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Facelift/Necklift

As one of the leading facelift specialists in the San Francisco Bay Area, Dr. Barbara Persons uses advanced surgical techniques to create natural-looking results while minimizing scarring and downtime. She is a fellowship-trained, board-certified plastic surgeon whose reputation for compassionate patient care and excellent outcomes attracts facelift patients to her Lafayette and Brentwood practice near Walnut Creek from throughout California.

Is a Facelift for You?

A facelift reduces sagging and wrinkling in the lower face and neck. It does not correct problems around the eyelids, at the corners of the mouth, or creases of the lips. The facelift is one of the most popular cosmetic operations performed because as medical advances and better health have increased the average life span, many women and men find that they look older than they feel and act.

Even though many people consider facelift surgery in their 50s and 60s to correct sagging skin, so they appear younger and rejuvenated, Dr. Persons sees younger women and men who get facelifts to nip those signs of aging in the bud. The amount of improvement depends upon the degree of wrinkling and sagging already present. If minimal, then the changes may be subtle, but the aging process is deterred. If the wrinkling and sagging are great, the results can be very dramatic.

Combining Facial Plastic Surgery Procedures

The term “facelift” is often used incorrectly to describe a total rejuvenation process. Dr. Persons may recommend combining other procedures to create more comprehensive results and to produce an overall youthful appearance. The most common procedures combined with a facelift include:

• Eyelid surgery
• Brow lift
• Fat transfer

Commonly Combined Nonsurgical Procedures

Nonsurgical treatments can help to maintain or enhance facelift results. Popular options include:

• BOTOX® Cosmetic and other neuromodulators smooth away lines in the upper face caused by facial muscle contractions.
• Dermal fillers restore volume around the eyes and on the cheeks and reduce folds around the mouth.
• Laser skin resurfacing rejuvenates the skin’s coloring, texture, and firmness.

What Happens During Facelift Surgery?

The facelift operation is most frequently performed using light sleep anesthesia. Light sleep anesthesia is the use of medicines to induce a state of relaxation and light sleep. After you arrive at the surgery center, we give additional medications intravenously to induce a profound state of relaxation. Patients typically sleep during the operation, usually have no memory of the operation itself, and experience no pain. Once the patient falls asleep, we use medicine to numb the surgical area. This type of anesthesia is most frequently preferred by patients because it requires almost no recovery from the anesthetics themselves, unlike general anesthesia which may produce nausea after the surgery. It also carries a lower risk of complications. Because of the benefits of light sleep anesthesia, we do not utilize general anesthesia for this procedure.

Dr. Persons makes incisions in the creases in front of and behind the ears and along the hairline, so they are concealed after healing. She applies a pressure dressing after the operation, and you recover in the surgery center until you’re fully alert. This typically takes about an hour, and then you can have someone drive you home.

How Long Does It Take To Recover From a Facelift?

Not all facelift patients recover at the same pace or experience the same level of comfort. There is minimal discomfort generally after a facelift operation, but it can vary from patient to patient. Prescription pain medicine can be used when needed. This timeline provides a glimpse of what most patients can expect.

Day of Surgery

Plan to stay in bed for the first 12 hours following surgery. The following morning you may walk or sit but no activities beyond that should be attempted for 14 days. You’ll return to the surgery center the day after the operation to have your dressing replaced. 

First 48 Hours

You should limit your diet to liquids for the first couple of days following surgery. Resume your normal diet after 2 days. You can remove the light dressing applied on the day after your facelift after the second day.

First Week

You may get the wounds wet 3 days after the surgery and wash your hair but avoid rubbing the scalp until 2 weeks after surgery. Never wash your hair the day sutures or staples are removed. Wait until the following day.

First Two Weeks After Surgery

You should sleep with your head elevated about 30 degrees for the first 2 weeks after surgery. Place 2 pillows under the top of the mattress and 1 or 2 pillows under your head. Try not to roll on your face or sleep on your side. Dr. Persons uses dissolving sutures, so they don’t need to be removed. Surgical staples are often used behind the ear and will be removed during the second postoperative week.

First Month

Avoid turning the head or bending the neck. When you must turn, move the shoulders and head as one unit or as though you had a stiff neck. This is important during the first 3 weeks after your procedure.

3 to 6 Months

You may experience tightness in your face and neck for several weeks. This is normal and will slowly disappear. A certain amount of swelling and discoloration is also normal after this operation. The majority of the swelling and all the discoloration will usually disappear in the first few weeks. Numbness around the ears and on the neck is a normal part of the operation and will generally be gone by 3 to 6 months after surgery.

Frequently Asked Questions

Is there a “right” age to get a facelift?

While facelift patients are usually at least in their late 40s, there is no specific “right” age for the surgery. If nonsurgical treatments do not provide the rejuvenation you desire, it could be a good time to consider a facelift.

Is the surgery painful?

Discomfort is generally minimal after facelift surgery; instead of pain, most patients report feeling sore and tight in the surgical area. You will be provided with a prescription for pain medication, which most patients use only for a few days, if at all.

Will my results look natural?

Modern facelift techniques that do more than tighten the skin provide very natural-looking results. When an experienced, board-certified plastic surgeon performs facial rejuvenation surgery, you won’t look like you’ve had “work done.” You will look like a younger version of yourself.

How many years younger will I look after getting a facelift?

Facelifts can make people look approximately 5 to 10 years younger, depending on their age, degree of facial aging, condition of their skin, and other factors. 

Are there less invasive facelift options?

A new class of facelifts has emerged in the past several years that promises to create a refreshed and rejuvenated look without the scars, downtime, and bruising/swelling associated with the more time-tested classical face-lifting procedures. Some of these are called string suspension facelifts, lifestyle lifts, or short-scar facelifts. Unfortunately, many problems are associated with these procedures. First and foremost, they do not last very long. Surgeons are often reporting a 30 to 40 percent need to re-do the procedure within one year. The longest results are about 4 years before a “re-do” is required. The recovery time for some of these procedures is as long as the more effective facelifts. The results are never as good as the more traditional types of facelifts, and often there is prolonged bunching with some short scar procedures, irregularities, and extrusion of the strings. For these reasons, as well as the fact that we have been able to evaluate these procedures for a number of years and found them to be lacking, we have elected not to offer them.

We do perform mini-facelifts in selected cases, which are short scar procedures. These, however, are never intended to create the same results as our classical facelifting procedures and are only offered in highly selective circumstances.

How long do facelift results last?

The duration of improvement varies somewhat from individual to individual. The aging process continues even after removing excess skin and repositioning sagging tissue. The surgical changes that have been created will slowly age and change, but the improvements will last 8 to 15 years, depending upon the skin tone, general health, previous and continued sun exposure, and if you are, or have been, a smoker. Seeing our own patients up to 15 years after surgery has demonstrated that we are getting excellent, long-term correction. You should realize, however, that you will look much better at any given age than you would have without the operation. So, in a sense, the changes are permanent.

What are the possible risks or complications?

Some developments may occur which are not in the normal postoperative course. You should call our office if any of the following are present:

• Body temperature elevated to greater than 101 degrees
• Sudden swelling or sudden discoloration
• Hemorrhaging
• Increased redness and tenderness of the wound edges, indicating infection
• Allergic reaction to drugs

These are fairly rare but should be immediately addressed.

Get Started

Choosing a facelift specialist is the first step in your journey. Request an appointment with Dr. Persons using the online form or call our office at (925) 283-4012 to schedule an appointment.

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