New Jersey Facelift Questions

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	Dr. Wise is a facial plastic surgern who practices in New Jersey.

Am I a good candidate for facelifting?
The best facelift patient is in good health, a non-smoker, and is able to avoid blood thinning medications for two weeks before surgery. He or she is unhappy with the sagging skin of the face and neck, which leads to a tired, aged appearance.

How does a facelift differ from a midface lift?
A facelift is really designed to improve the lower 1/3 of the face, and the neck. A midface lift, in contrast, will elevate the soft tissues of the cheeks. These two procedures can be combined in selected patients who have flattened cheeks as well as jowls and neck sagging.

I only want my neck improved. Is this possible without a facelift?
Yes, in some patients the neck can be tightened without a full facelift. This procedure, a "neck lift", usually involves making just the incision below the chin, and tightening the underlying muscle layer in the middle. Liposuction of the neck may also be used.  If necessary, small, inconspicuous incisions may be required behind the ears.

My eyes look tired also. What can be done for them?
A facelift does not improve the appearance of the eyes, but this can be easily accomplished with a procedure called a blepharoplasty. This procedure involves removing excess tissue of the eyelids to create a younger and refreshed look. You may also want to consider a brow lift, to raise the eyebrows to a more youthful position.

I also would like to improve the deep crease from my nose to the corner of my mouth. Will a facelift help this?
This crease is called the "nasolabial fold", and it is usually not improved significantly by a facelift. The nasolabial fold is best treated by injections of fillers under it, or by performing a midface lift which elevates the soft tissues of the cheeks.

Can I have other procedures done at the same time as a facelift?
You can, and often patients decide to have their eyes, brows, and/or midface improved at the same time. Doing multiple procedures on the same day does not lengthen the recovery time, and it allows the patient to accomplish many goals with one surgery.

How many doctors should I consult with?
As many as you need to feel completely comfortable with the doctor you choose. Some patients are able to settle on their surgeon after only one consultation, while others require several to best compare their rapport with each doctor.

Am I a good candidate for a mini-facelift?
Only a complete evaluation in our office can help you answer this question. In general, mini-facelifts (or limited incision facelifts) give a limited improvement compared to full facelifts, and this improvement may not last as long. However, mini-facelifts entail shorter recovery times, are less expensive, and still lead to an impressive aesthetic improvement.

Are "before and after" pictures helpful?
They are, and Dr. Wise will show you many. However, the best prediction for the outcome will be determined during your consultation, as your doctor examines your face carefully.

Do I need to see my own doctor before a facelift?
All patients require basic lab tests, and typically patients over the age of 45 require a written clearance from their personal physicians. All specific requirements are described in the attached Facelift Instructions.

What do I need to do the day before surgery?
The day before a facelift, you should eat normally but avoid excessively heavy meals, or foods that can lead to acid reflux. Prepare your affairs so that you completely relax and rest after surgery. Most importantly, do not eat or drink anything after midnight before your procedure. See the attached Facelift Instructions for all suggestions.

Where does the surgery take place?
Procedures are done at a hospital or at a fully accredited surgery center, depending on patient health and preference.

What kind of anesthetic will be used?
For almost all cases, a deep sedation will be used, which means you will be completely asleep and pain-free during the entire case. It is possible that no breathing tube will even be needed in these cases. Some other patients, having shorter procedures, can have lighter sedation. However, everyone will be completely comfortable during the procedure.

Can I wake up in the middle of surgery?
No. If you are having a deep sedation, an anesthesiologist will be dedicated to providing anesthesia during the entire case.

How long does the procedure take?
Facelifts take about three to four hours to complete.

How much pain will I have after surgery?
Facelifts do not generate excessive pain during recovery. You will mainly experience a sensation of tightness in your skin, which comes from swelling. Discomfort is well controlled with medications, which we will prescribe.

What are the risks of surgery?
Adverse events are rare. One possible but uncommon risk is bleeding, which occurs under the skin. Usually this bleeding will stop using compression, and no surgical intervention will be required. Very rarely, a patient will need a blood clot removed and bleeding controlled during a very quick surgical procedure. In all cases, the bleeding is not life-threatening. Nerve damage is also reported after facelifts, and may involve sensory or motor nerves. In the former case, numbness of the face will be experienced for several months, but this will recover. If a motor nerve is stretched, there may be slight weakness of certain facial muscles.  Motor nerve weakness is exceedingly rare under Dr. Wise's care.   During your consultation with Dr. Wise, you will be able to discuss all risks and complications.

Will I have scars?
The scars of a facelift are well hidden, and are usually only noticeable by the patient.

How much time off should I take from work and exercising?
You should plan to take one to two weeks off of work, so swelling and bruising can resolve. Exercise should be avoided for about three weeks after surgery.

Do patients ever need another facelift?
Your face will always look younger and more refreshed after surgery, but it will continue to age. After a complete facelift, some patients may want a revision surgery, usually ten or more years later.