A facelift can be performed in the office using local anesthetic or it can be performed at an outpatient surgical center under general anesthesia. In either procedure, the facelifts are the same duration and have the same post-operative period. Both procedures are outpatient, which means that you go home after the surgery. The only difference between the two locations is that for the procedure in the office, you are awake, and for the procedure in the surgical center you are asleep.
This depends on the patient. The percentage of people having traditional facelift surgery under local anesthetic versus general anesthesia is just about even. The decision for one method over the other will be discussed during the consultation.
How Long is the Downtime After a Facelift?
Downtime is defined by how long you will need to rest after your procedure and how long you may have to hide if you do not want anybody to know you had something done. The downtime also depends on how long your hair is at the time of the procedure. The majority of the bruising and swelling occur around the ears. So the longer your hair is the better you can hide the swelling and bruising and the earlier you can go out without anybody knowing you had a procedure. I instruct most women that the downtime is about two weeks (see the next question).
How Much Bruising and Swelling Will I Have After my Facelift?
Everything we do before, during, and after the facelift is designed to minimize bruising and swelling. No matter how meticulous and delicate I am there is still going to be some bruising and swelling. The vast majority of patients see their swelling and bruising diminish within 2 weeks. Therefore, I instruct patients to expect 2 weeks of downtime after the facelift.
Each facelift procedure is tailored to the individual concerns and skin quality of each patient. This almost always involves removing excess fat and excess skin in the mid to lower-face regions, tightening the underlying muscle and facial tissues, and suturing the incisions in a way to minimize scarring.
Anyone who has concerns about loose skin, sagging skin, or an aging appearance to the lower two-thirds of their face can be a good candidate. As long as they:
- Are in generally good health to undergo a surgical procedure
- Have no underlying conditions
- Have significant sagging facial skin, rather than just a few wrinkles
Dr. Stanislaw will carefully evaluate each patient prior to recommending the right facial rejuvenation surgery (or surgeries) for their unique condition.
Most patients have little or no discomfort after the facelift. If patients have discomfort, it occurs as a dull ache behind the ears and only lasts for a few days after surgery. Patients are given medications to control any discomfort they may have after the surgery. The patients should take the pain medication as needed and they usually only take it for the first few nights.
You should keep your head elevated for one week after the surgery, with a couple of pillows or a recliner to keep your head above the level of your heart. Sleeping with your head elevated minimizes the swelling after surgery.
No bending, lifting, or straining for one week after the surgery. Bending over for a minute to put your shoes on, for example, is fine. But no prolonged head bending (head below the level of your heart) activities.
You can start mild, non-strenuous walking 24 hours after surgery. Mildly strenuous activities, such as light jogging can be resumed 3 weeks after surgery, and very strenuous activities can be resumed 4 weeks after surgery.
No driving for one week after the facelift. Therefore, you will need someone to drive you to your follow-up appointments on the first day and seventh day after surgery.
No activities that require vigorous head and neck turning, such as golf, tennis, or swimming for one month after the facelift.
If you color or perm your hair, you should have this done the week before the surgery. You will not be able to have your hair colored or permed until one month after the facelift.
Facelifts are almost always performed with a neck lift. Liposuction below the chin is performed in select patients. A brow lift is another procedure often performed with a facelift. Many patients maintain the quality of their facelift results with non-surgical treatments such as laser skin resurfacing once they have fully healed from the initial cosmetic surgery.
The cost of a facelift includes surgeon’s fees, operating room costs, anesthesia fees, medications, preoperative medical clearance, preoperative laboratory tests, and a preoperative EKG. There are numerous surveys published on the internet stating the cost of a facelift. These surveys usually just look at surgeon’s fees and do not include any of the other factors that I have listed above. The cost of a facelift (based purely on surveys of surgeon’s fees) ranges from $6,408 to $11,500. One must also remember that these surveys are based on data that is several years old. During your consultation, you should obtain a written quote that includes all of the fees for a facelift, not just the surgeon’s fees.
Surgeons who are board-certified in Facial Plastic Surgery (www.abfprs.org) and General Plastic Surgery command a higher fee than surgeons who are not board-certified to do a facelift (i.e. obstetricians/gynecologists, dermatologists, oral-maxillo-facial surgeons, dentists). You should always ask and confirm your surgeon’s board certification.
Facelift fees are usually higher for facial plastic surgeons or general plastic surgeons who are more experienced in performing facelifts.
The geographic location of the surgery affects the cost of a facelift. Facelifts performed in large cities tend to be more expensive. A practice on Park Avenue in New York City or in Los Angeles does not make that surgeon better; it just makes them more expensive because of their higher overhead.
The type of facelift performed contributes to the cost of a facelift as well. There are many different types of facelifts and they address different facial features. The right type of facelift for you will be determined by your facial plastic surgeon during your consultation. For example, if there is a lot of excess fat below the chin, liposuction of this area would be added to the facelift. If there is a lot of loose neck skin or if there are vertical bands of the neck, a neck lift would be added to the facelift. The more areas of the face that need to be addressed, the higher the cost of the facelift.
How much time the surgeon takes to perform the facelift affects the cost of a facelift. If the surgeon makes the incision as a straight line in front of the ear and uses staples to close the scalp incisions; or if they perform limited facelifts (ie weekend facelifts or mini facelifts), then the surgery takes less time and the facelift is less expensive. If the surgeon hides the incisions in the creases of the ears, closes all of the incisions with very fine sutures, and is meticulous and artistic in the performance of the facelift, then the facelift takes a little bit longer and it is a little bit more expensive. The more attention paid to the details, the better the results are and the more natural is the person’s appearance.
There is usually a consultation with your facial plastic surgeon prior to the facelift. It is customary for the consultation fee to be deducted from the surgeon’s fee if the facelift is performed.
The preoperative visit and all of the post-operative visits related to the facelift are included in the surgeon’s fee for a facelift.
A facelift can be performed in an office surgical suite, at an outpatient surgical center, or at a hospital. The operating room fee is usually lowest in an office surgical suite and highest in a hospital operating room.
Again, geographic location has a significant impact on the operating room cost for a facelift. Large metropolitan regions are usually more expensive than other areas of the country.
A facelift can be performed under local anesthesia alone, under sedation, or under general anesthesia. The type of anesthesia depends on the medical status of the patient, the type of facelift to be performed, and the location of the surgery. As you would expect, a facelift performed under local anesthetic would be less expensive than a facelift performed under general anesthesia.
Preoperative medical clearance by your primary care physician is usually required prior to your facelift. The preoperative medical clearance is no different than your annual physical, which is usually covered by your health insurance.
Preoperative laboratory tests and EKG are again part of your routine annual physical exam and are usually covered by your medical insurance.
The preoperative medical clearance, laboratory tests, and EKG are usually done within a month of your surgery and these reports are then faxed to your surgeon.
Insurance may or may not cover the medications required for a facelift.