Facelifts & Necklifts
What Exactly Is A Facelift?
"A well done facelift restores the neck contour by tightening and elevating the skin of the neck. It lifts the lower cheeks substantially reducing the jowls, improving the jaw line. The "squared-off" look caused by the descent of the cheeks and jowls disappears giving the face a more youthful oval contour. Often the harsh lines between the nose and corner of the mouth soften and the upper cheeks appear more full and younger looking."
How Is A Facelift Done?
Incisions are made around the perimeter of the ear and just under the chin. The skin is lifted up from the tissues beneath. The SMAS, a layer of tissue under the skin covering the muscles of expression and other structures in the face and neck is elevated and pulled up and back towards the ears. and reattached in this new position. This corrects the cheeks, jowls, restores the jaw line, and tightens the neck skin. The excess skin around the ear is removed and a newly formed perimeter of skin is reattached to the ear.
Incisions are strategically placed in the hairline, around the ear and under the chin so as to be virtually undetectable when they heal. As the tension of the lift is on the SMAS underneath the skin and not on the skin itself, the final result is a natural, rejuvenated look, not the “wind tunnel” appearance characteristic of facelifts done in the seventies.
Where Is The Surgery Done?
We do all our facelifts in our own in-office surgical suite.
What Type Of Anesthesia Is Used?
Unlike most cosmetic and plastic surgeons, we do our facelifts under strictly local anesthesia with oral and intramuscular sedation. We do not use general anesthesia or intravenous sedation. Our method of anesthesia offers several important advantages: As your airway is not compromised, our method of anesthesia is unquestionably far safer than other means of anesthesia. There is substantially less postoperative nausea and vomiting (as much as 40% with general anesthesia). Because you are awake but sleepy, we can ask you to move muscles in your face, making sure we do not injure the nerves to them, (a risk with any facial surgery and impossible to ascertain under general anesthesia). Without the need for an anesthesiologist, the procedure is less costly for our patients.
Is The Procedure Painful?
No. Apart from the initial injections of local anesthesia taking a few minutes and less painful than a dentist numbing your teeth, there is no pain during the procedure. Most of our patients fall asleep during the procedure rousing only when we ask them to move their facial muscles and when we’re done.
What Is The Recovery Time? How Much Time Off From Work Will I Need?
Our patients are able to be up and around immediately after surgery. We remove our sutures and staples ten days after the procedure. For most patients, the swelling has largely disappeared by that time. Almost all of our patients are quite presentable prior to suture removal, usually by the sixth or seventh postoperative day, and can resume most light activities by then. If it occurs, bruising is usually minimal and rapidly descends in the lower neck where it can be easily covered up by a high collar.
Depending on what type of work you do, it is best to take a week off to heal after surgery.
Do I Need To Stay In A Hospital Or Convalescent Facility After Surgery?
Our facelifts are an outpatient procedure. Following the surgery and after a short stay in our recovery room, the vast majority of our facelift patients are discharged directly home, accompanied by a responsible adult. For those who have no one to help them for the first night following surgery, or for those who prefer it, we can arrange an overnight stay in a nearby convalescent home for a minimal additional charge.
What Follow-up Visits Are Required Following Surgery?
We see all our facelift patients the day after surgery. At that time we remove any drains we may have placed in the incisions behind the ears to prevent bruising and redress the incisions. Usually one or two subsequent visits are required prior to removing the sutures and staples on or about the tenth postoperative day. After that, the next visit is usually a month after surgery.
What Kind Of Dressings Or Bandages Are Used After Surgery?
We provide a comfortable, removable, lightweight, facelift garment worn for several days after surgery. Generally the facelift incisions require minimal care.
How Long Does The Facelift Procedure Take?
A standard facelift takes between three and four hours to complete. As indicated above, with our local anesthesia supplemented by oral and intramuscular sedation most of our patients sleep through the entire procedure.
Are There Any Risks Or Complications Of Facelift Surgery?
There are risks and complications associated with any surgery. However, when our simple instructions are followed, they are fortunately few and far between. Very rarely, bleeding in the operated area can occur immediately following surgery requiring us to reopen some of the incisions to stop it. Infection is possible, but to date we have not seen this in any of our patients. Loss of skin behind or in front of the ear is also possible, but our technique makes this highly improbable. Damage to a branch of the facial nerve which controls the facial muscles of expression can happen, but this too is very rare and almost always resolves.
Our overall safety record to date is impeccable and our complication rate is exceedingly low.
Can the Facelift Be Combined With Other Facial Cosmetic Surgical Procedures?
It is rare that we do not combine our facelift with some other facial cosmetic surgical procedure. Most commonly, we remove excess skin above the eyelids at the same time (blepharoplasty), and/or remove wrinkles around the lips (laser resurfacing), and/or augment the cheeks or lips with a fat transfer or other filler, and/or elevate the eyebrows. Additional procedures are limited by the time required to do them and the amount of additional healing they will require.
What Kind Of Result Can I Expect, When Will I See Them, And How Long Will These Results Last?
We aim to make you look like you did when you were five or ten years younger. We do not attempt to change your appearance, just refresh and rejuvenate it. After our facelifts, we never see the “windswept” look characteristic facelifts of the seventies, for as indicated previously, the tension of the lift is on the tissues beneath the skin, and not the skin itself.
You will start to see the results of the facelift within a week. How you look a month or two after surgery is how you will look for the next five to ten years depending on your personal habits and heredity. It should be noted that no cosmetic surgeon can guarantee how long the beneficial effects of surgery will last.
The Secondary Tuck
In some people, particularly those with very sun damaged, weathered or sagging skin, we offer a secondary “tuck up” procedure around the perimeter of the ears one to two years after the initial facelift. This secondary tuck, takes very little time to perform and heal and affords a substantial boost to the results and durability of the original procedure.
I Have Heard Of A “Mini-lift” or S-Lift. What Is This Procedure And Will It Benefit Me?
People vary greatly in how they age and what they need to rejuvenate their faces. Sometimes, if there is not a great deal to do to improve the neck, we can utilize a smaller procedure commonly known as a “Mini-lift” or “S-lift.” The difference between this procedure and full facelift is the extent we have to go behind the ear to tighten the neck skin. In the “S-lift,” we generally do not go behind the ear very far. Both “S-lift” and full facelift address the cheeks and jowls in the same manner. Recovery time with the “S-lift is usually less than a full facelift. Whenever possible we opt for a less extensive surgical procedure, however, in our experience, most people we see require a full facelift to get optimum results.
What Is A Necklift?
For some people, the sagging skin of the neck is their only concern and they do not want a full facelift. A necklift is really a modified facelift where only the skin of the neck is tightened and pulled up, and not the cheeks and jowls. Incisions are smaller and surgery less extensive than that of a full facelift. Necklifts are particularly useful for those who have undergone previous facelifts and have a recurrence of sagging neck skin.
Some older people, especially men, can develop an unsightly, isolated, central band of sagging skin directly below the chin. Often called a “turkey neck’ or “waddle,” this deformity can be easily addressed by a simple, very effective procedure known as a TZ plasty. An incision is made beneath the chin in the midline and the waddle is excised directly. Although this incision is a bit more noticeable than our facelift incisions, it is still very minimal. Overall, the results of this procedure have been quite dramatic cosmetically and very satisfying.
Our Fees, Payment And Financing Policies
The fee quoted for any proposed surgical procedure includes all preoperative blood tests, ECG’s, examinations, the facility, operating room set-up, materials used, postoperative care, dressings, and, of course, the surgery itself. There are no additional charges. We accept cash, personal checks, and most credit cards. A deposit, usually one third the full fee is required at the time the surgery is
scheduled, with the balance paid just prior to surgery. For those who would consider financing their surgery, we suggest CareCredit.
Click here to learn more about CareCredit.
If I Am Interested In A Facial Cosmetic Surgical Procedure, How Do I Get Started?
Simply call 623.876.9494 and arrange a complimentary consultation with Dr. Richard Fisher in our office. Our office address is 13090 N. 94th Dr., Suite 200, Peoria, AZ 85381. (Proceed 4 lights west of the Thunderbird exit off the loop 101, turn left or south at 94th Dr to the second two story building on the right and take the elevator to the second floor, Suite 200.)
At the time of your consultation, your individual concerns will be evaluated, and if appropriate, Dr. Fisher will provide you with a quote for proposed surgery. If you decide to proceed with the surgery, we will make an appointment for a preoperative assessment. At the time of this appointment, we will obtain your complete medical history and perform a brief physical exam, take blood for laboratory testing, perform an ECG if indicated, review the proposed surgery in detail, accept the required one-third deposit, and schedule the surgery for a mutually convenient time.
