Facial plastic surgery overview by John E. Sherman, MD, FACS New York Plastic Surgeon
What Happens During the Procedure?
Dr. Sherman uses the most proven techniques for facelift cosmetic surgery. Depending on the age and the relative health of the patient, facelift cosmetic surgery can be performed in the hospital or in our fully-accredited and equipped operating suite in New York. Various options are used with the facelift: mini facelifts, neck tightening or brow lift.
This cosmetic surgery procedure is usually performed in the our fully accredited office surgery suite. Patients may desire to stay one night in the hospital instead of the office setting for their facelift. The operation can be performed at any of the following hospitals in and around New York:
- New York Presbyterian Hospital – Weill Cornell Medical Center
- (Rated the Best Hospital in NY, US News and World Report)
- Lenox Hill Hospital
- The Greenwich Hospital, Greenwich CT
Facelifts are routinely performed on adults age 40 and over. Depending on the age of the patient, the goal of the facelift operation may be entirely different, as well as the type of operation, and where the plastic surgery is performed. Of course, the patient must be of good health, and if older, must have medical clearance.
Facial plastic surgery is usually performed under intravenous sedation anesthesia, avoiding the general anesthesia. However, there are certain patients with whom the general anesthesia may be preferable. This may be combined with the blepharoplasty (eyelid plastic surgery), or other plastic surgery procedures.
Your Experience in Recovery
The recovery period for a full facelift is approximately two to three weeks. This is the time that you may feel totally comfortable returning to your social calendar, without the need to explain discoloration and swelling to your friends and working associates. In general, the younger the patient, the quicker the return to full function.
Recovering from your facial procedure can take up to two weeks after the facelift procedure. The first two to three days is marked by a feeling of tightness, and swelling. This improves over the following week. Modest pain is usually controlled with the use of oral pain medication.
Variations of the Facelift Operation
This is performed on the younger patient, without the neck and or brow being done. The entire operation takes less than two hours and is performed in the office. IV sedation is the anesthesia of choice.
+ Neck Lift
An isolated neck lift may be performed in some patients where most of the changes are below the chin and in the neck area. A small incision is made behind the chin prominence, and may be made in conjunction with traditional behind the ear incisions to maximize correction.
+ Forehead Lift (Coronal forehead lift)
In some patients an open brow approach may be indicated . These are patients in whom there is an excess of skin, and the patient has a low anterior (front) hairline. The incision for the facelift is made in the hairline across the top of the scalp. The procedure is then performed and the scalp is tightened. This facelift procedure method will raise the edge of the hairline, and should not be used in patients who have a high forehead line.
+ Forehead lift (Endoscopic Forehead lift)
Forehead lifts are used in facelift procedures for correction of the eyebrow when it has descended too low. It also can be used to fix a permanent furrow between the eyebrows, and forehead lines. Dr. Sherman uses the latest techniques such as the endoscope, a device that has been popularized in knee surgery. Three small incisions are made in the hairline in this facelift procedure method. Then the endoscope, which is a small camera, is inserted and used for correction. Form this, brow correction is accomplished as well as the correction of the glabellar furrows (the muscle between the eyelids).This facelift plastic surgery procedure minimizes scarring and discomfort for patients who receive it.
What are possible complications?
As in all types of surgery, there are well-known and reported complications. Dr. Sherman will go over all of these with you. During this discussion, Dr. Sherman will also tell you the relative frequency of all complications, and the treatment. These potential complications include hematoma, and facial nerve damage. This nerve damage may be temporary, or permanent after the facelift procedure.
In the past few years, several New York surgeons have developed and refined the short scar for facelifts. Dr. Sherman has been employing this advancement since December of 2000. This greatly reduces the size of the scar located in the hairline and the area behind the ear.The scar now is limited to the inside of the ear, and the area behind the ear. In older patients, where there is a lot of skin to be tightened in the facelift, a small extension may be used near the side-burn area and behind the ear.
The advantage of this new technique is substantial. The scar is better concealed, and there is less healing time after the facelift. The scar is not exposed even when the patient wears her hair “up.” Dr. Sherman will discuss this option during the consultation.