Our face is our most visible feature, one that through expression and appearance conveys what and how we feel. Facial aging includes a loss of skin elasticity and firmness, sagging tissue and wrinkles. These visible signs of aging can greatly impact how we feel about ourselves and how others see us. Even a person who is energetic and excited about life can appear tired or sad due to aging in the midface, jaw line and neck. The loss of youthful contours in these areas is due to a variety of factors including heredity, gravity, environmental conditions and more.

If you are bothered by the signs of aging in your face, a facelift may be right for you. In general, a facelift corrects sagging facial skin and muscles, removing excess fat and restores firmness to create a more youthful, rested and vibrant appearance.

What is a facelift?

A facelift can improve the deep cheek folds, jowls and loose, sagging skin around the neck that come with age.

A facelift is designed to correct all of these aging features, restoring a more youthful, rested appearance with uplifted contours and improved tone in facial skin and underlying muscle. Where desired improvement can be isolated to the midfacial region and where excess skin is less a factor, a limited incision lift may be an alternative to a traditional facelift.

As a restorative surgery, a facelift does not change your fundamental appearance and cannot stop the aging process. Although you will continue to age naturally, aging will progress from the more youthful version of yourself that has been restored by a facelift. Rejuvenation procedures typically performed in conjunction with a facelift are brow lift, to correct a sagging or deeply furrowed brow, and eyelid surgery to rejuvenate aging eyes.

A facelift is best performed on adult men and women who feel that their outward facial aging no longer reflects the youth and vigor they feel physically and emotionally. Good candidates are:

• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing.
• Non-smokers.
• Individuals with a positive outlook and specific, but realistic goals in mind.

Incisions usually begin above the hairline at the temples, follow the natural line in front of the ear, curve behind the earlobe into the crease behind the ear, and into or along the lower scalp.

A consultation with Dr. Prevel is the first step to learn how a facelift can improve an aging face and neck. A consultation is designed to fully educate you about facelift in a non-pressured environment, and will include:

• A discussion of your goals and an evaluation of your current signs of aging
• The options available to you for facelift and facial rejuvenation
• The likely outcomes of a facelift and the potential risks and complications associated with the procedure
• The course of treatment recommended by Dr. Prevel

Dr. Prevel will also answer all of your questions.

Evaluation

Overall health and personal outlook can greatly impact the outcome of a facelift. These will be carefully evaluated in consultation with Dr. Prevel. The success of your procedure, safety and overall satisfaction require that you:

• Honestly share your expectations
• Fully disclose health history, current medications, the use of vitamins, herbal supplements, alcohol, tobacco and drugs
• Commit to precisely following all of Dr. Prevel's instructions

Safety

By making the decision to consult with your plastic surgeon and following all the instructions given, you are taking an important step in helping to assure your safety.

Your plastic surgeon is certified by The American Board of Plastic Surgery® or The Royal College of Physicians and Surgeons of Canada@. This certification designates surgeons who are specifically trained in plastic surgery of the face and entire body.

Facial, neck tissue and muscle may be separated; fat may be trimmed or suctioned and underlying muscle may be tightened.

A facelift is a highly individualized procedure. Dr. Prevel will evaluate your skin, muscle and bone structure and the specific conditions that contribute to your aging appearance. These factors are the most significant considerations in determining the appropriate technique or combination of procedures to best achieve your realistic goals. A facelift can only be performed surgically; non-surgical rejuvenation treatments cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate. Most patients are reassured to know that a facelift will not change their basic appearance, but will restore it to a younger version of itself that will then continue to age naturally over time.

A traditional facelift restores the midface, jowls and neck, allowing excess skin to be removed. Where improvement is desired in the midface region alone and where excess skin is less a factor, limited incision techniques may be an alternative to a traditional face lift. Your goals, anatomy and your plastic surgeon's surgical judgment are all factors in determining the best approach to your individual case.

Procedures that may further enhance the outcome of a facelift may include: facial implants or soft tissue augmentation to recontour the facial structure, and resurfacing techniques to improve the tone and texture of facial skin. Wrinkle reduction by injection (Botox®) may be recommended prior to your procedure (to help underlying muscles fully relax before repositioning and tightening) or after (to help maintain results).

Preparing for surgery

Dr. Prevel will carefully explain the facelift procedure you will undergo. Prior to your procedure, you will be given specific instructions that may include:

• Pre-surgical considerations, diagnostic testing and medications
• Day of surgery instructions and medications
• Specific information related to the use of anesthesia

In addition, you'll be asking to sign consent forms to assure Dr. Prevel you fully understand the procedure you will undergo and any risks and potential complications.

After deep tissues are tightened, the excess skin is pulled up and back, trimmed and sutured into place.	Most of the scars will be hidden within you hair and in the normal creases of your skin.

Risks associated with a surgical facelift include infection, bleeding beneath the skin (hematoma), correctable hair loss at the incisions, facial nerve injury with weakness, facial asymmetry, skin loss with scarring, numbness, and risks associated with anesthesia. These and other potential risks and complications will be fully discussed prior to your consent.

It is important that you address all your questions directly with Dr. Prevel. It is natural to feel some anxiety, whether from excitement for the anticipated outcomes or preoperative stress. Discuss these feelings with Dr. Prevel.

What to expect

A facelift may be performed in your plastic surgeon's accredited office-based surgical facility, an ambulatory surgical facility or hospital. The decision for anesthesia will be based on the requirements of your specific procedure and considerations of patient and surgeon preference. Dr. Prevel and the assisting staff will fully attend to your comfort and safety.

Following surgery

Once your procedure(s) are completed, a bandage will gently be placed around your face to minimize swelling and bruising. A thin tube may be present to drain any excess blood that may collect under the skin. Before you are released, you and an accompanying caregiver will be given specific instructions that may include:

• How to care for the surgical site
• Medications to apply or take orally to aid healing and reduce the potential for infection
• Specific concerns to look for at the surgical site or in overall health
• When to follow up with Dr. Prevel

Progress and healing

Initial healing will include swelling and may include numbness and discomfort that can be controlled with medication. Your skin will likely look bruised and discolored. In addition, facial movements may be temporarily restricted. These are common conditions.

Dr. Prevel will instruct you to keep your head elevated at all times until initial swelling has subsided. You will be provided specific postoperative instructions including cleansing of your face and hair. Follow all instructions carefully; this is essential to the success of your outcome. A return to light, normal activity is usually possible within a few days of surgery.

For the most part, facelift incisions are well healed within a week. You will be ready to return to work and light, normal activity sometime between 2 to 4 weeks. Cosmetics can usually camouflage any bruising that remains.

After surgery, you'll present a fresher, more youthful face to the world.

Healing will continue for at least several more weeks swelling resolves and incision lines continue to improve. You must practice diligent sun protection until the healing process is fully complete. Continue to follow Dr. Prevel's instructions and attend follow-up visits as scheduled.

Results and outlook

It may take several months for swelling to fully dissipate and up to 6 months for the incision lines to refine and fade to some degree. Life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend the results of your rejuvenated, more youthful appearance. Most patients find that the benefits of their initial facelift results are long-lasting, even as they continue to age.