Facelift involves the dissection of the skin and soft tissue of the cheeks and neck from incisions placed just in front of both ears with extensions into the hair above and behind the ear. An incision may also be made under the chin is fat excision and/or muscle tightening is required. After the dissection is performed the skin/soft tissues of the face and neck are (as previously indicated) re-suspended thereby providing a more youthful appearance. Excess skin is removed from the area in front of the ears in most cases.
Many surgeons recommend (or require) that the patient go to an aftercare facility. These are staffed with nurses that care for the patient while the anesthesia wears off. Afterwards, the patient is pampered for as long as he or she wishes to stay. The stays at these facilities are variable (from 1-4 days). They cost $250 and up per day.
Patients take on average a week off work. Sutures are removed in two to four days. Drains (if required) may be removed in one to two days. These items should be removed by your doctor (or his/her nurse). (This may seem obvious but patients have asked before.)
Another poor outcome is facial nerve or muscle paralysis. Some degree may be present in 10-20% of patients. The good news here is that over 95% of these resolve with time, but the time is variable...weeks to 2 1/2 years. The most frequently injured nerve is the one providing sensation to behind the ear. All patients have numbness post-operatively which in most cases (as mentioned) will pass with time.
Asymmetry is always possible and frequently pre-operatively visible. I will discuss with patients pre-operatively that this can be addressed during the operation, but absolute symmetry is impossible and unnatural. This is where patient expectations come in. Those patients will less than realistic expectations are those for which an operation may not be warranted.