Face Lift

Face Lift Surgery by Dr. Steven Williams at Tri Valley Plastic SurgeryActual Patient
A surgical procedure designed to make the face appear more youthful by lifting up the facial skin and tissues and the underlying muscle, to make the face tauter and smoother.
Length of Surgery 2-3 hours
Length Of Procedure Usually Out patient
Anesthesia General or IV sedation
of results
Permanent improvement, though a face lift will not stop the aging process

Face lift and neck lift cosmetic surgery procedures are designed to reshape facial structures, improve your natural appearance and restore a youthful look. Dr. Williams is an expert at creating a natural look and improving areas that are of concern. Face lift and facial cosmetic surgery can remove the excess skin and fat accumulation in your face. Face lift surgery is very popular in our San Francisco Bay Area practice, and may be combined with skin rejuvenation techniques like chemical peels to provide a more youthful skin tone and appearance.

Click links below for details

Am I a candidate for face lift surgery?

The goal of a Face Lift operation is to rejuvenate the neck, lower face, and mid-facial regions. A face lift will reposition the sagging facial tissue, resulting in a more youthful appearance. Opting to undergo a face lift or neck lift operation can make a significant difference in a persons appearance and as with any procedure, is a highly individual decision.

You may be a suitable candidate for a Face Lift procedure if you are unhappy with how the aging process is affecting your facial appearance. If you are concerned with any of the following, you may benefit from face lift surgery:

  1. Sagging in the midface
  2. Deep creases below the lower eyelids
  3. Deep creases running from the nose to the corners of the mouth
  4. “Jowls” caused by loss of muscle tone in the lower part of the face
  5. Displaced fat
  6. Loose skin and excess fatty deposits under the chin and jaw

Certain factors affect whether you are a suitable candidate for a face lift procedure:

  1. Do you smoke?
  2. Are you physically and emotionally healthy?
  3. Do you have realistic expectations of what face lift surgery could do for you?

What is a face lift procedure?

A Face Lift (or Rhytidectomy), usually in combination with a Neck Lift is a surgical procedure designed to make the face and neck appear more youthful by lifting up the skin and tissues and the underlying muscle to make the face tauter and smoother. With age or excessive sun exposure, wrinkled creased skin can develop on the face, neck or forehead along with fat deposits and folds around the jaws and jowls. While face lift surgery cannot stop the aging process or gravity, it can improve one's appearance, making patients look younger.

Dr. Williams and the Tri Valley Plastic Surgery team specialize in creating a natural rejuvenated look with minimal scars. Face Lift surgery can make you look younger and fresher by improving the appearance of your face.

Your facial appearance is dependent on the bone, muscle, fascia, ligaments, fat and skin. During the natural aging process, the muscles can lose their tone, and the fascia and ligaments can stretch as the skin loses elasticity. The fat around the lower half of the face may droop as the ligaments relax and form jowls and deep wrinkles along the edge of the mouth. A Face Lift will improve the sagging areas of your face that have lost their tone, but may not get rid of all your wrinkles. Facelift is most appropriate for dealing with the mid and lower face and neck. Other techniques (brow lift, fat grafting and eyelid surgery) can address wrinkles and facial aging in other parts of the face.

Modern face lift procedures go beyond simply tightening the skin and often include working below the skin to tighten the underlying facial muscles. Dr. Williams may also move, remove, or in some cases add fat to the face. Older face lift procedures simply pulled on the skin, which left it abnormally stretched. Tri Valley Plastic Surgery patients benefit from newer face lift operations that are done by lifting a deeper tissue layer called the SMAS, a relatively thin layer of fibrous tissue situated just under the skin’s fatty layer. Lifting the SMAS transmits the lift to the skin via small fibrous connections. Unlike skin, the SMAS layer does not stretch, so it tends to stay where it is repositioned and sutured, giving a long lasting improvement. The extra skin is trimmed away, and as there is no pull on the skin, the face looks natural and heals well.

Face lift operations are most commonly performed under a general anesthetic and can take between two to four hours to perform. Most of our patients go home the same day. During the Face Lift surgery, incisions are made just inside the hairline at the temple extending down along the natural curve of the ear, back behind the ear and then horizontally back into the hairline. The face and neck are re-shaped by the surgeon, making adjustments to the muscles and fat. The incisions are closed with little metal staples around the hairline and thin nylon sutures around the ears.

There will be some discomfort following surgery that can be managed with pain medication. You can expect to feel swollen, bruised and numb for a few days afterwards.

Preparing for face lift surgery

The Tri Valley Plastic Surgery team will give you specific instructions on how to prepare for your Face Lift procedure, including guidelines on eating, drinking, smoking, and taking or avoiding certain vitamins and medications.

If you smoke, you will be asked to stop at least two months before Face Lift surgery, as smoking inhibits blood flow to the skin. Patients who smoke take longer to heal and can have serious wound healing complications. If you are overweight, your surgeon will advise you to lose weight prior to the face lift surgery. Patients must also avoid taking painkillers containing aspirin two weeks before the Face Lift procedure as aspirin interferes with blood clotting.

Face lift surgery procedure steps

A face lift operation takes two to four hours and is performed under general anesthesia, although intravenous sedation can be used in some situations. Dr. Williams will discuss the options with you and recommend the best anesthesia for you. Your Face lift procedure is always tailored to your specific needs and anatomy.

Step 1 – Anesthesia

IV medication is used to induce general anesthesia. In addition, local numbing medication is always injected to give you post-operative pain control.

Step 2 – The incision
  1. There are multiple incision techniques that Dr. Williams may use when you have a face lift. These depend on the degree of change you’d like to see and the problem areas. We always strive for the shortest possible scar to give you the look you want.
  2. Traditional Face Lift: The incision is made from the hairline at the temples, continuing around the ear (part of this incision will be partly inside the ears to help hide the cuts) and ending in the lower scalp. Fat may be sculpted or redistributed from the face, jowls and neck, and underlying tissue is repositioned. The deeper layers of the face and the muscles are also lifted. The facial skin is then re-draped over the uplifted contours and excess skin is carefully trimmed away. A second incision under the chin may be necessary if you also want the Face Lift surgeon to improve the appearance of the neck. Sutures or skin adhesives close the incisions.
  3. Limited incision Face Lift (Short Scar Face Lift): This is an alternative to the traditional face lift and uses shorter incisions at the temples, continuing around the ear and perhaps inside the lower eyelids or under the upper lip.
  4. Neck lift: If you have significant loose skin around the neck, the surgical incisions and technique are modified to include correction of this area. These incisions are typically very well hidden behind the ear. Liposuction may also be used to contour the neck.
Step 3 – The sutures

Absorbable and non-absorbable sutures are used on the incisions on the face and small metal staples are used around the hairline to close the Face Lift incisions. Once the surgery is complete, dressings are placed.

Step 4 – The results
  1. When you wake up after your face lift surgery you will have dressings and bandages on your face, as well as drainage tubes inserted behind the ear to minimize fluid accumulation under the surface of the skin. You will be given painkillers, although you should only feel mild to moderate pain after a Face Lift procedure. Your skin will feel uncomfortable and tight.
  2. There will swelling over the face, which will subside after a short time.

Face lift surgery recovery and healing steps

Face lift recovery times vary from patient to patient. The injected numbing medicine typically keeps our patients comfortable in the first twelve hours, after which prescribed medication or Tylenol can minimize discomfort.

The swelling will be at its worst two to three days after Face Lift surgery. Sleeping upright supported by pillows will help in reducing swelling. Cool compresses can also help, however great care should be taken to not put ice or anything too cold directly on your skin as you will still have some numbness and may not feel things that are too cold. Patients of Face Lift surgery are recommended to rest as much as possible the first week, keep your incision sites as dry as possible, and avoid closed-neck clothing to prevent contact on your head and face.

Some numbness, swelling, and bruising of the skin is likely to last for up to two weeks after the surgery.

After five to ten days, your stitches and drains will be removed, and a few days later you should start seeing the results of the face lift. Five to fourteen days after the face lift procedure, you will start to look and feel better. Visible swelling should go down after four to six weeks. You should avoid any strenuous activity during this time. You will probably feel numbness in your face for a few weeks.

Dr. Williams and the Tri Valley Plastic Surgery team will give you a check list and a precautions list for your recovery.

It may take several months for swelling to fully dissipate and up to six months to a year for incision lines to mature. Maintaining or adopting a healthy lifestyle and wearing a high SPF sunscreen whenever you go out will help to extend the results of your face lift. You will see the end result of your Face Lift approximately six to nine months after your Face Lift operation.

Face lift side effects and surgery risks

Face lift complications are infrequent and usually minor. Surgical face lifts are commonly performed and generally safe. The possibility of Face lift risks and complications depend on each patient's anatomy, their physical reactions, and their healing abilities. As with any surgery, the outcome is never completely predictable.

Side effects as a result of Face Lift surgery can vary from patient to patient. Common Face Lift side effects include:

  1. Soreness, swelling and bruising which can last up to a month
  2. Scarring which usually fades over the course of a year, but won't completely disappear
  3. Raised hairline in front of and behind your ears

Complications that may arise as a result of a face lift operation are:

  1. Unfavorable scarring
  2. Bleeding (hematoma)
  3. Infection
  4. Poor wound healing
  5. Allergic reaction to the anesthesia
  6. Facial nerve injury with weakness
  7. Asymmetry
  8. Skin loss
  9. Numbness
  10. Fatty tissue found deep in the skin might die (fat necrosis)
  11. Fluid accumulation
  12. Pain which may persist
  13. Skin contour irregularities
  14. Skin discoloration, sensitivity or swelling
  15. Unsatisfactory surgical scar location
  16. Deep vein thrombosis, cardiac and pulmonary complications
  17. Possibility of revisional surgery

It's possible that you may not be completely satisfied with your appearance after the operation.

The exact risks are specific to you and differ for every person, so if you have any concerns or worries about the Face Lift procedure and the risks and side effects involved, Dr. Williams will take time to explain how they may apply to you.

The American Society of Plastic Surgeons (ASPS) American Board of Plastic Surgery Yale University Plastic Surgery Yale School of Medicine American Society for Aesthetic Plastic Surgery Expert Reviewer of California Medical Board