Surgery

Facelifts: Frequently Asked Questions

Al Aly, M.D.
Division of Plastic Surgery
University of Iowa Hospitals and Clinics

Creation Date: May 2000
Last Revision Date: May 2000
Peer Review Status: Internally Peer Reviewed

Have you ever heard of "chemical facelifts"? What exactly are they?

Chemical facelifts are probably a misnomer. There are chemical peels that treat the skin and the face. Essentially those procedures burn the skin of the face and hope that the new skin that comes in is less wrinkled and younger appearing.

Will a face lift help my acne scars?

Facelifts improve the contour of the neck and the jowl area. They do not improve the quality of the skin in general. In order to improve the quality of the skin, you need to do a laser peel or some type of chemical peel. Dermabrasion can also be done to improve acne scars.

What is the recovery time like after a facelift?

The recovery time for facelifts as in any other surgical procedure is related to multiple factors. The younger the patient is, the less the recovery time in general. The average patient for a facelift is about 50 to 55 years old, and the average recovery time is somewhere around 2 to 3 weeks. The term "recovery" depends on what you mean by it. Some people consider recovery just getting up and being out of bed and getting around the house. In that situation people are up and around the very next day after surgery. However, if you are considering recovery being out in public, that is usually 2 to 3 weeks.

What kind of risks are involved?

Risks with a facelift include some common risks as with any surgery including infection, bleeding, hematoma formation, which is a blood collection under the skin flaps. As far as facelifts go, the specific risks include nerve injury, skin loss especially if the patient is a smoker, and unattractive scarring. Those are the major risks that are involved with facelifts.

At what age do most people have a facelift?

Most people have their facelifts done in their late 40s and early 50s. However, any time an individual shows the signs of aging that can be helped by a traditional facelift, they are good candidates. Those signs of aging are laxity of the neck and jowling. In the mid face area, which is treated by a different kind of facelift, aging is manifested by cheek fat droopiness. Some people start to show those signs as early as their 30s. Whenever the signs of aging appear, the patient is a candidate for surgery.

What kind of care do you need to give your facelift after the procedure?

The care that your face will need after surgery is dependent on the surgeon and how they like to take care of their patients after the surgery. Some surgeons like to keep a fairly large dressing around the face for 4 to 7 days and others like to only keep the dressing on for 1 to 2 days. After that, most will have on what is termed a facial bra, which is a special kind of garment used to reduce swelling and bruising.

I have some small cholesterol deposits under my eyes; do I need a plastic surgeon?

Although this is not related to facelifts, you would be correct in seeking the help of a plastic surgeon in the treatment of these cholesterol deposits.

What questions should I ask my plastic surgeon when contemplating a facelift?

As with anyone's search for a plastic surgeon, one should take into account the surgeon's training, whether they are board certified in plastic surgery, whether they do cosmetic surgery as part of their practice, and whether they do a reasonable number of facelifts and are comfortable with the procedure. You should also ask your surgeon what complications he has had with facelifts. It is unusual for a surgeon never to have a complication. If the surgeon claims that they have never had a complication in a facelift, they probably are not truthful, and one should consider another surgeon.

What can I do to take care of my face while I am young? Does Vaseline around the eyes prevent wrinkles?

There are only two things that one can do to slow down the aging process. One - one should not smoke. Smoking causes faster aging of the skin. Two - One should not spend time in the sun. Sun damage causes the skin to age much more quickly. Some of the things that one can do to maintain skin health is to wear sun block, and get on a skin care regiment that helps maintain skin health. This usually includes a Retin A component.

I was very overweight, and now I am stuck with a lot of excess skin under my chin...what can be done? What will a procedure cost me?

If you have a lot of excess skin under the chin then you are a good candidate for a facelift. The cost of a facelift varies greatly depending on where you are in the country. There are 3 things to consider in the cost of a plastic surgery procedure. First, the surgeon's fee; second, operating room fees; and third, the anesthesia. The cost in your area is dependent on many factors. The average cost of facelifts across the country is somewhere between $5,000 and $7,000.

Is any plastic surgery covered by insurance?

Plastic surgery is a large field that includes many reconstructive aspects. Almost all-reconstructive plastic surgery is covered by insurance. However, cosmetic plastic surgery is not covered by insurance, which includes facelifts.

After a facelift, is it necessary to stay out of the sun? Can your face melt?

After a facelift, it is a good idea to avoid the sun so that the scars that go around and behind the ear do not heal to a different color than the surrounding skin. However, your face will not melt.

Are there any scars left from a facelift?

Anytime you have a surgical procedure, you will have scars. Plastic surgeons hide the scars in inconspicuous areas. In the case of a facelift, the scars are located right in front of the ear, around the ear lobe, up behind the ear and then into the hairline. Sometimes there is also a scar underneath the chin. When those scars are well healed they are located in positions that are difficult to see. However, they are present.

What kind of special training does a plastic surgeon have to have?

There are a variety of ways that doctors can become plastic surgeons. The most common way is to be fully trained in a surgical specialty such as general surgery or ear, nose and throat surgery and then do a residency in plastic surgery.

Do you take credit cards? What about a payment plan?

Most cosmetic plastic surgeries are paid upfront by the patient. Some plastic surgeons take credit cards, and there are some companies like banks that are willing to finance your surgery. However, there are not many plastic surgeons, if any, which have payment-plans.

Is a facelift an outpatient procedure?

Most facelifts are done as an outpatient procedure. However, some people are interested in staying in the hospital an extra night after surgery, and, if it is affordable, in many situations it would be advisable to stay in the hospital for one night. I would say that 90 percent of facelifts, however, are done on an outpatient basis.

What is the difference between a mid-facelift and a traditional facelift?

The traditional facelift is used to treat the neck and jowl areas. The neck and the jaw line in a young individual have clear demarcations from each other. As one ages, the distinction between the two is obliterated by extra skin, fat, and droopiness in the jowl area. The traditional facelift, which really should be called a lower third facelift, addresses these areas. A mid-face lift treats cheek fat that has fallen down from the cheek. This causes the lower eyelid to look like it has descended downwards with an appearance of droopiness and fat in the cheeks. The mid-facelift is performed to lift this soft tissue back into a higher more youthful appearance. The mid-facelift is a relatively new procedure in plastic surgery but has been utilized in the last couple of years.

Will the face look even better if you have a second chemical peel?

What I assume you mean by a second chemical peel is that the patient has a facelift first and then a chemical peel is performed. In this situation, the jowls and the neck laxity are addressed by the facelift, which does not address wrinkles. The chemical peel is then utilized to reduce the wrinkles.

No, I had a chemical peel 5 weeks ago. There is definitely an improvement, but I was wondering if I should have another one. Would it improve my appearance even more?

Having a second chemical peel sometimes can be advisable. However, 5 weeks may be too soon, and that is not a judgment that I can make without seeing you. It would be advisable for you to see your surgeon, and check with them.

Is laser skin resurfacing usually done with a facelift?

Laser skin resurfacing is generally not done with a facelift. The skin of the face is elevated off of the underlying tissue when you perform a facelift thus the skin is injured from below and if you injure it from above you may cause it to die as in the case of laser resurfacing. However, you can laser resurface areas of the face where the skin was not elevated. With all that being said, there are surgeons out there who would perform them together. I personally do not. I would be very hesitant to recommend that to anyone.

See related Patient Topics Plastic and Cosmetic Surgery, Procedures and Therapies or Surgeries.

See related Provider Topics Procedures and Therapies or Surgeries.

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