Most patients considering a face lift have a simple goal: to look younger. Perhaps you were looking through old photos (or your Facebook timeline) and caught a glimpse of yourself from 20 years ago. Or maybe you suddenly realized that the person looking back at you in the mirror didn’t look the way you felt. Either way, the goal is to turn the clock back and reverse some of the side-effects of days spent under the Texas sun.
Facial aging affects different parts of the face at different speeds in different people, so facial rejuvenation has to be highly customized to each patient. As the face ages, it falls and loses volume, leading to any combination of furrowed or droopy brows, bags under the lids, sunken cheeks, jowls, or a “turkey” neck. Facial rejuvenation procedures, of which a face lift is just one component, are designed to improve each of these problems. Face lifts in particular, can lift and fill the cheeks, correct jowls, and tighten the neck to recreate a well defined jaw line. They are often combined with eyelid surgeries that correct drooping upper lids and tired-looking lower lids to completely freshen the face.
The original face lifts just tightened cheek and neck skin to remove wrinkles, resulting in a stretched and artificial look. Most patients I have met don’t want that “operated” look, or to look like someone else altogether. Most patients just want to feel rejuvenated, to look the way they did 10 or 20 years ago. Unlike the abdomen or the breast, the face becomes wrinkled not because the skin has been stretched out, but because it has lost its internal support. As a result, I use face lift techniques that focus on restoring the underlying foundation and support of the face, and replacing the lost fat over the cheekbones and lips. This provides a natural and beautiful result.
Who is a good candidate for a face lift:
Patients often wonder if they are too old, or too young for a face lift. The truth is that everyone ages differently, so there’s no right answer to this question. You may be a good candidate for a face lift if you are in your 40s or your 70s. The best candidates for a face lift are patients who need correction of sagging of the cheek and mid-face area, jowls, or a turkey neck, regardless of their age. It is also important that you are in generally good health, and a non-smoker. If you are a smoker, you must completely stop smoking and refrain from any nicotine-containing smoking cessation aids (such as patches or gums) for 6 weeks before and after surgery. High blood pressure, which affects so many people, must be well controlled before surgery.
How to prepare for surgery:
Most patients will need to visit their primary care doctor for a pre-operative physical and get clearance for surgery. If you are a smoker, you must completely stop smoking and refrain from any nicotine-containing smoking cessation aids (such as patches or gums) for 6 weeks before and after surgery. This is critical: smokers who undergo a face lift can have significant complications including skin loss and open wounds on the face.
You should discuss with Dr. Nagarkar which medications and supplements you need to stop taking before surgery, and which ones you can continue. In general, blood-thinning medications such as Aspirin, Warfarin, Coumadin, Plavix, or Xarelto must be stopped for a few weeks before surgery. It is very important to provide complete information to prevent any post-operative problems. You will get detailed written instructions for pre- and post-operative care. In addition, you will receive any postoperative prescriptions you might need so that you can have them filled by your pharmacy in advance.
What to expect on the day of surgery:
Face lifts require around 3 to 5 hours depending on whether or not eyelid or brow surgery is also being performed at the same time. You should plan on having nothing to eat or drink after midnight the night before surgery. Generally, you will stay at the hospital for one or two nights for observation. You will need to have someone drive you to and from the surgery, and to help around the house for a few days while you get your energy back.
What to expect after surgery:
Results
Your surgery is designed and performed to achieve the best possible result and as close to 100% symmetry as possible on the operating table. In the first 24 to 48 hours after surgery, significant swelling occurs, and this is often asymmetric in nature. Swelling will resolve slowly over the course of 2 to 3 months.
The first few days
The first night after surgery, it is critical that you are out of bed and walking. This reduces the risk of forming blood clots in your legs. Dr. Nagarkar will call you the day after you go home to check in with you and to answer any questions you might have.
Pain
Narcotic pain medications are usually only needed for the first few days after a face lift. Afterwards, anti-inflammatory over the counter medications like Tylenol are adequate. You should not use blood-thinning medications like Aspirin or Ibuprofen for pain, as these increase the risk of bleeding.
Incision care
Your incisions will be closed with absorbable sutures. You can generally start showering the day after surgery, when your surgical drains will be removed. It is critical that you protect your incisions from sun exposure as they are very sensitive to sunlight for the first six months of the healing process.
Drains
You will have a small drain placed behind each ear (a little plastic tube to remove any fluid that collects underneath the skin) – these drains are removed the day after surgery, while you are still in the hospital.
Diet
You can return to your regular diet after surgery, but for the first day or two, stick with lighter meals. Anesthesia can sometimes make your digestive system a bit sensitive, and having a double cheeseburger the evening after surgery is not recommended. It is very important to refrain from high-sodium foods because these will increase swelling and undo some of the improvement made by surgery.
Work
You will be able to wear makeup and look presentable around the 2 week mark. If you also had eyelid surgery performed at the same time, this will take 3 to 4 weeks.
Activities
You will be able to go back to non-strenuous activities such as walking, using a computer, writing, and so on, immediately after surgery.
Exercise
Aerobic exercise such as yoga, running, cycling, barre, etc., must be stopped for 3 weeks to allow the skin to heal. You should not lift anything over 10 lbs for the first 3 weeks.
Driving
You can resume driving once you are no longer taking narcotic medications, and when you feel that you are in full control of your car. This often takes a week or two.
Follow-up visits
You will see Dr. Nagarkar in the office usually 7 – 10 days after surgery to examine the incisions and ensure that you are healing appropriately. We will see you again at the 4-6 week mark at which time Dr. Nagarkar may clear you from any activity restrictions if you are healing appropriately. Finally you will have appointments around 3 months, 6 months and 1 year after surgery.
To meet Dr. Nagarkar in person, schedule your consultation or call us.