At some point one looks into the mirror at the face that looks back and realizes that over the course of time those familiar features have changed. Wrinkles, folds, blemishes, pigmentations and sagging skin are all characteristic of an aging face. While these features might be considered distinguished, or can be worn as the proud badge of a life full of experience and wisdom, more often it just seems like the face in the mirror has gotten old. But age isn’t what it used to be. Baby Boomers don’t seem to want to act their age. They are typically more physically active than their parents were and continue on in their careers for a longer period of time. Even in retirement this generation is typically busier, more involved and engaged in active lifestyles more than the generation that preceded it. Often, the face in the mirror just seems to look a lot older than the life it represents. While there are a number of less aggressive remedies for some of the effects of aging, a facelift is the gold standard for correcting the loose, sagging skin of the neck, jowls and cheeks that can develop with aging.

Because every face is unique, every face lift is tailored to address the variety of individual problems that may be of concern. But for the most part, a facelift involves tightening of the deep structures of the face that have become lax and then removing and tightening the overlying skin. This will smooth the contours of the face to a more youthful appearance. The surgery is performed in a hospital or ambulatory surgery setting under a general anesthetic or can be done with a local anesthetic with sedation. The incisions necessary to complete the procedure extend in front and in back of the ear, and then along the hairline behind the ear. Sometimes the scar can be limited to just the area around the sideburn and in front of the ear depending on the individual problems that need to be corrected. The procedure can take from 3 to 5 hours and afterwards patients might stay overnight or can be sent home to recover – it all depends on individual needs.

The head is bandaged afterwards with soft compressive gauze. This bandage comes off the first postoperative day. The first two days or so are uncomfortable, but not too terribly painful. Pain medication is prescribed to be used as needed, but often Tylenol or ibuprofen are enough. You can eat normally and get around the house but you probably won’t want to go out since the face and eyes are swollen and bruised and the visual effect is quite striking. After the initial 48 hours, there is only some persistent discomfort but the swelling and bruising are at their peak an won’t resolve for about 2 weeks. Drains are typically used and usually come out after 24 – 48 hours. Some of the stitches come out after 5 – 7 days and the remainder after 10 – 14 days. The results are evident within those first few weeks, but there will be some minor settling over the course of 3 months before the healing process has become complete. There are regular and frequent office visits and help is available by phone from a doctor or nurse 24 hours a day.

~James D. Baldwin, M.D.


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