Sagging or wrinkled skin occurs naturally with increasing age. Folds and fat deposits appear around the neck, and deep flexion creases form between the nose and mouth. The jawline grows jowly and slack. Heredity, poor diet, smoking, or obesity may contribute to early or severe skin problems. A facelift can help repair some of the visible damage to skin, fat, and muscles and can restore a younger look. A facelift can be done alone or with nose reshaping, a forehead lift, or eyelid surgery.
While the patient is sleepy (sedated) and pain-free (local anesthesia) or deep asleep and pain-free (general anesthesia), the plastic surgeon makes incisions above the hairline at the temples, behind the earlobe, to the lower scalp. The surgeon removes some of the fat tissue and loose skin, then stitches (sutures) the incisions closed.
Usually there is not much discomfort after surgery and pain medication can relieve it. Some numbness of the skin is normal and will disappear in a few weeks or months. The head will be elevated on two pillows (or at a 30 degree angle) for a couple of days after surgery to keep the swelling down. The drainage tube will be removed 1 to 2 days after surgery if one was inserted. Bandages are usually removed after 1 to 5 days. The face will look pale, bruised, and puffy, but in 4 to 6 weeks it will be looking normal. Most of the stitches will be removed in 5 days. The stitches or metal clips in the hairline could be left in a few days longer if the scalp takes longer to heal.
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.