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THE SEATTLE FACIAL PLASTIC SURGERY CENTER
DR WILLIAM PORTUESE | 1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
Dr William Portuese - Board Certified Facial Plastic Surgeon in Seattle WA

Patient’s Complete Guide To A Facelift and Neck Lift

When the facial aging process begins to take place and the face is sometimes out of harmony with the eyelids or forehead, some patients become self-conscious. And when patients state that they look older than they truly feel, a facelift or a neck lift is performed. The face / neck lift is a very popular procedure done frequently in the United States. The facelift is done for cosmetic reasons, and it is a procedure that is done on the face and neck to rejuvenate the face. This procedure tightens up lax facial skin, neck skin and muscles, jowls, and addresses neck fat as well. It also tightens the muscles in the face, the posterior portion of the neck and the front portion of the neck. Excess skin is removed around the ears and fat is removed underneath the neck.

Facelift – General Information

There are three components that are addressed with a facelift. The first one is the fat in the neck, which is removed with both direct and indirect liposuction and fat sculpting. The second component is muscle, which is tightened underneath the neck to redefine the jaw line, tighten behind the jaw line to accentuate the posterior portion of the jaw line, and it is tightened up at the cheek area to lift the jowls. The third component is excess skin. Once the muscles have been tightened and the fat has been removed, there is usually excess skin that has to be trimmed in a very conservative fashion.

There are different types of facelifts that are performed. There is a traditional facelift, which addresses a full face and neck lift. This addresses facial skin laxity, the jowls and all of the neck fat and laxity of the muscles in the neck. There is also a mini lift, which is done for simple facial laxity to lift the jowls only and does not address the neck area. This is typically done on younger patients less than 50 years old who just have jowling but have an adequate jaw neck line. There is also a neck lift alone, which can usually be done on patients who are less than 50 years old, to address only neck fat and redefine the jaw line, but it does nothing for the jowls and facial laxity

The goal for a mini lift is to simply remove the jowls by lifting them. The goal for a neck lift is to sculpt only the neck fat without removal of any skin or jowls. The neck lift is not performed if there are jowls present that need to be addressed. The S-Lift is a mini lift.

The facelift operation is performed on both men and women starting in the late 40s and into their 50s and late 60s when the face and neck start to sag and a fullness in the neck and the jowls start to descend over the jaw line. The incisions for a facelift start at the hairline at the sideburn and weave behind the tragal portion of the front of the ear and then placed behind the ear crease and up into the hairline. Patients are usually able to put their hair up off their shoulders within a few months after the surgery, and there is no shift in the hairlines.

Facelift and Necklift Side Effects

POSTOPERATIVE FACELIFT AND NECK LIFT PHASE ONE MONTH

  • Swelling: Any emergent swelling in the first 24 hours after the surgery that even the drains cannot keep up with, will need to be addressed in the office the night after the surgery. A majority of normal postoperative swelling, edema and bruising usually subsides at about two weeks after the facelift surgery. When the drains are used there is usually very minimal bruising. This is because the blood, which causes the bruising, is now removed through the drains. There is swelling present that takes approximately two weeks to go away, But there is still an additional 10% of swelling that will need a month to two to go away. The incisions take two to three months to settle down but are hidden within the hairline and natural creases.
  • Bruising: Some bruising usually occurs in the face and neck, but since drains are being used to remove the blood that causes bruising, there is very minimal bruising.

Complications of a facelift or neck lift

  • Asymmetry: This is usually a result of preexisting asymmetry where one cheek bone is higher than the other or the underlying jaw line is asymmetrical. Sometimes the neck structures and muscles can be larger on one side of the neck than the other.
  • Bleeding: Excessive postoperative bleeding can occur after a facelift and would need to be addressed in the immediate postoperative phase. This is very rare, but it happens approximately 2-3% of the time. If this should occur, sometimes the incision has to be opened up, the bleeding cauterized and the incision re-sewn together.
  • Infection is extremely rare after a facelift or neck lift. It is more common in smokers. Patients are given antibiotics to prevent this.
  • Numbness: There will be some numbness around the ears and in the chin area, but this goes away 99% of the time and is usually not an issue. This can sometimes take up to six to eight weeks to go away.
  • Motor nerve loss: Permanent motor nerve loss is much less than 1%. This can be caused from a stretching of the nerve, usually in the lower lip. This is usually temporary.
  • Healing: On a rare occasion, there are some nonhealing areas behind the ears that eventually heal more white in the surrounding tissue. These are usually related to smoking or poor healing.
Washington Ambulatory Surgery Center Association Washington State Medical Association American Academy of Facial Plastic and Reconstructive Surgery Real Self