Traditional Face Lift: Step-By-Step

1
Anesthesia Is Administered

Perforation lines on females face, plastic surgery concept. Shallow sharp focus on eye.
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The first step in face lift surgery is the administering of anesthesia. Some surgeons prefer the use of general anesthesia, while others believe that a combination of local anesthetic, mild sedatives and a light intravenous sedation is sufficient for patient comfort. Be sure to discuss your anesthesia options and concerns with your surgeon.

2
Surgeon Makes Incisions

Image shows the incision lines for a traditional face lift. The red dashed line represents the incision which is placed behind the ear. © Dr Steven Denenberg

The surgeon makes the incision for a traditional face lift surgery beginning in the temple area behind the hairline, then continuing down in front of the ear, and circling around the ear lobe back up to the point where it started, in the scalp. Care is taken to position the incision in a natural skin crease so it is camouflaged from view.

3
Muscle and Connective Tissue Are Repositioned and Tightened

Illustrations show the repositioning of underlying muscle and connective tissue, called plication. Red represents muscle and connective tissue, while blue represents the skin. Black lines indicate the placement of sutures. © Dr. Steven Denenberg

The surgeon pulls the skin outward to gain access to the underlying muscle and connective tissue. He or she then repositions and tightens the tissue, securing it in its new position with sutures and/or tissue glue. Some fat may also be removed or repositioned at this point.

4
Excess Skin Is Trimmed Away

Shaded areas show skin that will be trimmed away. . © Dr. Steven Denenberg

After the tightening of underlying tissues, the excess skin is trimmed away. Care must be taken to cut precisely so as not to ultimately alter the patient's features or facial proportions, or to leave the patient with the dreaded "wind-blown" look.

5
Incisions Are Closed

Images depict incisions closed with a combination of staples and sutures. © Dr. Steven Denenberg

The surgeon will use fine sutures, staples, and possibly more tissue glue to close the incisions and promote healing.

6
Healing Begins With the Application of Dressings

The first image shows a patient 1 week post-op, before removal of staples and sutures. Second image shows an ideal healing result, 2 weeks post-op. © Dr. Steven Denenberg

The patient's face will be wrapped in sterile surgical gauze, completely covering the incision sites. These bandages will remain in place for at least 1-2 days. In some cases, a drainage tube may have been inserted during surgery as well. In these instances, the drains will usually be removed along with the bandages, 1-2 days following the surgery. Sutures are generally removed after one week, and healing of the incisions is usually visibly complete in 2-3 weeks.

7
After Care Instructions Are Given

Before and after photos of a face lift performed by Dr. Adam Tattelbaum. © Dr. Adam Tattelbaum

Your surgeon will presribe pain medication for you and instruct you to keep your head elevated when lying down and to avoid strenuous activity. You should expect some bruising and swelling, though some patients find that cold compresses help to minimize swelling. Recovery from face lift surgery usually takes about 2-3 weeks.

sources:
interview with Adam Tattelbaum, MD - conducted on 12-17-07
American Academy of Facial Plastic and Reconstructive Surgeons
American Society of Plastic Surgeons
interview with Steven Denenberg, MD - conducted 12-14-07

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