Facelift is a cosmetic surgery procedure with the purpose to improve visible signs of aging. Wrinkles from stress, sun exposure and effects of gravity often cause patients to seek facelift surgery. Facelift surgery can smooth out the skin in the face and neck area and help to make the patient look more youthful and revitalized.
Our renowned Pittsburgh plastic surgeon, Dr. Lori Cherup, at Radiance Plastic Surgery evaluates patients for facelift surgery.
In the temporal area, Dr. Cherup can make the incisions within the hairline or in front of the hairline. If made in front, the scars will be visible but the hairline will not change. Scars made within the hairline cause the hair to move up and slightly backward when the facelift is done. Our Pittsburgh facelift surgeon, who practices throughout all locations within the Pittsburgh, Pennsylvania, area, finds it best to place the preauricular (in front of the ear) scar behind the tragus (the small flap at the external opening of the ear), as that incision is least noticeable.
The incision behind the ear can also be made within or below the hairline. If made within the hairline, much of the scar from the facelift will be hidden, BUT THERE WILL BE A CHANGE IN THE HAIRLINE AND THERE WILL BE MORE HAIR-FREE SKIN BEHIND YOUR EAR. If Dr. Cherup places the incision below the hairline, the hairline will remain intact, but the scar will be visible if you wear your hair up.
Longer, rather than shorter, facelift incisions produce a better result, as more skin can be removed. On the other hand, longer incisions and more skin removal mean that more changes will occur in the hairline if the incisions are placed there. Dr. Cherup can attempt to re-approximate the hairline behind the ear and eliminate the notching, but usually at the expense of the overall facelift result!Hematoma:
If excessive bleeding occurs under the skin after facelift surgery, a collection of blood under the skin (a hematoma) can form. If the hematoma remains small, the body will absorb it gradually. If it becomes larger, it may need to be removed by suction. Further surgery to remove clots is uncommon, but occasionally necessary. If it is necessary, our cosmetic surgeon can perform surgery to correct the effects from the facelift.Loss of Sensation:
Permanent numbness rarely occurs from facelift surgery. When it does, it usually involves the earlobes and rarely the skin in front of the ears.Skin Loss:
Occasionally after facelift surgery, poor circulation coupled with skin under tension will lead to blistering, redness, and, rarely, small areas of skin loss. Skin loss most commonly occurs behind the ears but can occur elsewhere. If this happens, it will delay healing, and superficial scarring may occur. You may require some "touch-up" procedures. (This is why we ask smokers to discontinue smoking for several weeks before and after facelift surgery, as they are at the greatest risk for this complication).Postoperative Sagging:
Your cosmetic surgeon will walk a tightrope during facelift surgery. If the skin is pulled too tight, circulation diminishes and skin can die. At her practices around the Pittsburgh, Pennsylvania area, Dr. Cherup will lift or tighten your skin as much as it is safe to do. If your skin does not have normal elasticity, it may stretch or sag sooner than desired. This is not your cosmetic surgeon's fault. A subsequent small tuck can be very helpful if you have this kind of skin.Nerve Injury:
It is extremely rare for the main trunk of the facial nerve to be injured. Temporary damage from facelift surgery to one of the peripheral branches is uncommon. If this should happen, you might have difficulty in moving your forehead, upper lip, or lower lip. Resolution usually occurs in a month or two after your facelift; however, permanent damage remains a remote possibility. Occasionally, the sensory nerve that supplies the earlobe may incur damage despite the best efforts to preserve its function.Asymmetry:
No one's face is totally symmetrical. Many people notice asymmetry for the first time when they scrutinize themselves after a facelift. Because this facelift surgery is as much an art as a science, surgical asymmetries can occur. Further surgery is rarely necessary. Our cosmetic surgeon can be reached for surgery to help correct the previous facelift effects.Chronic Pain:
Most facelift procedures cause very little discomfort for more than a few days and all the skin sensation will have returned to normal in 3-5 months. In very rare cases, patients have noted chronic pain at the surgical site that lasts a year or (occasionally) longer. Rarely, our facelift Pittsburgh patients complain that the operated areas become superficially hot or red from the facelift. These symptoms can occur following exercise or for no apparent reason and can occur for several months. The reasons for all the above symptoms are unclear and specific treatment is not known. Massage and ice packs may be symptomatically helpful. Some patience while the symptoms clear over time is required.» Back to top
The surface of the parotid gland (a large salivary gland below and in front of the ear) is exposed as part of the facelift procedure for tightening the deeper layers. Occasional swelling of the parotid gland or discomfort while eating may occur for 1-4 weeks after facelift surgery. This is a self-limiting problem and will resolve without treatment.Scars:
Scars from a facelift will occur and may go from pink and firm to faded and soft over a period of six to twelve months; some scars may widen, become depressed, or appear raised, firm, and "ropey" red which may take two years or longer to fade and soften; scars will be permanent and visible.Hair Loss:
Possible loss of some hair along the incision lines on the scalp is possible following a facelift.Fluid Collections:
Fluid collections may accumulate under the skin and may require drainage or aspiration (withdrawal by needle) after facelift surgery.Injury to Deeper Structures:
Blood vessels, nerves and muscles may be injured during facelift. The incidence of such injuries is rare. (See Nerve Injury)
Further information on facelift risks can be obtained by reaching our staff at one of our offices in or near the Pittsburgh, Pennsylvania area.
The bulky dressing placed at the time of facelift surgery puts some pressure on the areas operated on and helps soak up any external drainage of normally occurring serum and blood. If the dressing is too tight or causes pain, please call our main Pittsburgh, Pennsylvania location at (412) 220-8181 to talk to a cosmetic surgeon or nurse. You may be instructed to cut part way or completely through the portion of the dressing under the chin. This will usually relieve the discomfort. Removing the entire dressing will not cause any problems, in the unlikely event that this seems to be necessary. We remove the bulky dressing the morning after facelift surgery and replace it with a very light one, which you will remove the following day. After that, there are no more dressings.Position:
Keeping your head elevated as much as possible will help to reduce postoperative facelift swelling. If you can, sleep on two or three pillows to keep your head above the level of your heart.Drains:
On each side of your face, a small drain may be placed under the skin and brought out through a small incision made in the temple. These drains evacuate the fluid that accumulates after facelift surgery and enable you to heal faster. When the drain is first put in place, the bulb at the end of each tube will be compressed to create gentle suction. As the fluid collects in the bulb, it will expand.Drain Care:
Secure the bulb of the drain to the dressing on your head with a safety pin. The evening of the facelift surgery, you should empty the bulb by opening the plug at the top and pouring out the contents. Do not attempt to remove the bulb from the tubing. Squeeze the bulb to recompress it, and put the plug back into the hole at the top in order to maintain the vacuum. Do this whenever the bulb fills or expands 50% or more.
If the bulb fills rapidly after emptying it, or you need to empty it more than three times daily, please call our main location at (412) 220-8181. Dr. Cherup or a nurse will usually remove the drain the day after facelift surgery, but occasionally they are left for 2-3 days. Removing them feels a little strange, but is not painful. You may shower and shampoo your hair the day after the drains are removed.Bleeding:
Small amounts of oozing and bleeding after facelift surgery are normal. The bulky dressing may be stained and the size of the stain may enlarge after you go home - this is normal. If serious bleeding occurs after the facelift, apply pressure and call us. Bleeding under the skin flaps that causes serious swelling and discomfort is very uncommon, but if it does occur, it requires attention and evaluation by your cosmetic surgeon. Call us at (412) 220 - 8181 immediately.Sutures:
The sutures in front of your ears will be removed 4-6 days after facelift surgery. If you have had an incision made under your chin, those sutures also will be removed 4-6 days after facelift surgery. The staples within the hair and the sutures behind the ear are removed 9-12 days after facelift surgery.Sunscreen and Makeup:
It is imperative that your scars be protected from the sun for a good 6 months after facelift surgery. Use a sunscreen with a skin-protection factor (SPF) of at least 15 at all times. It should be applied before your makeup. You may begin applying makeup 2 days after your sutures are removed. Speak to our nursing staff or the front office about scheduling a skin care appointment at one of our offices in or near Pittsburgh, Pennsylvania. We provide this service to help you maximize the benefits of your "new look."Skin Care:
All the skin of the face and neck may feel dry and chapped after facelift surgery. We recommend that you make frequent and liberal use of a good moisturizer without fragrances in it.Hair Care:
After a facelift, most patients experience a temporary change in the texture and manageability of their hair. Your hair is reacting to the "shock" of facelift surgery and will recover naturally within 6 weeks. If you color or perm your hair, plan to have it done before facelift surgery or wait until 6 weeks afterward for the best results. Your hair will be a little "lifeless" during that period of time.Shampoo:
Forty-eight hours after facelift surgery or 24 hours after the drains have been removed, you may wash your hair. You may prefer to have your hairdresser wash it for you. In either case, a hair dryer, if used at all, should be kept on the lowest heat setting, as your scalp may be partially numb.
Further information on facelift postoperative instructions can be obtained by reaching our staff at one of our offices.» Back to top
When the skin is separated from the underlying tissues during facelift surgery, small sensory nerves are cut. Varying degrees of numbness will be present after surgery and will improve gradually as the nerves reconnect to the skin. This process can take from 2 months for face, neck, and cheeks to 9-12 months for the forehead and scalp.Tightness:
Frequently there is a tight feeling in the neck after a facelift. During facelift surgery, not only the skin, but the underlying muscles are tightened to create a better and longer lasting result. Additionally, the swelling will move downward in the first week and the neck will feel even tighter. Do not be alarmed! You will not choke, and the sensation will decrease during the first month.Healing of Sensory Nerves:
As the nerves regenerate, itching, burning, tingling, and shooting sensations will occur. Ice, moisturizers, and gentle massaging are helpful during this phase of the facelift healing process.Firmness Under Skin:
Some degree of firmness or lumpiness under the skin is normal after facelift surgery and will resolve with time. Local massage will speed resolution of this problem, which normally takes 2-4 months to disappear completely.Asymmetric Swelling:
Do not be alarmed if one side of your face is slightly more swollen or numb than the other. This is common and usually disappears within a few weeks after a facelift.Eye Symptoms:
Your eyelids may feel tight even if they have not been operated on, because of the swelling that occurs in the entire face. Your vision may also be blurred from the ointment that is placed in them for protection during facelift surgery. Eye drops and ice packs will feel particularly soothing for the first few days after facelift surgery.Activities:
Most facelift Pittsburgh patients feel reasonably normal within 3-4 days after surgery even though they are swollen. If you wish to do light office work, you may. Do not, however, do any heavy activities or aerobic exercise for at least 3 weeks after facelift surgery! Strenuous activities can cause bleeding and swelling for a longer period than is necessary.
For more information on the cosmetic surgery risks, postoperative instructions or healing information for the facelift procedure, contact surgeon Lori Cherup.Back to top