Facelift

Factors That Cause Aging

As people age, the effects of gravity, exposure to the sun, smoking, and the daily stress of life can be seen in their faces.  The typical signs of aging begin with the deep creases that form between the nose and mouth. “Crows feet” around the eyes and creases across the forehead become evident.  “Laugh lines” and “marionette” lines become visible on the lower face. The jaw line becomes poorly defined and jowls form. Folds and fats deposits appear around the neck.

Nothing can completely stop the process of aging.  A facelift (technically known as rhytidectomy) can’t stop this aging process, but can “set back the clock,” and improving the most visible signs of aging.  This is accomplished by removing excess skin and fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift (brow lift), eyelid surgery (blepharoplasty), chin augmentation, and nose reshaping (rhinoplasty).

If you’re considering a facelift, this page will give you a basic understanding of the procedure: when it can help, how it’s performed, and what results you can expect.   Dr. Zemmel will be pleased to answer all of your detailed questions during your consultation.

The Best Candidates For A Facelift

The ideal candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well defined. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties.  A facelift can make you look younger, fresher, and rejuvenated. It may enhance your self-confidence in the process. But it can’t give you a totally different face, nor can it restore the health and vitality of your youth.

Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Zemmel.

All Surgery Carries Some Uncertainty And Risk

When a facelift is performed by a qualified plastic surgeon, complications are infrequent and usually minor.  Individuals, however, vary greatly in their anatomy, ability to heal wounds, so the outcome is never completely predictable.

Complications that can occur include hematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles (usually temporary), infection, and reactions to the anesthesia.  Smoking and other tobacco use increases the complication rate and increases the time needed to heal.

Dr. Zemmel will instruct you how to reduce your risks of complications before surgery.  He will assist you in quitting smoking and optimize your ability to heal. Dr. Zemmel will provide you with a full set of instructions after surgery as well.

Planning Your Surgery

No two faces are alike and therefore no two facelifts procedures are the same.  Facelifts are very individualized procedures. In your initial consultation Dr. Zemmel will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery.

Your surgeon should check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. Be sure to tell Dr. Zemmel if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.

If you decide to have a facelift, Dr. Zemmel will explain his technique and the anesthesia he will use, the type of facility where the surgery will be performed, and the risks and costs involved.

Don’t hesitate to ask any questions you may have, especially those regarding your expectations and concerns about the results.

Preparing For Your Surgery

Dr. Zemmel will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Following these instructions will help your surgery go more smoothly. If you smoke, it’s especially important to stop at least 4 weeks before and after surgery.  Smoking reduces blood flow to the skin, and can interfere with the healing of your incision areas.

If your hair is very short, you might want to let it grow out before surgery, so that it’s long enough to hide the scars while they heal.

You should arrange for someone to drive you home after your surgery, and to help you out for a day or two if needed.

Where Your Surgery Will Be Performed

Dr. Zemmel performs facial rejuvenation surgery in his operation room.  The facility is a “quad-A” certified operating room that meets the highest standards of safety for an outpatient facility.

Patients recover at the office and then spend the night at home.  Dr. Zemmel always calls each patient personally night to ensure his patient’s safety and conform.

Types Of Anesthesia

Dr. Zemmel performs facelifts under local anesthesia with deep sedation.  You will not feel any pain and you will asleep the entire operation.

The Surgery

A facelift usually takes Dr. Zemmel two to four hours depending on how many additional procedures are being done. Dr. Zemmel completes one side at a time to ensure results are even and symmetric.

Incisions usually begin above the hairline at the temples, and extend in a natural line in front of the ear.  It then courses in back of the small cartilage at the front of the ear, and continues behind the earlobe to the lower scalp. If the neck needs tightening, a small incision may also be made under the chin.

In general, Dr. Zemmel separates the skin from the fat and muscle below.  Fat may be trimmed or suctioned from around the neck and chin to improve the contour. He then tightens the underlying muscle and membrane, pulls the skin back, and removes the excess. Stitches secure the layers of tissue and close the incisions.

Dr. Zemmel uses very light dressings over each incision.

After Your Surgery

There isn’t usually significant discomfort after surgery; if there is, it can be lessened with the pain medication prescribed by Dr. Zemmel.   Some numbness of the skin is quite normal and usually disappears in a few weeks or months.

Dr. Zemmel will tell you to keep your head elevated and as still as possible for a couple of days after surgery to help with the swelling.  Don’t be surprised at the pale, bruised, and puffy face you see. Just keep in mind that in a few weeks you’ll be looking normal.

Most of your stitches will be removed after about five days. Your scalp may take longer to heal, and the stitches or metal clips in your hairline could be left in a few days longer.

Getting Back To Normal

You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first.

Dr. Zemmel will give more specific guidelines for gradually resuming your normal activities. They’re likely to include these suggestions: Avoid strenuous activity, including sex and heavy housework, for at least two weeks (walking and mild stretching are fine); avoid alcohol, steam baths, and saunas for several months. Above all, get plenty of rest and allow your body to spend its energy on healing.

At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff and you’ll probably be self-conscious about your scars. Some bruising may persist for two or three weeks, and you may tire easily. It’s not surprising that some patients are disappointed and depressed at first.

By the third week, you’ll look and feel much better. Most patients are back at work about ten days to two weeks after surgery. If you need it, special camouflage makeup can mask most bruising that remains.

Your New Look

The chances are excellent that you’ll be happy with your facelift-especially if you realize that the results may not be immediately apparent. Even after the swelling and bruises are gone, the hair around your temples may be thin and your skin may feel dry and rough for several months.

You will have some scars from your facelift, but will be well hidden by your hair or in the natural creases of your face and ears. In any case, they’ll fade within time and should be scarcely visible.

Having a facelift doesn’t stop the clock. Your face will continue to age with time, and you may want to repeat the procedure one or more times-perhaps five or ten years down the line. But in another sense, the effects of even one facelift are lasting; years later, you’ll continue to look better than if you’d never had a facelift at all.