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 yeares. 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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