A surgical procedure to reposition advanced skin and soft tissue laxity in the face and neck due to aging, sun damage, or rapid weight loss.
Indication
- Advanced soft tissue laxity in the lower face and neck (jowls, loss of jawline)
- Banding and excess skin in the neck due to platysma muscle laxity
- Loss of tissue support in the face and neck after major weight loss
- Correction of asymmetry following facial palsy (Bell's palsy sequelae)
- Reconstructive reshaping after trauma or tumor surgery
- Repair of congenital or acquired facial asymmetry
Preparation
- Detailed dermatologic and surgical evaluation
- Smoking is stopped at least 4 weeks before the procedure (critical to reduce skin necrosis risk)
- Blood thinners and vitamin E are discontinued with physician approval
- Hypertension is controlled (to reduce hematoma risk)
- 8 hours of fasting before the operation
How it's performed
- Performed under general anesthesia or sedation
- Incision begins at the temporal hairline and passes in front of and behind the ear
- Excess skin is removed, and the lower face-neck soft tissue layer (SMAS) is tightened
- Platysma muscle repair may be performed in the neck region
- Skin is closed without tension
- A temporary drainage catheter is placed and a pressure dressing is applied
Post-procedure
- Usually same-day or 1-day hospital stay
- Head is kept elevated for the first 48-72 hours (for edema and hematoma)
- Drains for 1-2 days, sutures removed in 7-10 days
- Most swelling and bruising subside in 2-3 weeks
- Return to social activities in 2-3 weeks, heavy sports in 6-8 weeks
Risks
- Hematoma (especially with hypertension and smoking history, approximately 2-8%)
- Skin necrosis (significantly increased in smokers)
- Facial nerve injury; temporary or rarely permanent weakness
- Sensory loss around the ears; resolves in most cases within weeks
- Scar problems, hypertrophic scar, hairline distortion
- Asymmetry and need for revision
FAQ
Is facelift covered by insurance?
Standard facelift is generally not covered. Reconstruction after trauma, facial palsy sequelae, or post-tumor reconstruction may be eligible based on the payer's evaluation.
How long do the results last?
Surgery corrects skin laxity, but the aging process continues. The tissue tightening achieved is durable; individual skin structure, lifestyle, and smoking determine the longevity.
I smoke; can I have the surgery?
Smoking severely impairs skin blood circulation and increases the risk of skin necrosis several-fold. Stopping at least 4 weeks before and after surgery is mandatory for a safe outcome.
Will the scars be visible?
Incisions are placed within the hairline and natural ear folds. They fade significantly within 12-18 months but do not become completely invisible.
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