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As we age the skin and soft tissues around our face and neck tend to fall. They are held in place, however, by ligaments which connect the skin to the underlying bone. One area where these ligaments hold tight is at the sides of the chin. As our soft tissues fall, they “accumulate” here, producing a jowl. In the neck, there are no ligaments to hold things up. The skin of the neck has a thin underlying muscle called the platysma. You can see this muscle when you try to pull down the corners of your mouth. As time passes the skin of the neck falls forward. Occasionally the muscle will form visible bands extending from the chin downward. If this is really pronounced we may say someone has a “turkey neck”. (Not exactly the way any of us wants to be thought of!).

A facelift tightens up the tissues under the chin, recreating the nice angle between your chin and neck.  It also tightens the “jowls” recreating the elegant jaw line we all associate with youth and beauty.  In order to do this we make incisions in front and around to the back of your ear.  The skin and underlying tissues are pulled up and back and resuspended.  Any excess skin is trimmed. The incisions usually heal very well, and are also often hidden by your hair.  


FAQ’s (Frequently Asked Questions) about facelifting.


If I have a facelift will I then age more quickly?

While a facelift does not stop the aging process, neither does it speed it up.  You will always look better after a facelift than you would have if you had not had the facelift. 


How long will my facelift last?

The beneficial effects of any facelift last your entire life.  As time goes on you may get to the point where another facelift would help you.  While every individual is different, some general rules apply.  People with a tendency to have very loose skin and lax connective tissue may need a repeat facelift slightly earlier than people with very firm tissues.  Skin maintenance regimes can also make a difference.  Depending on the technique used to perform the first lift, most people will not need a repeat facelift for about ten years.  Younger patients often go much longer without wanting anything more done.  


If I need another facelift later will it work?

Yes.  Repeat procedures are often easier and can give even more dramatic results.  This is because scar tissue forms between the skin and underlying tissue.  This scar tissue is firm so we can put a little more tension on it when we pull it back. 


I’ve seen people who looked “pulled” after their facelift, could this happen to me?

We make it a top priority to make patients look completely natural.  The goal is to look refreshed and well rested.  Most patients don’t want an “operated” look, and it is not particularly difficult to avoid.  


What are the possible complications of a facelift?

Thankfully, complications from a facelift are actually rare.  Sometimes a blood clot (hematoma) may collect underneath the skin flap necessitating drainage in the clinic or the operating room.  The motor nerve to the face has many branches and occasionally one may be stretched or cut during the operation.  The resulting weakness is almost always temporary until the nerve recovers. Numbness of the earlobes may occur, but almost always gets better several months after surgery.  If you are a smoker a small area of skin behind the ear may be slow to  heal, but new skin regrows quickly usually leaving no visible evidence.  Complications are actually very rare because we are so careful.  


I am a smoker and I have heard smokers can’t have a facelift, is this true?

Smoking damages the blood tiny blood vessels in the skin, and the nicotine in smoke (or gum or patches) causes constriction of these blood vessels as well.  This means that skin put under tension may not get enough blood to live, increasing the risk of a slough.  While some surgeons will categorically not operate on smokers, I have found an individualized approach works best.  I modify my operation somewhat to minimize any disturbance of the blood supply.  The most important thing for a smoker to understand is that they cannot smoke (or chew or use patches) for two weeks prior to and two weeks after surgery.  We have studies that show that even this little bit of abstinence will greatly increase the chance of a good result.


How much time should I schedule for recovery from my facelift?

You may go home on the night of your facelift if you live in Memphis.  If you are from out of town we will want you to spend the night in Memphis.  You will be slightly bruised and swollen for 10 days to 2 weeks after surgery.  You will want to avoid social engagements for a minimum of 3 weeks after surgery. 


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