Facelifts are a great procedure for patients in their 50s, 60s, and 70s to reverse signs of aging such as excess skin and sagging along the jawline (jowls). Both gravity and diminished volume result in the facial features of aging. Most patients requesting evaluation for a facelift feel that their facial features do not reflect the fact that they still feel youthful and energetic. Facelift procedures are designed to smooth the skin of the face, tighten the underlying tissues and muscle, and remove excess skin.
Many facelifts also incorporate some degree of a neck lift, depending on the severity and location of excess skin. If you are interested in getting a neck lift in conjunction with a facelift, please see our Neck Lift procedure page for more information. For patients who are looking for a smaller facial rejuvenation procedure, please see our Mini-Facelift procedure page for more information.
Good candidates for this procedure:
Patients with sagging skin in your midface and/or jawline
Patients with deep creases extending from the nose to the corners of the mouth (nasolabial folds)
Patients with lines extending from each corner of the mouth down the chin (marionette lines)
Patients with fallen or displaced facial fat (volume)
Patients with sagging and loss of muscle tone in the lower face, resulting in jowls
What to expect: Consultation
All cosmetic consultations are complimentary and serve as a great opportunity to gain further insight by voicing your concerns and having questions answered. During the initial consultation, Dr. Hsu will ask some questions to get to know you and determine if you are a good candidate for a facelift.
After learning about your unique history and examining the relevant area carefully to assess the anatomy, Dr. Hsu will ask you about your past medical history, including any existing medical problems, prior surgery, daily medications, allergies, and any smoking habits. Dr. Hsu will then give you his assessment on whether to go forth with the procedure and, if so, how the surgical plan should be individualized for your anatomy. Since each patient’s desires and anatomy are different, you and Dr. Hsu will work together to reach optimal aesthetic results.
On the day of surgery, arrive early to fill out paperwork, meet the anesthesiologist, and be prepared for surgery. Dr. Hsu will meet you in the pre-operative area before surgery to make markings on the areas planned for surgery and answer any last minute questions you may have.
Facelift procedures are performed under general anesthesia for a duration of approximately four hours. Dr. Hsu will make the incision where the ear meets the cheek, ensuring it will be nicely hidden. Depending on the degree of the facelift, the incision can trace from the hairline in the temple to the front of the ear and may extend to behind the ear. Dr. Hsu will use the unique technique of lifting the skin, accessing the muscle, tightening the muscle, and then removing excess skin. This method creates a more naturally enhanced result rather than a pulled look.
Recovery & Post-operative Instructions:
After the surgery, Dr. Hsu will wrap dressings around the surgical area which will remain there for the first week during healing. You must keep your head elevated during recovery periods, making sure to sleep on two pillows at night. We also recommend wearing a handkerchief or shawl to cover the area so that you will be more comfortable going outside. For most patients one week after surgery, bruising and swelling has subsided enough for makeup and concealer to cover any remaining bruising.
Most importantly, you should keep the surgical area dry until Dr. Hsu gives his approval to shower. To clean the rest of your body, you can bathe from the shoulders down. Dr. Hsu will usually remove stitches during your first week follow up appointment. Swelling & bruising will peak about 48 hours after surgery but will then decrease significantly in the first two weeks. Most patients can return to work after two weeks, but many patients return even sooner! The biggest limitation for post-operative patients is driving, which should be avoided while taking pain medication. Patients usually stop taking pain medication after five to seven days and plan their work schedules accordingly. Six weeks is usually an appropriate time to gradually return to full exercise and activity.
During the recovery period, we recommend walking within the house several times per day to speed healing and minimize the possibility of developing blood clots. If you have any inquiries, Dr. Hsu is available 24 hours following surgery through his personal cell number. For an extended period of time after surgery, Dr. Hsu will maintain regular contact with you to make sure you are healing well. Most follow up appointments are scheduled one week, two weeks, and several months to a year afterward.
Dr. Hsu's view on a Facelift.
The facelift and mini-facelift procedures are two of my favorite procedures. Especially when combined with a neck lift, and/or upper eyelid surgery, the results from these procedures can be quite astounding in some patients.
Perhaps more than any other plastic surgery procedure, the facelift and mini-facelift procedures are highly individualized by patient. In my experience, I’ve seen that different patient faces can age quite differently. In some people, it is more in the jawline and “jowls” with excess skin hanging around the chin. In other patients, it is in the deepening of their smile lines around their mouths (the “nasolabial folds”). In yet others, it is in the descent of the cheeks. It is really quite surprising how different the facial aging process affects different faces, and so careful evaluation is needed to appropriately “set back the clock” for the individual patient’s face.
In nearly all patients, I prefer to perform my facelifts and mini-facelifts in two layers, working on both the skin as well as the muscle layer below. I feel that this gives an excellent lift which is natural appearing, without giving the skin a “pulled” appearance. Overall, my goal is to give patients a rejuvenated appearance, done in conservative fashion so that their friends just notice that they look “fresher” and more rejuvenated, without knowing immediately how it was accomplished. I can not emphasize enough that each face is individual and unique, and careful and meticulous technique is required in order to give a natural rejuvenation.