The term “facelift” or “face lifting” covers several variants of cosmetic surgery on the face. A facelift essentially serves to tighten deeper wrinkles on the face. These wrinkles are a sign of aging due to a slackening of the tissue. The excess tissue in the skin and subcutaneous tissue follows gravity and sags downwards. The task of a facelift is to smooth out the pronounced skin folds. The face becomes firmer after the procedure, and as a result, the face looks younger and happier. The exact procedure of the surgical face lift depends on the individual findings and the ideas of the patient. Among other things, the forehead, the temple region, the cheeks, and the neck can be lifted.

Woman Face - Cosmetic Dermatology

Why facelift?

A facelift is primarily performed to smooth deep wrinkles on the face. Such wrinkles can be found on the forehead, temples, corners of the mouth, cheeks, and neck. Deep facial wrinkles are mainly caused by aging processes that cause gradual tissue relaxation. A constantly recurring increased tension of the facial muscles contributes to tissue weakness, as well as other factors such as frequent exposure to the sun, nicotine abuse, or severe weight loss. The flaccidity causes the skin to be pulled down by gravity and sag in wrinkles. Larger wrinkles can be smoothed out with a facelift. Small wrinkles, such as at the corners of the mouth or on the eyelid, cannot be improved with a facelift.

At the same time, the facelift serves to restore the original proportions of the face, as the drooping areas are pulled back into their correct place. This applies primarily to the subcutaneous fatty tissue. A facelift on the forehead, for example, can raise the sunken eyebrows again. If the temple is operated on, it also tightens the eye area. Sagging contours on the chin or over the cheekbones can be corrected. Fat deposits on the chin can also be removed as part of the facelift surgery on the neck. A facelift comes into question when other treatment measures are not sufficient to beautify the face satisfactorily.

A detailed consultation is one of the prerequisites for a facelift operation. There we will discuss which wishes exist and can be realized and which procedure can be chosen. The doctor also finds out whether there are any diseases or whether the patient has an allergy.

The doctor conducts the necessary preliminary examination of the patient. The face is assessed with the changes that have occurred over time, and the possibilities as well as the limits are weighed up. The general state of health is also important. The anesthetist (anesthesiologist) then talks to the patient and do the examination. Of course, possible risks and complications must be explained to the patient. As with all aesthetic procedures, the decision to operate is free and must be made by the patient based on all information. Finally, the patient has to agree and sign a form that says he wants the operation and agrees to it being carried out.

Smoking should be stopped four weeks before and four weeks after the operation because it increases the risk of wound healing disorders. Alcohol and sleeping medications should also be avoided if possible. Anticoagulant medication must be stopped before the operation. This will be discussed with the doctor.

There are some circumstances that speak against cosmetic surgery. In addition to severe general diseases (e.g. of the heart), these also include blood clotting disorders and the tendency to excessive scarring. Ultimately, the doctor must decide whether to give the green light for a facelift.

How does the facelift work?

The procedure differs from patient to patient. The doctor depends on the patient’s wishes and the conditions found in the facial skin and soft tissue. The patient is admitted to a hospital ward for an extensive facelift operation.

In some cases, facial lifting procedures are performed under general anesthesia. In other cases, the operation is performed under local anesthesia with simultaneous sedation using medication.

The course of the cut is created as determined in the preliminary discussion. In most facelifts, the incision goes from the side in front of the hairy temple region, over the area in front of the ear, to the nape of the neck. There are a few cheap alternatives.

The skin is lifted from each incision, revealing the underlying tissue. The muscles under the skin of the face and neck (SMAS, superficial musculoaponeurotic system) are also relocated. As a result, improved tension can also be achieved. Excess skin parts are removed if necessary. During a facelift, facial muscles, fat, and connective tissue can be corrected. Tissues and muscles can be attached to the ground with very fine threads.

The temples, cheeks, and neck are usually tightened in the same operation. But there are many possibilities for variation depending on the findings. The ultimate goal of a facelift operation is restoration—not changing the face. The surgeon must analyze all age-regressive changes and incorporate any combinations into the treatment plan. This then allows for a natural result.

Recovery after a facelift

Any drains inserted can be removed after about two days, as can the bandage. The patient should rest for five to seven days. The head should be elevated, and the face can be carefully cooled to keep swelling to a minimum. Ointments should be avoided as the skin heals best undisturbed. Showering is possible immediately. The doctor can remove the stitches after ten to twelve days. The healing time varies, depending on the type of facelift and the patient’s condition. Smoking and sports should be avoided for four weeks, and no intense sun should get on the skin for three months.

What success can be achieved with a facelift?

It will only be clear after a few months whether the operation has ultimately gone satisfactorily. In most cases, the result corresponds to the goals that were agreed upon in the preliminary discussion. The facelift leads to a significant tightening of the skin. The face looks younger, and it seems livelier, friendlier. The contours are clearer and more beautiful. Very small wrinkles do not disappear during the procedure, and sometimes more noticeable wrinkles are left, simply so that the face does not appear too artificial. In general, a perceived skin rejuvenation of about 10 years is realistic with a facelift.

It should be noted that the aging of the skin will certainly progress despite the procedure. The result has changed noticeably after about 8 to 10 years. However, this can vary greatly in different patients. If desired, another facelift operation can be performed if no other circumstances speak against it.


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Facelift Before After


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