6 Things You Need to Know if You're Thinking of Getting a Facelift

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Saggy skin? Check. Loose jowls? Check. Turkey waddle? Check.

If these are just a few of the problems looking back at you in the mirror, chances are a facelift is what you need. But before you commit to the procedure, you should know what really goes into it. This includes everything you need to do, both pre- and post-surgery, to optimize your results, which can make you look 10 years younger and tighten everything back to where it belongs.

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The Scar Situation
In order for your plastic surgeon to tighten loose skin and tissue, an incision (about two inches long) will be made above your ear behind your hairline, down the contour of your ear before looping around your earlobe and the back of your ear and ducking into your hairline. “If we’re addressing the neck, an incision is made under the chin,” says New York plastic surgeon Craig A. Foster, MD. These incisions allow your surgeon to get to the underlying muscles and tissues. Post-surgery, the incision points are closed with stitches or staples. Once you are healed, scars are usually minimal.

Where Does the Loose Skin Go?
Once the incisions have been made, your plastic surgeon will tighten the muscles and tissues under your skin. “To do this, the skin on your cheeks, jawline and neck needs to be manipulated in such a way that to get to the underlying layers of your face. The deeper layer, also called SMAS or fascia, is lifted and repositioned,” says Mexico plastic surgeon Juan Carlos Fuentes, MD. Any fat that needs to be removed or added will be done at this time. From there, excess skin is removed and the skin is gently stitched back into place.

You Want to Look Like an Improved Version of Yourself
“Facial rejuvenation is different today than it was years ago. It’s all about lifting what needs to be repoisitoned to where it should be and filling in what’s been lost so that you look like yourself, just younger,” says Northbourough, MA, plastic surgeon Cynthia M. Poulos, MD. “One of the biggest concerns patients have is that they’ll look like they’ve had surgery, which means that the face is too tight or excessively pulled in the wrong direction. Nobody wants to look like they’ve had a facelift. They just want to look like themselves, only better.”

Be Realistic About Your Recovery: Take Two Weeks Off Work
“Some ads say you can have a facelift done during lunch or go back to work two days later, but that’s not realistic,”says New York facial plastic surgeon Andrew Jacono, MD. “There is major downtime with a facelift.” After surgery, you’ll need a few hours to wake up from the anesthesia. There may be drains under your skin to prevent blood and fluid from collection. A week later, stitches are removed and you’ll still be swollen, numb and bruised (it can take a few months to resolve). You’ll want to stay home and keep activities to a minimum. With a mini-facelift, the recovery may be shorter because the procedure is not as extensive.

The Results Are Long-Lasting, but You May Need to Do It Again
A facelift delivers long-lasting results, but as Dr. Fuentes explains, the results are dependent on factors like genetics and health. “If only the skin is pulled and the underlying muscles and tissues are not repositioned, the results won’t last as long.” Some people may need a secondary facelift because surgery doesn’t stop the aging process—your face will continue to age. For the most part, getting a facelift at a younger age leads to longer-lasting results than if you were to have it done when you’re older. “You’ll always look better than you would if you never did it,” Dr. Foster adds.

You May Need Additional Procedures to Get Rid of Wrinkles
One of the biggest things to know about a facelift is that it addresses parts of the face that are drooping. “Anything that has to do with the surface of the skin is a textural issue and a facelift won’t fix that,” says Dr. Jacono. While it will smooth out some lines and wrinkles, it won’t fully erase them, so you may need additional procedures (done while you’re under anesthesia or post-procedure). “Oftentimes, I combine a facelift with a fractional CO2 laser. It’s common for a facelift to be done in conjunction with a browlift, necklift, eyelid surgery and light peels, as well as fillers and Botox Cosmetic, too.”