Facelift

As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases can form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck.

A facelift (rhytidectomy) can't stop this aging process. What it will do is "set back the clock," improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift may be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.

If you're considering a facelift, this web page will give you a basic understanding of the procedure-when it can help, how it's performed, and what results you can expect. It won't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask Dr. Jensen about anything you don't understand.

The ForeverLift™ (Dr. Jensen’s signature Facelift)

The ForeverLift™ is a procedure that leaves you looking fresher and more youthful. People may not notice that you have had surgery, just that you look refreshed. The ForeverLift™ helps to remove excessive neck skin and fullness, jowling around the chin, deep creases that appear between your nose and mouth, and restores the outline of the jaw. The ForeverLift™ is less invasive than traditional facelift procedures and leaves a shorter scar. This type of facelift will lift and hold up sagging tissues in the neck, cheeks, chin, or near the nose with permanent suspension sutures in the deeper tissues. This operation is done in our outpatient surgical center basis while you are under sedation and local anesthesia.

The Foreverlift™, or mini-facelift, is Dr. Jensen’s signature facelift that compares very favorably with the traditional facelift. The Foreverlift™ is not designed to replace the traditional facelift completely but it is an adjunct for men and women in their late 30s, 40s and mid to late 50s. It provides natural rejuvenation with shorter operative time, quicker recovery, and less potential for complications compared with traditional face-lifts.

The ForeverLift™ provides a change that is subtle and youthful, creating a very soft, natural look that is often described as refreshed. The ForeverLift™ involves less undermining of the skin than the traditional facelift and does not require exposing the facial nerves. In fact, the extent of undermining of the skin is probably 50 percent of that of the traditional facelift. The procedure is characterized by short incisions, limited skin undermining and multiple suture suspensions of the deep tissues of the face.

The ForeverLift™ procedure is quicker, taking an average of two hours versus the four to five hours required for a traditional facelift, plus the operation can be performed under local anesthesia with sedation and is tolerated quite well by the patient.

The ForeverLift™ is probably best suited to the patient who is contemplating facial rejuvenation for the first time and requires mild to moderate changes in the lower face and neck region. The procedure is designed for patients who have started to notice jowling and sagging of the face and neck, but who are not ready for, and really does not need a more involved full face lift. Recovery is fast- two weeks as opposed to four to six weeks for a traditional facelift. Downtime is a significant factor economically for the age group of patients who choose to have a facelift.

The ForeverLift™ procedure provides youthful, natural, soft rejuvenation and is not intended to dramatically alter a patient’s appearance. Its goal includes:
- Tightening the cheek
- Suspending the jowl
- Defining the jaw line
- Improving neck contour
- Providing natural, soft facial rejuvenation

Dr. Jensen will make strategically placed, well camouflaged incisions along the hairline and in front of the ear. Limited skin undermining is performed. Permanent sutures are then used to suspend the deeper tissues of the face, reversing gravitational signs of aging. Excess skin is excised, and the incisions are closed with dissolving sutures. Fat transfer is then used to replace lost volume in the cheeks, around the mouth and eyes that occurs naturally with aging. Patients appreciate the shorter scar and the very soft, natural look. While facial swelling and some bruising may be seen, the severity and duration is more limited when compared with a traditional face-lift. Light activity is permitted within days, and patients can return to work within 7 to 10 days.

The best candidates for a facelift

The best candidate for a facelift is a person whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their mid-forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well.

A facelift can make you look younger and fresher, and it may enhance your self-confidence in the process. But it won't give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your goals & expectations and discuss them with Dr. Jensen.

The ForeverLift™ (mini-facelift) was developed as a modification of the S-lift by Dr. Jensen in 2002.

Essentially, it differs from a regular facelift in the following ways:

  1. The incision is limited to the skin hairline junction above the ear and just inside the ear. There is a minimal extension behind the ear.
  2. The area of undermining, unlike a conventional facelift, is much smaller and essentially involves a portion of the cheek and neck. Because there is less undermining, the blood supply to the skin is more robust and the technique is therefore safer in smokers. There is less risk of any skin necrosis.
  3. A line of permanent suspension sutures are used to elevate the underlying tissue. These pass down from the corner of the eye to the neck, jowls and malar fat pad. Unlike many other facelifts which do not include significant mid face elevation the ForeverLift™ elevates the cheek pad, reducing the cheek folds.
  4. Because there is no undermining of the deeper tissues there is very little likelihood of damage to the facial nerve.
  5. Because the undermining and dissection is more limited, post-operative swelling and edema is less than in normal facelifts and recovery is typically quicker.
  6. Because fat transfer is used in nearly ever ForeverLift™, this greatly softens the look, restoring a more youthful volume to the face.
  7. In nearly all cases liposuction is performed to the neck area below the angle of the mandible, both to remove excess fat here and also to free up the skin to allow it to be re-draped by the suspension sutures.
  8. In my opinion the ForeverLift™ produces results at least equivalent, or in most cases, better than a conventional facelift. It is ideally suited to the younger patient with a sagging mid face. In patients with really excess skin facility in the neck region, it may be necessary in some cases to make an incision posterior to the ear to take up this slack.

All surgery carries some uncertainty and risk

When a facelift is performed by a qualified plastic surgeon, complications are rare and usually minor. Still, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable.

Complications that may occur include hematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles (almost always temporary), infection and reactions to the anesthesia. Poor healing of the skin is more common to affect smokers. You can reduce your risks by closely following Dr. Jensen's instructions both before and after surgery.

Planning your surgery

Facelifts are very individualized procedures. In your initial consultation, Dr. Jensen will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery. Dr. Jensen will check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems or the tendency to form excessive scars.

Please be sure to tell Dr. Jensen if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting. If you decide to have a facelift, Dr. Jensen will explain the techniques and anesthesia he will use, the type of facility where the surgery will be performed, and the risks and costs involved. Don't hesitate to ask Dr. Jensen any questions you may have, especially those regarding your expectations and concerns about the results.

Preparing for your surgery

Dr. Jensen will give you specific, written instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it's especially important to stop at least a week or two before and after surgery; smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas.

If your hair is very short, you might want to let it grow out before surgery, so that it's long enough to hide the scars while they heal. You should arrange for someone to drive you home after your surgery, and to help you out for a day or two if needed.

Where your surgery will be performed

A facelift is most frequently performed in our office-based facility. It's usually done on an outpatient basis. Certain conditions such as diabetes or high blood pressure should be monitored after surgery, and may require a short inpatient stay.

Types of anesthesia

Most facelifts are performed under local anesthesia, combined with sedation to make you drowsy. You'll be almost unconscious and very relaxed; your face will be anesthetized with local anesthesia and insensitive to pain. (However, you may feel some tugging.) General anesthesia is available but is rarely recommended.

The surgery

A traditional facelift usually takes 3 to 4 hours-or somewhat longer if you're having more than one procedure done. For extensive procedures, we may schedule two separate sessions. Every surgeon approaches the procedure in his or her own way. Some complete one side of the face at a time, and others move back and forth between the sides. The exact placement of incisions and the sequence of events will also depend on your facial structure.

Illustration 1: After deep tissues are tightened, the excess skin is pulled up and back, trimmed and sutured into place

Incisions usually begin anterior to the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of your ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision will also be made under the chin.

In general, the skin is separated from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. Dr. Jensen then elevates a second layer and tightens the underlying muscle, pulls the skin back, and removes the excess.

Dissolving stitches secure the layers of tissue and close the incisions; metal clips may be used on the scalp.

Illustration 2: Most of the scars will be hidden within the hairline and in the normal creases of the skin

Following surgery, a small, thin drain-tube will be temporarily placed under the skin behind your ear to drain any blood that might collect there. Dr. Jensen will also wrap your head loosely in bandages to minimize bruising and swelling.

After your surgery

Discomfort after surgery is usually minimal; if there is, it can be controlled with the pain medication prescribed by Dr. Jensen. (Severe or persistent pain or a sudden swelling of your face should be reported to Dr. Jensen's office immediately.) Some numbness of the skin is quite normal; it will disappear in a few weeks or months.

You will be asked to keep your head elevated and as still as possible for a couple of days after surgery, to keep the swelling down. If you've had a drainage tube inserted, it will be removed one or two days after surgery. Bandages, when used, are usually removed after one to two days. Don't be surprised at the pale, bruised, and puffy face you see. Just keep in mind that in a few weeks you'll be looking normal.

Most of your stitches will be removed after about seven days. Your scalp may take longer to heal, and the stitches or metal clips in your hairline could be left in a few days longer.

Getting back to normal

You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first.

Dr. Jensen will give you more specific guidelines for gradually resuming your normal activities. They're likely to include these suggestions: Avoid strenuous activity, including sex and heavy housework, for at least two weeks (walking and mild stretching are fine); avoid alcohol, steam baths, and saunas for several weeks; limit your exposure to the sun for several months. Above all, get plenty of rest and allow your body to spend its energy on healing.

At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff, and you'll probably be self-conscious about your scars. Some bruising may persist for two or three weeks, and you may tire easily. It's not surprising that some patients are disappointed and depressed at first. By the third week, you'll look and feel much better. Most patients are back at work about ten days to two weeks after surgery. If you need it, special camouflage makeup (Physician's Formula-found at Walmart) can mask most bruising that remains.

Your new look

The chances are excellent that you'll be happy with your facelift-especially if you realize that the results may not be immediately apparent. Even after the swelling and bruises are gone, the hair around your temples may be thin and your skin may feel dry and rough for several months. Men may find they have to shave in new places - behind the neck and ears - where areas of beard-growing skin have been repositioned. You'll have some scars from your facelift, but they're usually hidden by your hair or in the natural creases of your face and ears. In any case, they'll fade with time and should be scarcely visible.

Having a facelift doesn't stop the effects of time. Your face will continue to age, and you may want to repeat the procedure one or more times - perhaps five or ten years down the line. But in another sense, the effects of even one facelift are lasting; years later, you'll continue to look better than if you'd never had a facelift at all.

To learn more about our Cosmetic + Plastic Surgery Services, please contact us at (541) 770-6776 / (800) 681-6776 today to schedule an appointment.

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