As one of the most rewarding procedures in facial plastic surgery, facelift is also one of Dr. Jess Prischmann’s favorite surgeries to perform. This operation lifts the lower area of the face and creates a more defined jawline and neckline.
Who is a Good Candidate?
Loose or sagging skin of the lower face and neck
“Jowls” of the lower face
Ill-defined jawline or neckline
(no active smoking for 4 weeks prior to surgery or after surgery)
The best candidates are healthy and had a naturally “defined” or “high” jawline/neckline in their teens and twenties.
How is the Surgery Performed?
Our experienced facial plastic surgeon feels very strongly that facelift/necklift should be performed in an operating room under deep sedation or general anesthesia. This is for the best interest of her patients and leads to the best cosmetic result.
The term “facelift” actually refers to a number of different procedures and approaches. It is very important to ask your surgeon details about the operation. Dr. Prischmann performs a procedure that tightens the layer underneath the skin (termed a “Modified Deep-Plane Extended SMAS Rhytidectomy”). This allows her to get maximal results without creating a “stretched” or “windblown” look.
What is the Recovery?
Generally speaking, the downtime associated with a facelift/necklift is about two weeks. During that time, you will feel some tightness and your activities will be restricted. Bruising and swelling will be greatest in the first couple of weeks, but should subside in about four weeks. In Dr. Prischmann’s experience, facelift is not a very painful operation.
Recently, I underwent a surgical procedure to lift my lower face and neck as well as a total facial laser resurfacing procedure as a patient of Dr. Jess Prischmann. I found Dr. Prischmann to be a highly competent, compassionate, skilled surgeon. Through her guidance and education, I went into my surgery feeling very secure and informed. After my surgery, her care and follow-up were exceptional. I absolutely love the results she was able to help me achieve and highly recommend her as a very gifted surgeon.
Frequently Asked Questions
What incisions are necessary for a facelift? Where are they made?
For a facelift, a very elaborate and inconspicuous incision is made in front of and behind the ear. Sometimes, a very small incision is made under the chin. Dr. Prischmann carefully plans facelift incisions so that she can achieve the ultimate goal: to make all evidence of a facelift expertly hidden in naturally-occurring creases and folds. She wants you to be able to interact with people in very close range (even with your hair up in a ponytail) and have confidence that no one will know that you have had a facelift.
For a mini-facelift, Dr. Prischmann doesn’t make an incision under the chin, but still makes incisions around the ears. Even though it is called a “mini” lift, she meticulously plans the procedure to ensure the best results possible. Dr. Prischmann often tells her patients that she performs a “MAXIMAL” mini-facelift to indicate that she still tightens the muscle layer thoroughly during the procedure.
If I have a facelift, will I have the appearance of looking “pulled”?
No. You should not look pulled.
Are drains necessary after a facelift? Why/why not?
Not every facelift surgeon uses drains, but Dr. Prischmann does. She places very small drains for less than 24 hours. This prevents any major fluid accumulation in the neck. Typically, our patients have not seen any major side effects from having drains in place.
Some experts believe that drains can help prevent one of the more common complications following a facelift: hematomas. A hematoma is a collection of blood that typically occurs on the night of surgery. Hematomas after facelift are not life-threatening, but they do require going back to the operating room to reduce pressure at the surgical site.
Will there be a lot of bruising after surgery?
The amount of bruising varies from patient to patient. Because this procedure is performed around the ears and neck, bruising occurs in locations that can be easily camouflaged. Between day 10 and day 14, our advanced practice esthetician will perform a lymphatic massage and use medical-grade makeup to conceal your bruising. We love seeing our patients feel more confident about going out in public after this appointment.
Additionally, we advise our facelift patients to take Arnica Montana (a homeopathic supplement) prior to surgery and during the first week of recovery. We feel that this also decreases the duration and intensity of bruising following surgery.
What can patients do to reduce the risk of a hematoma after facelift?
As a patient, there are several things that YOU can do to reduce your risk of hematomas. They include:
- Avoid aspirin, ibuprofen, or naproxen two weeks prior to surgery.
- Avoid all fish oil supplements two weeks prior to surgery.
- Avoid garlic, ginko, ginseng, and Vitamin E supplements.
- Check your blood pressure three times daily for one week (at various times of the day). If your pressure is high, please let Dr. Prischmann know, and we will decide what steps to take. Remember, high blood pressure typically has no symptoms.
- Consider taking a homeopathic supplement called Arnica Montana beginning 24 hours prior to surgery. There are some studies that suggest taking this supplement could decrease your bleeding risk.
Dr. Prischmann and her team thoroughly prepare patients before surgery and provide Arnica to our patients during this process.
- Keep pain and nausea under control. Sharp increases in pain and nausea can increase blood pressure and your risk of bleeding.
- Consider continuing Arnica Montana. Dr. Prischmann has a protocol that we suggest for patients.
- Consider taking Vitamin C supplementation. Vitamin C is essential during the healing process.
- While it is important to keep blood circulating throughout your body to prevent blood clots, you should avoid strenuous activities for two weeks following a facelift.
PLEASE NOTE: IT IS IMPORTANT TO TALK TO YOUR PERSONAL PHYSICIAN BEFORE STARTING OR STOPPING ANY MEDICATIONS OR SUPPLEMENTS.
How do you address excessive fat in the neck?
Excessive fat can be addressed with liposuction. In some cases, the fat is deep in the neck, deeper than what conventional liposuction can address. In this case, a deep neck lift is the procedure that gives the best results. Unfortunately, this procedure carries risks that Dr. Prischmann does not feel are acceptable for elective surgery. During your consultation, she will set appropriate expectations and let you know which procedures are best for you.
When will my face “soften”? What should I do to help promote healing?
It is extremely common for patients to feel numbness and swelling after a facelift. Sometimes, patients will use the term “wooden” to describe the feeling. It is important to understand that this is just a normal healing phase after surgery and it will pass. Swelling decreases from days to weeks after surgery. Numbness typically subsides several weeks after surgery.
For more information on our face lift and neck lift procedures, please contact our facial plastic surgeon today. Dr. Prischmann can meet with you in a confidential consultation to discuss all aspects of treatment.