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In time, gravity, sun exposure, and the stresses of daily life take their toll on our faces: deep creases appear beside the mouth, the jawline slackens, and folds and fat deposits appear on the neck. Facelifts counteract these problems by removing fat and tightening skin and muscles, giving your face a fresher, youthful look -- after surgery, some patients appear as much as ten or 15 years younger.
Facelifts are most often performed on people in their 40s-60s; those in their 70s or 80s can have facelifts as well. The procedure can be combined with others (browlift, eyelid surgery, nose reshaping) for more dramatic results, or it can be restricted to the neck (necklift) if the patient’s problems center there.
Patients who smoke, take medications or have certain medical conditions such as high blood pressure, blood clotting problems or the tendency to form excessive scars should discuss potential risks with their surgeons. Patients with short hair may want to consider letting it grow before surgery to better conceal scars.
Facelifts are usually outpatient procedures and may be performed in an office-based facility, surgery center or hospital, typically under local anesthesia combined with a sedative. The procedure itself varies depending on the surgeon and the patient’s facial structure (i.e., where the incisions are placed, whether one or both sides of the face are worked on at once, in which order the steps are performed).
In most facelifts, incisions are made from the temples down in front of the ears and back behind the earlobe to the lower scalp. The surgeon lifts the skin, suctions fat, tightens muscle, trims excess skin and then stitches the incisions closed. Sometimes metal clips are also used to hold incisions firmly closed on the scalp, and bandages are often wrapped around the head to reduce bruising or swelling. Patients may temporarily need a thin surgical drainage tube which is placed behind the ear.
Any numbness, bruising, or thinned hair around the scar will fade in a few weeks; bandages, stitches and clips are removed within a day to a week. Most patients are back on their feet in a day or two, although the face may appear distorted and feel stiff, and many return to work within two weeks. At first you should be gentle with your skin and hair, and men may need to shave behind the neck and ears where areas of beard-growing skin have moved.
In addition to being located in inconspicuous places such as behind the hairline and in natural folds of the face and ears, scars fade to near invisibility in time.
Results of a facelift do not last forever; you may want to have another procedure in five or ten years. But in another sense, the effects are permanent; years later, your face will continue to look better than if you had never had the procedure.
Complications are rare but may include include hematoma, temporary or permanent nerve injury, infection, and allergic reactions to anesthesia.
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By removing excess fat, skin and muscle from the upper and lower eyelids, blepharoplasty can rejuvenate puffy, sagging or tired-looking eyes. It is typically a cosmetic procedure but can also improve vision by lifting droopy eyelids out of the patient's field of vision. The procedure is usually performed in an office with local anesthesia and lasts as little as 45 minutes. Blepharoplasty cannot be used to raise the eyebrows or reduce the appearance of wrinkles, crow's feet or dark circles under the eyes, but browlift and BOTOX® treatments can achieve these results.
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Browlifts can revitalize drooping or lined foreheads, helping you to look less angry, sad or tired. Using either traditional or minimally invasive (endoscopic) methods, browlifts involve the removal or alteration of the muscles above the eyes to smooth lines and raise the eyebrows for a more youthful appearance. The procedure is often combined with other operations such as blepharoplasty (eyelid surgery) and facelifts to improve the look of the eyes and other areas of the face.
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One of the most common plastic surgery procedures, rhinoplasty is performed to reshape, reduce or augment a person’s nose, remove a hump, narrow nostril width, change the angle between the nose and the mouth, or to correct injury, birth defects, or other problems that affect breathing. Results depend on the patient’s nasal bone and cartilage structure, facial shape, skin thickness and age (teenagers should have had their growth spurt). Insurance may cover rhinoplasty if it is done for reconstructive or medical reasons, but likely not for cosmetic purposes.
Rhinoplasty is usually an outpatient procedure performed under either local or general anesthesia and lasts one to two hours unless more extensive work needs to be done.
Surgeons use one of two techniques: the incision is either made within the nostrils, thus hiding scars after surgery, or across the columella (the vertical strip of tissue separating the nostrils) in an "open" procedure, where scars are small and hidden on the underside of the base. In both procedures the skin is lifted, the bone and cartilage sculpted, and the skin replaced and stitched closed.
For a short time after surgery you may experience puffiness, nose ache or a dull headache, some swelling and bruising, bleeding or stuffiness. Most patients feel like themselves within two days and return to work in about a week. Contact lenses can be worn immediately but glasses will have to be taped to your forehead or propped on your cheeks for up to seven weeks.
Complications are rare and, when they occur, minor. These may include infection, nosebleed, or a reaction to the anesthesia.
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Chin surgery can change the shape of the chin to reduce a prominent chin or to extend the chin from the face. The contour of the chin can be reshaped to be smoother, or more angular in appearance.
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Ear surgery is typically performed to set prominent ears back closer to the head, or to reduce the size of large ears. Surgery may be helpful for “lop ear," "cupped ear" and "shell ear,” large or stretched earlobes, and lobes with large creases and wrinkles. The operation can be performed on children as young as four years of age when the ears are fully grown, in order to minimize teasing in school. The procedure lasts from one to two hours and may be performed in a hospital, office-based facility or an outpatient surgery center under general or local anesthesia.
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