Many patients presenting for facelift and necklift surgery often say that when they look in the mirror, they a see an old and aged reflection, but feel young and refreshed on the inside. To quote the usual patient, “I feel like I’m still thirty years old on the inside, but I look in the mirror and see my mother!” This is true of most patients – while we continue to age physically, most of us still feel young and vibrant on the inside. And it’s not only women that feel this way – many men undergo facelift surgery for the same reason.
A facelift, or rhytidectomy, is a surgical procedure designed to lift the soft tissues back to where they belong, thus improving cheek and jawline contour. It may also help to smooth and firm the skin, providing a fresh, youthful appearance. Additionally, fat injections may be used to improve the volume of the face.
A neck lift removes excess fat, skin, bands, and restores a smooth, refined appearance to the neck. It can also improve the appearance of the neck by creating more definition of the angle of the jaw. Neck rejuvenation may involve only liposuction, or may be more involved and require tightening of the muscles and removal of skin. The vast majority of the time, a necklift is combined with a facelift, or at least a lower facelift, to improve the overall appearance of the neck and jawline. This will be discussed with you during your surgical consultation.
The ultimate goal of aesthetic facial surgery is to give you a natural and refreshed facial appearance. The tissues of your face, including your jowls, cheeks, and neck will be “lifted” and restored to a more youthful position. In addition, your neck will be sculpted if necessary to restore its youthful look. Lifting the tissues will also restore critical volume to your face, and you may also have additional procedures to enhance this as well. This can all be done using well-hidden incisions that should not be noticeable over time, even if you wear your hair up or have short hair.
The goal of facelift and necklift surgery is to avoid an “overpulled’ or “overdone” look that makes your face appeared “stretched” and unnatural. Dr. Warner uses the latest techniques to achieve an exceptional result and to avoid an overdone look. Using these advanced techniques, you can be assured that you will look natural. Following surgery, the majority of our patients hear comments like, “Where did you get your hair done?” or “Where did you go on vacation – you look great!” Others will notice your refreshed appearance, but will not be able to tell that you had surgery to achieve your new look. Other additional procedures can be used to enhance your facial appearance as well, including Botox® injections, filler injections, and facial resurfacing.
The standard procedure for a facelift involves making small incisions hidden along a normal crease in front of the ear and just inside the hairline, continuing to the backside of the ear. Tissue and fat deposits are separated, the skin is tightened and excess tissue is removed. If the neckline requires attention, an additional incision may be made under the chin. Very fine stitches are used to close the incisions and to reduce any chance of visible scarring. Fat injections can also be done at the same time to improve the volume of the face, thus helping to achieve a more youthful appearance.
There are several different facelift techniques that can be employed. Dr. Warner will discuss the options with you during your consultation and help you decide what is right for you.
General or local with sedation
Length of surgery
2 to 4 hours
Length of stay
Outpatient (home the same day) or 1 overnight stay in the hospital (your surgeon will discuss a specific plan with you during your consultation).
Back to work
May be resumed in 3 weeks
Mild (anticipate 2-3 days of prescription pain medication)
Moderate (should be significantly resolved in 2 to 3 weeks)
Moderate (will decrease within 2 weeks)
Removed in 4-8 days
You will see noticeable improvement within 1-2 weeks, but your final results will be seen in a few months.
I’ve heard that I can have minimally invasive surgery – why would I want to have a “big surgery?”
In general, when it comes to facial rejuvenation surgery, the “smaller” the procedure you have, the more subtle (and usually less noticeable) your results will be and the shorter they will last. Most patients presenting for facial rejuvenation surgery will get suboptimal results with “minimally invasive” techniques (i.e. “threadlifts” and “lunchtime lifts”) and feel that their results were not worth the investment. However, certain patients may be good candidates for “less surgery.” You can discuss these options with your surgeon and find out if you are a candidate for minimally invasive surgery or injectable filler treatments. More commonly, patients require more involved facelift techniques in order to achieve exceptional results that will stand the test of time. Additionally, non-invasive techniques, such as Botox® injections, filler injections, and facial peels can temporize the aging process by improving the skin, but will not “lift” or rejuvenate the deeper tissues of the face to a more natural and youthful position.
Will I be awake or asleep for surgery?
This is dependent on your preference and also your surgeon’s preference. Some patients want to be under “twilight” because they feel it’s safer than general anesthesia, and other patients prefer general anesthesia because they just “want to be out” and not know what’s going on. It is important to keep in mind that general anesthesia is very safe for those patients who are generally healthy. Additionally, some surgeons have a very strong preference and will only perform your facelift and necklift surgery one way or the other. Regardless, both types of anesthesia are acceptable and you will need to develop a plan with your surgeon prior to surgery.
Will my face look natural after facelift surgery? I don’t want to look like I had my face “done.”
There are many ways to perform facial rejuvenation surgery. Regardless of the technique, the goal of facial rejuvenation surgery should be to achieve a natural and refreshed appearance. When this is done properly, the result is a natural, un-operated look that makes you look rejuvenated and younger. Your face will not look “pulled” or distorted. Additionally, your scars will be very well-hidden, even if you wear your hair up or have short hair. You will hear comments like “Wow, where did you go on vacation!” or “What spa do you go to – I want to join that one!” Rather than notice you’ve had your face “done,” you should still look like “you,” but younger and more refreshed. When this happens, facial harmony is restored and the ultimate goal has been achieved.
Why did my surgeon talk about my entire face during my consultation?
Facial harmony is a term used to describe how all of the different components of your face fit together to create an overall pleasing appearance. When you have finally decided that you would like to speak to a surgeon regarding your face, you should expect a thoughtful and thorough discussion. You should arrive at the consultation prepared to discuss your specific concerns related to your face. It is important that the surgeon understand exactly what is bothering you. He or she will then discuss these issues with you and provide you with options. A thorough facial evaluation in preparation for surgery will entail your surgeon discussing your entire face with you, not just your expressed concerns. This is done for multiple reasons.
First, it is important that you understand the aging process and what is happening to your facial tissues. Second, your overall facial appearance is made up of many components – changing only the thing you have pointed out to your surgeon may have an impact on another part of your overall facial harmony. Third, if you are thinking about more than one aspect of your face, it is often easier to undergo one operation rather than a second operation in the future. And lastly, your surgeon wants you to have the most exceptional results possible and will discuss not only your concerns, but what he or she feels may be necessary to help you achieve that goal.
It is important to keep in mind that although your surgeon may discuss your entire face with you and point out things that may not bother you, he or she is not trying to “push” you into having more surgery. If something that your surgeon points out doesn’t bother you, then it will not bother the surgeon and there is no need to fix it. Your facial analysis consultation is meant to be an educational experience and discuss all of the possibilities in order to help you determine as a team how to accomplish your goals. It is also important that you understand all of your options, including what to expect in terms of outcome and also the limitations involved with surgery. Once you feel that you are on the same page with your surgeon, then you’re likely to be ready for surgery!
What are the limitations of facelift and necklift surgery?
There are certain limitations to these procedures. While we can restore a more youthful appearance and “turn back the clock,” we cannot make you look twenty years old again. Likewise, you will still continue to age as the environment and gravity continue to take their effects on your face. However, once the clock is turned back, it will always be “reset” to an earlier position and you will look younger and more refreshed at every stage of your life compared to your facial appearance had you not chosen to undergo surgery. Another limitation is that facelift and necklift surgery will not affect the many of the wrinkles in your face, nor will it necessarily improve the color or appearance of the skin itself. Improvement in your skin will require adjunctive procedures like Botox® injections, filler injections, facial peels, and good skin care.