Face-lift

Before and after a face-lift

Enlarge

A face-lift is surgery to remove excess skin from the neck and lower jaw line (jowl) to give the lower two-thirds of the face a more youthful and rested appearance. A face-lift treats loose, sagging skin. It does not eliminate wrinkles. Face-lift scars are hidden behind the ears in the hair and under the chin.

Face-lifts are most commonly performed on people age 40 to 70. The results of a face-lift can range from subtle to dramatic, depending upon aging changes that were present prior to surgery.

At Mayo Clinic, face-lift surgery is performed by board-certified surgeons specially trained in facial plastic surgery. Mayo's experienced plastic surgery staff takes special care to address the natural anxiety patients have about the face-lift procedure and the extent of post-surgery scarring. Every effort is made to minimize and hide scars strategically in and around the hairline, and to reduce postoperative pain. Patients are followed closely in post-surgery visits to assure they are healing properly.

A person may be a candidate for a face-lift if any of the following conditions are present:

• A deep crease or fold running from the corner of the nose to the corner of the mouth.
• An undefined jawline with excess skin (jowls).
• Loose skin and excess fatty tissue at the neck.

A face-lift can help you feel better about how you look. How long the effects of the procedure last is influenced by such factors as exposure to sun and tobacco products, as well as your genetic makeup.

Limitations

A face-lift alone will not reverse changes in the eye or forehead region. This may require eyelid surgery or a forehead lift. A face-lift will not remove fine wrinkles that are part of natural aging, such as those around the lips and eyes. Skin resurfacing procedures such as chemical peel or laser treatment may be needed to address these wrinkles.

What to Expect

A face-lift is usually done under general anesthesia, but can be done under local anesthesia with intravenous sedation (delivered into a vein through an IV). The surgery is performed through incisions made in existing skin creases and hair-bearing areas surrounding the ear. The goal is to hide scars as much as possible. The incisions are made in the scalp above the ears. They extend to the front of the ears, continue under the earlobes and curve behind the ears into the hair-bearing scalp. Minimal or no hair is trimmed from the scalp along the incisions. The surgeon may adjust underlying tissue to create a smoother and more defined contour to the neck and jawline. Excess skin is then removed.

If necessary, the surgeon will trim or remove with liposuction localized deposits of fat along the jawline or under the chin. Sometimes an incision under the chin is necessary. The surgeon tightens the tissue by moving the skin and often the deeper subcutaneous tissues and muscles to achieve the best possible symmetry. Excess skin is removed and the incisions are closed with sutures and staples.

Risks

As with any operation, face-lift surgery has risks. These may include, but are not limited to:

• Problems related to anesthesia
• Infection
• Ear numbness, facial numbness or paralysis
• Numbness or weakness in moving the eyebrow or corner of the mouth (usually subsides in weeks, but may last for several months or, rarely, may be permanent)
• Hair loss or changes in the hairline
• Skin discoloration or irregularity
• Blood under the skin (hematoma), fluid under the skin (seroma), blood clots in veins (deep vein thrombosis) or lungs (pulmonary embolism)
• Less than optimal healing of scars, especially among people who smoke

Patients can help avoid complications of surgery by:

• Abstaining from all nicotine products for at least six weeks before and after surgery. This includes cigarettes, cigars, chewing tobacco, nicotine gum and patches. These products impair circulation and contribute to poor wound healing.
• Avoiding secondhand smoke.
• Controlling blood pressure. High blood pressure may contribute to or cause bleeding.
• Avoiding aspirin, vitamin E and nonsteroidal anti-inflammatory and anti-coagulant medications for three weeks before and after surgery. These medications may also promote bleeding.