A facelift is plastic surgery to repair sagging, drooping, and wrinkled skin on the face and neck. As people get older, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. There may be deep creases between the nose and mouth, the jaw line may have grown flabby, and there may be folds and fat deposits around the neck. A facelift will not stop the aging process. A facelift can be done to remove the excess fat, and tighten the muscles and skin. It is sometimes performed with other plastic surgery to reshape the nose, forehead, or eyelids.
The best candidate for a facelift is a man or woman whose face and neck have begun to sag. The individual's skin should still have some elasticity and their bone structure should be strong and well-defined. Another consideration is the cost. Most health insurances do not cover the expense of a facelift. A plastic surgeon may request full payment before the surgery is performed.
A facelift may be performed in a surgeon's office, a same day surgery center, or a hospital. Facelifts may be performed under local anesthesia, combined with a sedative to cause drowsiness. In this setting, the person will be awake, but relaxed. There should be no pain. Some surgeons prefer to use general anesthesia, meaning the person is put completely to sleep with medications.
Incisions are made above the hairline, at the temples, and behind the earlobe. The skin is separated from the fat and muscle underneath. Excess fat can be trimmed or suctioned from around the neck and chin to improve the contour. The muscle and skin are tightened. Tiny stitches are generally used to close the layers of tissue. Metal clips are sometimes used on the scalp.
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The Merck Manual of Medical Information, Home edition, 1997