Nearly everyone has heard of a facelift, but how many people know that there is more than one type? This is good news for people who prefer a deeper facelift and for those who want one that is not as extensive. 

The Consultation

Before a person has facelift surgery they have to have a consultation with their cosmetic surgeon to make sure that they are a good candidate for the procedure. A person who is a good candidate is in good health and has realistic goals when it comes to their facelift. They should discuss these goals with their surgeon. The surgeon will take the patient’s medical history, and ask if they’ve had previous surgeries, medical conditions or treatments. The surgeon will also need to know if the patient is on any medications, is taking vitamins or herbal supplements and whether they drink alcohol or smoke.

The patient’s bone structure and their skin are then evaluated. People whose skinis still fairly elastic have the best outcome after their facelift. The surgeon examines the patient’s hairline to determine where the incisions will be made and takes note of the wrinkles, lines and folds in the patient’s face. They will discuss the different types of facelifts that are available to the patient. Some patients also request other procedures along with their facelift. These include eyelid surgery, rhinoplasty or minimally invasive treatments such as dermal fillers or laser resurfacing.

If the patient is deemed a good candidate, the surgeon or nurse will tell them what they need to do in the weeks and days before the operation. For example, they must stop smoking if they do, and they might have to avoid some medications that can make healing from the surgery difficult. During this time, the patient should arrange for transportation to and from the surgical center and prepare their home for their recuperation.

Here are the different types of facelift:

Basic Facelift

Basic facelift takes about two hours and is done under general anesthesia. After the patient is asleep, the doctor makes incisions behind their ears, around the earlobes and into their hairline. This allows the incisions to be hidden by the patient’s hair or makeup. Some doctors also make a small incision beneath the patient's chin. 

The doctor uses these incisions to free the skin of the patient’s face from the muscles and other tissue, and pull it up and back. Excess skin is then removed and deep tissues can be repositioned to make the face appear more youthful. If the surgeon has made an incision in the chin, they’ll remove the fat from there, and smooth out platysmal bands in the patient’s neck.

The doctor then closes the incisions with non-absorbable sutures on the face. The incisions around the hairline are closed with metal staples. The doctor then bandages the patient’s head to keep down bruising and swelling, and the patient is taken to a recovery room.

SMAS and Extended SMAS Facelift

SMAS stands for superficial musculo aponeurotic system. This is a deep face lift where the surgeon pulls back the muscles and connective tissue as well as the skin and rearranges them over the patient’s cheekbones. The extended SMAS facelift is even deeper and is concentrated on the middle of the patient’s face.

Deep Plane Facelift

This type of facelift is popular with younger patients who do not need surgery on their neck. The doctor makes incisions in the brow, the lower eyelids and even inside the patient’s mouth. 

Recovery

The amount of recovery time depends on the type of facelift that was done and on the patient. They will need pain relievers for a few days, and some patients find relief with over-the-counter medications as opposed to stronger analgesics prescribed by their surgeon. In either case, it is a good idea for the patient to purchase pain relievers before their surgery, so they’ll be there when they get home. 

The patient needs someone to drive them home from the clinic and stay with them for at least 24 hours. The nurse gives the patient advice when it comes to caring for the surgical wounds and will schedule the patient for a follow-up appointment with the doctor.

Considerable swelling is to be expected after a facelift. The patient may also experience some numbness and bruising, which can last up to two weeks. They can find relief by sleeping with their head elevated on a pile of pillows. Ice compresses also help. While the incisions heal, the patient should rest as much as they can, and keep the wounds dry.

The doctor takes out the stitches in about a week, and the patient eventually begins to see the results of their facelift though full results won’t be visible for about nine months. They will also be able to do some light house cleaning and gentle exercise, though it may be close to two months before they should go back to the gym. 

After a few months the swelling is gone and the incisions are not as noticeable, though the patient should always wear sunscreen when they go outside. This is because when the sun darkens scar tissue, the darkening tends to be permanent.

A person in the Naples, Florida area who wants to learn more about the different types of facelift should contact our surgeons. Dr. Anurag Agarwal, MD FACS is a board certified member of the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology – Head and Neck Surgery. Dr. Kiranjeet Gill is also a member of the American Board of Plastic Surgery and specializes in surgery of the face and breast. Dr. Richard W. Maloney is a specialist in facial plastic surgery and multimodality laser surgery. He is board certified by the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology – Head and Neck Surgery. 

Published by Dawn Richard