Mini-facelift (Skin-only lift)

AM I A CANDIDATE FOR THIS SURGERY?

Anyone who cares about his or her appearance is a candidate for a mini-facelift. As long as they are in good health, it may be performed on both men and women of any age. If the changes on the face are too advanced, your surgeon may tell you that a full facelift is a better option.

PROCEDURE

The surgery generally takes 2 hours to perform, and is done under local anesthesia. In our clinic, we prefer local anesthesia because the recovery time for the patient is much less.

The incision-line can vary between surgeries. If the hairline is low, then the incision may be hidden mostly in the hair. Should the hairline be high, then it is best the place the incision in front of it to avoid raising the hairline further during the lift. Even then, the incision line is generally inconspicuous and easily covered by the hair. The incision then goes around the ear and ends behind the earlobe, forming an S-shape (commonly called an S-Lift).

The skin is then gingerly lifted off of the underlying fat and muscles and pulled to flatten out the jowls and tighten the neckline. Excess skin is removed and the skin is closed with fine sutures, and a dressing is placed. Men undergoing a facelift should be made aware that the bearded skin would be shifted upward toward the ear because the skin is pulled in that direction.

PREPARATION BEFORE SURGERY

Let your hair grow enough to be able to hide the healing incision lines

If the hair needs to be colored, do so about a week before surgery since you will not be able to do so until about 6 weeks after surgery.

Aspirin and all anti-inflammatory medication should not be taken for three weeks before surgery until two weeks after surgery. Anti-inflammatory medication and Aspirin causes thinning of the blood and may lead to excess bleeding during and after surgery. Tylenol (Acetaminophen), however, does not cause this problem and may be taken.

Alcohol in any form is not to be consumed for three weeks before surgery until two weeks after surgery. Alcohol has properties that dilate blood vessels and thin the blood, and can contribute to excessive bleeding during and after surgery. Even a small amount can cause problems.

Cigarette smoking and nicotine intake in any form, including patches, is strictly banned for the period of one month before surgery until one month after surgery. Cigarettes and nicotine contain properties that diminish oxygenation of skin and other tissues, and can contribute to skin necrosis (see below).

Should you have regular medications to take, ask your surgeon if you should take them before surgery or not. Certain medications can cause problems and only your surgeon can determine this.

AFTER SURGERY

A soft diet is recommended for about a week in order to let the lower face rest.

Avoid any activities that can increase the blood pressure. Increased blood pressure can cause bleeding in the 2 weeks after surgery. For example, do not do the dishes, lift heavy objects, clean the house or perform any activities where the face has to be looking down for extended periods. Sexual and other emotionally charged activities should also be avoided for the same reason. Pretend that you are a monk!

Sleeping on three pillows in not necessary, contrary to popular belief. This is true for any surgery. However, try to sleep on your back since sleeping on your side may cause more swelling to occur on one side of the face when compared to the other.

When the dressing is removed, wash your hair in the shower every day using your regular shampoo. This will remove any crusts that develop around the sutures, making suture removal an easier task. The sutures placed in the scalp are very solid and can withstand gentle combing.

Your sutures will be removed about one week after surgery.

In order to reduce the swelling, you may place cold compresses over the cheek and neck for the first 2 weeks. To do this properly, dip a facecloth in a bowl of ice-cold water and wring it before applying to the face. This will make you feel better, especially when applied around the eyes. Do not place ice directly on the skin as this may freeze the skin and cause skin loss.

If swelling is not an issue but there remains some residual bruising after 2 or 3 weeks, application of warm compresses may help the bruising fade away faster. Warm compresses may restart the swelling, so use them with this is mind.

Dyeing your hair may be safely done 6 weeks after surgery. You may use makeup at about 2 weeks after surgery without problems. When using makeup, we suggest using a light colored, water-based variety. Dark pigments may be ‘picked up’ by healing incisions and cause ‘tattooing’ of the incision line. Hydrating creams can be used at 2 weeks after surgery, but do not massage the face excessively unless instructed to so since this may cause the internal sutures to ‘pop’ prematurely and cause increased swelling.

THINGS TO EXPECT SOON AFTER SURGERY

• Facial swelling

• Some mild bruising, most often near the eyes and the lower neck

• You can expect to return after 2 to 3 weeks, depending on the type of work

THINGS TO EXPECT LATER ON

• The skin that was lifted will have diminished to absent sensation. This generally lasts from 6 months to one year. During this time you should be aware that the affected skin will not be able to feel hot or cold properly and therefore you will not be able to tell if the face is about to burn or freeze. Avoid extremes in temperature and protect the skin from the elements, especially when going out in the cold. As for heat, things like the light touch of a curling iron may cause a severe burn since you will not have the normal withdrawal reaction.

• The incision line will heal to leave a faint scar. This can be covered with the appropriate makeup and hairstyle.

POSSIBLE COMPLICATIONS

Hematoma (rare): if bleeding continues after the surgery is finished, this can lead to a collection of blood accumulating underneath the pulled skin which is called a hematoma. A hematoma generally occurs within the first 24 hours after surgery. To minimize the risk, avoid ingesting anything that can thin the blood. This includes Aspirin and its derivatives as well as ‘natural’ products such as Vitamin E and garlic pills. Alcohol consumption is prohibited before surgery because of it’s blood-thinning properties.

Infection (rare): This may occur in any surgical intervention and is generally treated with antibiotics.

Tissue loss or necrosis (very rare): If the oxygen delivery to the pulled skin is diminished to a great extent for any reason, the affected skin may not survive or necrose. When this happens, the skin becomes a dark color and forms a crust that eventually falls to be replaced by scar tissue. Things that can increase the risk of necrosis include a severe infection, a large hematoma and extreme swelling. By far, though, the biggest contributor to tissue necrosis is cigarette smoking and nicotine, which is why we strictly forbid smoking for a period encompassing the month before and after surgery.

Nerve damage (extremely rare): Certain branches of the facial nerve may be touched during a facelift. The branches tend to be deep and the risk of affecting them is technique dependent, where certain facelift techniques carry a higher risk than others. Fortunately, this is an extremely rare event.