Procedures » Surgical Procedures
• Facelift and Neck Lift
"...Love my face!..."
—J.C., facelift patient
Men and women today are living longer, healthier, and more active lives than ever before. This is particularly true here in the greater Jacksonville, Florida and Ponte Vedra area where our proximity to the beach seems to put an emphasis on looking your best. Unfortunately, despite these improvements in health and lifestyle, the biological processes of aging are something over which we still have little control.
As we age the structural proteins of our skin, specifically collagen and elastin, begin to degrade. Coupled with the relentless effects of gravity, the skin becomes loose and saggy. Transient lines of expression become more permanently etched in the form of wrinkles. On the face, this sagging and wrinkled skin eventually creates the typical appearance we associate with advancing age: jowls along the jaw line, cording under the neck, a blunted neck line, folds extending from the corners of the mouth to the chin (a.k.a., "marionette lines"), etc. The result for some is an eventual disharmony between the way they look on the outside and the way they feel on the inside.
The facelift, which is more appropriately called a lower face lift and neck lift, is designed to reposition the skin and soft tissues of the neck and the lower two thirds of the face to achieve a more youthful look. Modern advances in surgery for the aging face allow surgeons to avoid creating the "windswept", unnatural appearance people often associate with this procedure. These advances include techniques to remove accumulated fat under the chin and jaw and to tighten the muscles of the neck. In addition, the "lifting" itself is actually done on the deeper tissues of the face. The overlying skin simply travels with this underlying support, with the excess neatly tailored away. Incisions are hidden in the hair-bearing scalp, around the ear, and under the chin. Specific variations include the extended SMAS facelift, deep-plane facelift, and mini facelift (a.k.a., "minilift").
It's also worth emphasizing that this operation should not be confused with so-called "non-surgical" facelifts and such as the much publicized Threadlift™*, Contour Threads™* and other suture ("thread") lifting techniques, or radiofrequency tissue tightening like Thermage™. While those procedures may have some value for patients needing minimal correction and no skin removal, Dr. Pearson has not been particularly convinced that those procedures are worth most patients' time and money given the current state of the art.
[*UPDATE: the Contour ThreadLift™ has been pulled from the market by its manufacturer. In Dr. Pearson's opinion, this is a good thing.]
The following is provided to answer questions relevant to most patients:
- What happens next if I proceed with a facelift (rhytidectomy)?
If Dr. Pearson feels that you are a good candidate for face and neck lifting and you feel that results he expects to achieve coincide with your desires then several things will need to be arranged for your surgery. Pre-operative photographs, routine lab work, a physical exam, and various paperwork will need to be completed. Typically a second visit is then arranged shortly before your surgery date. This will allow you time to think over the many things discussed in your initial consultation, and it will allow you time to have additional questions or concerns answered.
- Where is facelift surgery performed?
Dr. Pearson performs most of his surgery at Fleming Island Surgery Center or Middleburg Surgery Center. Both are state-licensed outpatient surgical facilities fully accredited by the AAAHC (Accreditation Association for Ambulatory Health Care). Both locations are close to his office (and a conveniently short drive from Jacksonville, Florida). Both facilities offer excellent safety while also providing the privacy and convenience patients desire.
- What kind of anesthesia is required for a facelift? Do I need to stay in the hospital?
Your surgery will be performed on an out-patient basis under general anesthesia overseen by a licensed anesthesiologist (a physician), meaning that you will be completely asleep for the procedure. Modern anesthesia techniques have tremendously improved the safety and comfort of general anesthesia and we have found that most patients prefer this method. Most patients go home a few hours after their procedure. You will not be allowed to drive for the first 24 hours, and we insist that you have a responsible adult with you for the first night.
- How long does a facelift take?
Again, because of the custom nature of this sort of surgery, exact times cannot be given. On average surgery may take three and a half to four and a half hours. Dr. Pearson will be able to give you a better estimate at the time of your consultation.
- When are the follow-up visits after a facelift?
In most cases you will be seen in the office the day after surgery, again on day four or five, and again at about a week to ten days. Dr. Pearson also likes to see patients six weeks, three months, and one year after surgery. These are at no charge to you and more visits may be necessary. Yearly follow-up after the first year is appreciated but not essential.
- Is a facelift ever covered by my insurance carrier?
Generally, insurance does not cover cosmetic surgery and the patient will be responsible for the entire cost of surgery. Exceptions may apply when the procedure is primarily reconstructive (such as in cases of facial paralysis). Check with your insurance carrier for a specific answer. Call us for more details.
- How long does a facelift last?
This is an important question that has a very specific answer: the lift itself lasts forever, but you will continue to age. Put another way, a facelift can turn back the clock, but it can't stop it from ticking. If a facelift gives you a ten year improvement in your looks, for example, you will always look ten years younger than your chronological age. See the related question below, "How much improvement can I expect?"
- How much improvement can I expect after a facelift?
Most people can expect between 7 and 15 years of improvement in their apparent age. Those who are having their facelift earlier in life when there are only subtle signs of an aging face have less to lift than someone older, and hence their results will be proportionally more subtle.
- When should I have a facelift?
Facelift candidates tend to fall into two different categories. There are those who reason that they want to minimize their signs of aging from the start. These patients tend to undergo their first facelift in their early forties. As a result, they often have second facelifts ten or fifteen years later and so on. The results from the lifts are subtle but real, and friends and colleagues never notice the change thinking only that their friend is aging very well.The second group of patients waits until later in life, typically their fifties and sixties. They want to see a more dramatic change from a lift and have waited for more overt signs of aging face to be present. It's a "more bang for the buck" philosophy. Neither group's choice is more reasonable than the other. As a general rule, though, extremely few individuals under age forty will be candidates for a formal facelift.
- How long will I be off from work? How long will it take to heal after a facelift?
Everyone heals individually, and no two people will have exactly the same procedure. We caution patients that the timelines for recovery are rough guides only. Generally, you can go back to work as soon as you feel able, which is generally within a few days, but most patients will take one to two weeks off. Engaging in strenuous physical activity or heavy lifting should be avoided for two weeks.
In most cases, swelling and bruises will have faded by 14 days. Bruises as well as any incisions can be concealed immediately with camouflage makeup, if desired. However, other standard cosmetics should be avoided for the first week after surgery. In most cases though, by two weeks patients no longer "look surgical" and can engage in work and social activities without worry about their appearance.
In most cases, swelling and bruises will have faded by 14 days. Bruises as well as any incisions can be concealed immediately with camouflage makeup, if desired. However, other standard cosmetics should be avoided for the first week after surgery. In most cases though, by two weeks patients no longer "look surgical" and can engage in work and social activities without worry about their appearance.
Facelifts and necklifts can rejuvenate the appearance of the aging face allowing the reflection in the mirror to more closely coincide with the spirit within you. For more information about facelifts and cosmetic facial plastic surgery here in Fleming Island, Orange Park, and the greater Jacksonville, Florida area, please contact us or call (904) 215-7377 to schedule an appointment.
