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Facelift Surgery (Rhytidectomy)

Why does someone have a facelift?

A facelift can be one of the most dynamic procedures to address the signs of aging. The loss of youthful contours in the face can be due to a variety of factors, including heredity, gravity, environmental conditions, and stress. There are three common areas that patients may notice change as they age. The first is the mid-face, an area that is gradually depleted of its fat volume, leaving a hollow-looking appearance in its wake. Second, the areas around the nasolabial folds begins to droop and sag, giving the face a tired, sinking aesthetic. Lastly, the jawline begins droop and one will begin to develop jowls with loss of the youthful couture of the jaw line. A facelift and sometimes a combination face and neck lift address all areas of the aging face.

What will a facelift do?

A facelift, also termed a rhytidectomy, is actually a number of procedures that might include any or all of the following: facelift, neck lift, and even fat grafting. The procedure can address jowls around the mouth, wrinkles around the face, the nasoabial folds (the creases that extend from the nose to the corners of the mouth) and loose skin and fat underneath the neck. The “facelift” is unique for each individual and requires a full consultation to determine each individuals needs.

What won’t a facelift do?

A facelift does not change your fundamental appearance and cannot stop the process of aging, but it does set the clock back. It will address the upper and middle third of the face and improve the lower face. Sometimes a separate incision or “neck lift” is necessary to address specific pathology in the neck.

During your consult

At the time of your consultation we will review your goals. Dr. Brown will evaluate your medical conditions, drug allergies, current medications/herbal supplements and prior surgical history.

He will examine your face, sometimes take measurements, and finally take photographs. From that information Dr. Brown will recommend a course of treatment, likely outcomes, and discuss potential complications as well as the type of anesthesia.

Prior to surgery

To get ready for surgery there are a number important steps. We will obtain recent blood work and sometimes obtain medical clearance from your primary doctor

You must stop smoking. In most cases Dr. Brown will not perform a facelift on anyone who is actively smoking. You must avoid taking Aspirin, anti-inflammatories and herbal supplements for 3 weeks prior to surgery as this increases the risk of bleeding. Certain hormones must also be stop as these increase the risk of Deep vein thrombosis

The procedure

Anesthesia. A number of medications are administered for your comfort. Choices of anesthesia include intravenous sedation or general anesthesia. Dr. Brown often recommends intravenous sedation due to a reduction in side effects and eased recovery

There is a traditional facelift incision, which start in the temple area. Dr. brown uses a pretrichial (just behind the baby hairs of the hairline) incision that does not distort the hairline. The incision is carried in front of the area and around the lower side of the scalp. A more limited facelift incision from the ear and behind is used when just addressing the lower face. A neck incision is added to address specific issues in the neck such as bands for the platysma muscle, excess subplatysmal fat and prominent digastric muscles.


Thin tubs or drains are placed to collect blood or fluid. You be given specific instruction on how to take pain medication, care of the incisions, and use of cold compresses to help with swelling. You will come to our office the day after your surgery and we will clean and redress your incisions. The drains are often removed after 3 to 4 days. Your incision will be closed with dissolving sutures. Most Swelling in present for 1-2 weeks, but it can take a couple of months for incision to mature. We ask that you avoid exercise for 2 weeks and then slowly resume activities. Patients are often able to return to work within 2 to 3 weeks.


  • Anesthesia
  • Bleeding
  • Infection
  • Poor wound healing and skin loss
  • Facial nerve injury with weakness
  • Temporary or permanent hair loss
  • Fluid build up
  • Numbness or changes in the skin sensation
  • Unfavorable scars
  • Prolonged swelling
  • Skin irregularities
  • Unsatisfactory result may include asymmetry, surgical scar formation
  • Deep vein thrombosis, cardiac and pulmonary complications