin scar massage with Mederma twice daily. Mederma is available at our front desk or over-the-counter at your pharmacy. If you prefer, you may use Vitamin E or Aloe Vera. Continue scar massage for about 3 months.
If liposuction and/or muscle tightening was performed beneath your chin, you must wear a neck compression garment all day and all night (except for showers and massage) during the first two weeks. Wear the garment on an intermittent, tapering basis for the second two weeks. This will reduce the swelling under your chin.
You should begin gentle massage to the face and neck one week after surgery. This will help smooth any irregularities and areas of firmness. You may apply lotion to your hand to massage and/or you may use a vibrating massager. Massage in an up and back direction.
You may begin light showers but should avoid scrubbing your incisions. Avoid immersing your face in a pool, lake, or ocean for 4 weeks.
One week after surgery, you may resume use of any medications or supplements that you discontinued prior to surgery. However, for at least 3 weeks, you should avoid Motrin, aspirin, and any other product that may thin your blood.
Do not smoke for at least one month (and preferably much longer) after surgery. Smoking may increase your risk of infection, lung problems following anesthesia, and wound healing problems.
You should avoid unprotected sun exposure to your incisions for at least 6 months. You may use a high-SPF sunscreen (30 or greater). Premature tanning of the incisions may cause them to darken permanently.
You may resume intercourse about 3 weeks after surgery.
You may begin use of make-up one week after surgery. A camouflage makeup (available at most department stores) is helpful to hide bruises. Do not place makeup directly over your incisions until 3 days after the stitches are removed.
Please feel free to ask Dr. Friedman or his staff about any additional questions or concerns.Back To Top