These days, having a facelift isn’t what it used to be.   For one thing, people are having facelifts earlier than ever before.   “I didn’t want to wait until I looked like my mother,” or “I just didn’t like my reflection in the mirror” are common refrains from women in their 40s and 50s who have opted for facelift surgery now rather than later.

Today’s facelift patient has a variety of options unavailable to his or her counterparts in decades past.   A full facial rejuvenation, a “mini lift” or something in between may be customized for each individual, depending on the patient’s special needs and goals.   A variety of techniques make it possible not only to smooth loose skin and tighten underlying tissues, but also to add or decrease fullness in specific areas.

Facelift surgery may have come a long way, but the quality of the results still depends on the same essential element – the plastic surgeon’s skill and experience.   The planning process begins with the very first consultation.

Many people come to a facelift consultation with a very specific complaint.   For example, they don’t like their “jowls,” or they are bothered by the deep folds that extend from the base of their nose to the corners of their mouth.   (These are called “nasolabial folds” and they are among the most difficult signs of aging to correct.)   It’s very helpful if patients can focus on the areas that bother them most and be prepared to point them out during the consultation.

A complete medical history is a necessary prerequisite to physical evaluation.   During the physical evaluation for facelift surgery, things to be considered are the condition of the skin (thickness, texture and elasticity) and the severity of the wrinkles and folds.   Some of the other factors that will need to be addressed include:

• Is facial aging confined to specific areas of the face, such as the lower one-third, or is it apparent in the mid-face and upper face (forehead) areas as well?   A facelift frequently is combined with eyelid surgery and/or surgery to lift the brows.   If the patient has identified any problems related to these areas, then additional surgeries may be discussed.

• What would be the best location for incisions based on factors such as the extent of facial sagging and excess skin, the position of the hairline and any existing facial creases?

• Would the skin benefit from a chemical peel, dermabrasion or laser treatment, either at the same time as a facelift or as a separate procedure?

• Would facial contours be enhanced by fat or collagen injections, or perhaps by a facial implant such as commonly used for chin augmentation?

A combination of good surgical planning and proper patient preparation is the best way to help ensure successful facelift surgery.   Once the decision has been made to go ahead with surgery, there are a number of things the patient will need to do.   Smokers will be asked to stop smoking for a while in advance of surgery.   Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so they should be avoided for a period of time before surgery.   If the facelift will be performed on an outpatient basis, the patient will need to arrange for someone to drive him or her home and to stay at least the first night following surgery.

Sufficient time should be allowed for recovery following surgery.   The amount of time needed depends on the extent of surgery and individual healing factors.   Scheduling a facelift a week before the date of a special event is never advisable!

How long-lasting the results of a facelift will be depends on many variables including hereditary and lifestyle factors.   Even though science has yet to figure out how to stop the aging process, having a facelift in your 40s, 50s, 60s or beyond is a choice that can help you look your best for many years to come.

Have a plastic surgery question for Dr. Dickie?   If so, e-mail us at info@BahamasInstituteOfPlasticSurgery.com .   Dr. Kenneth Dickie is certified by the Royal College of Physicians and Surgeons of Canada in Plastic Surgery.   He specializes in Cosmetic Plastic Surgery as well as Plastic, Reconstructive, and Hand Surgery.   Dr. Dickie has been in clinical practice since 1984, and is currently a member of the Canadian and American Societies of Plastic Surgery, and the Canadian and American Societies of Aesthetic Plastic Surgery.   For a consultation, please contact the Bahamas Institute of Plastic Surgery at (242) 351-1234 or toll-free 1(242)300-1235.