A facelift is a surgical procedure used to minimize visible signs of aging, such as sagging skin, fat, and fold lines in the face and neck. The medical term for a facelift is rhytidectomy. 

During a facelift, excess facial fat is sculpted and repositioned, facial muscles are tightened, and excess facial skin is lifted and trimmed to give your face a fresher and more rested appearance. A neck-lift is often performed along with a facelift to reduce excess fat and sagging skin from the neck.

The technique utilized by Dr. Greco is called a deep plane facelift. This involves releasing the ligaments of the face and lifting fat and skin in an anti-gravitational (upward) fashion, which results in a significant yet natural-looking rejuvenation. 

Dr. Greco encourages realistic expectations for patients seeking his medical and surgical expertise. He advises his patients to look at facial aesthetic surgery as a means to present their best face to the world. He draws on his experience and knowledge to develop a realistic and customized treatment plan to achieve your goals.

How Skin Ages

With age, changes occur in the soft tissues and bones of the face. The facial skin thins, your cells divide at a slower rate, and the proteins that give your skin elasticity begin to break down. 

As the skin loses elasticity, it succumbs more regularly to the effects of gravity, causing the skin to sag. Wrinkles are caused by the tissue beneath the skin changing with age. 

These changes include loss of fat in the face. Some fat may begin to descend and collect in the jowls and under the chin, and the facial muscles become lax. All of these changes contribute to an aged, tired look.

How a Facelift Works

Bright and tight skin is a factor of age. Other factors that can result in the loss of a youthful appearance include thinning skin, loss of facial fat, gravity, sun damage, smoking, heredity, and stress. 

During a facelift, the skin on the face is lifted off the underlying fat and muscle. Facial tissues and muscles are then tightened. Additionally, the fat in the face and neck is sculpted and moved to recreate youthful contours after releasing key ligaments of the face. This is known as the deep plane facelift. 

The skin is then re-draped over the reconstructed face. Any excess skin is removed, and the wound is closed.

It is important to remember that while facelifts are a great tool to slow the visible passage of time on the face, the procedure cannot stop the aging process.

Candidates for a Facelift

A facelift can be performed at any age. However, it tends to show the best results for patients in their 40s to 60s who are in good health and can maintain a normal weight. 

You can have a facelift well into your 80s and still have a positive experience with pleasing results. Patients in the process of losing weight should consider waiting until they have lost the appropriate weight to allow for a more ideal outcome.

People experiencing a significant degree of facial wrinkling and sagging might consider a facelift followed by skin rejuvenation for a more youthful appearance. 

If you suffer from health conditions, such as diabetes and high blood pressure, please discuss these issues with Dr. Greco during the consultation so that appropriate care can be taken while planning treatment.

Pre-operative Consultation

Before the facelift procedure is planned, you will have an aesthetic consultation with Dr. Greco. During this consultation, you will have time to discuss your concerns, and Dr. Greco will answer any questions you may have. 

The consultation will also include a thorough physical examination of your face, and the following checks below will be performed. 

  • Checking for sagging facial soft tissue descent in the midface, lower face, jowls, and neck
  • Testing the suppleness of the facial skin
  • Inspecting the neck for loose skin, fat, and muscle 
  • Checking the skin around the eyes and eyebrows for the need for blepharoplasty or browlift

Dr. Greco does not advise his patients to go for an over-operated look and targets natural-looking results. He encourages his patients to have realistic expectations from the results of the facelift. Digital imaging is performed during your consultation to help visualize your results.

The detailed discussion during the pre-operative consultation helps Dr. Greco formulate the treatment plan tailored to your specific needs and aesthetic desires. 

Therefore, ensure you discuss your facelift surgery goals with him in detail during this meeting. It is helpful to bring pictures of yourself at an age you were pleased with your appearance to help convey your goals.

What to Expect with a Facelift

The facelift procedure is performed under MAC (twilight) anesthesia. 

Typically, for a facelift, an incision is made along the hairline and around the ears to lift the skin before the underlying tissue and muscle can be adjusted. The type of incision used will depend on the complexity of the procedure as well as the patient’s needs.

  • A traditional face-lift incision begins near the hairline at the temples and continues down, around the front of the ears, and ends behind the ears. An additional incision is made under the chin.
  • A limited incision lift is not as extensive. It begins near the hairline just above the ear and continues around the front of the ear. It does not extend into the lower scalp like with the traditional incision.
  • Neck lift incision starts in front of the earlobe. It continues around the ear into the lower scalp, and a small incision is made under the chin.

After the face has been remodeled, the skin is settled back into place. The wound is then closed with sutures and covered with bandages. 

A small tube may be placed under the skin behind one or both ears to drain any excess blood or fluid. This will be removed the following morning. 

Length of Facelift Procedure

The length of the procedure depends on its complexity. If additional cosmetic procedures are included as part of the same surgery, the procedure will take longer. In general, a facelift can take at least four hours.

Scarring and Pain After Facelift

Facial plastic surgery aims to create desired changes in appearance without noticeable scars. Dr. Greco will discuss the placement of the incision with you during your pre-operative consultation.

Typically, facelift incisions are concealed in the natural folds of skin around the ear within the hairline, so they are almost invisible once healed. If you have bothersome scars, they can be improved with injections of steroid medication into the scar and/or the use of a pulsed dye laser, such as the Vbeam Perfecta.

Pain and discomfort are usually minimal after a facelift. Dr. Greco uses conscious sedation (twilight anesthesia) and local anesthesia for additional comfort during the procedure. The procedure is performed in Dr. Greco’s comfortable, state-of-the-art, private, state-licensed surgery center. 

After surgery, you will be prescribed oral medication for any post-operative discomfort. There may be some tightness in the neck and jaw region until the post-operative swelling decreases in two weeks.

Recovery After Facelift

After the surgery, you can expect to see swelling or bruising on the face for about two weeks. Any residual swelling can be concealed with make-up that our aesthetician will customize for your individual needs.

Most facial swelling subsides within two weeks after surgery, and you should avoid strenuous activity during this period. Any remaining swelling usually subsides over the next two months. 

Unfortunately, swelling in the face immediately after surgery is unavoidable. A feeling of disappointment on seeing the swelling on your face immediately after the surgery, combined with the after-effects of the anesthesia, can sometimes cause patients to experience mild depression for a few days after surgery. 

To deal with this situation, keep a positive outlook and stay mentally active. Finally, get plenty of rest and have nutritious meals. This is the perfect time to pamper yourself and catch up on rest.

Ease Your Recovery

You should be able to return to daily activities within two weeks after surgery. To ease your recovery, you should:

  • Avoid smoking for at least four weeks before and after surgery.
  • Use ice compresses for the first three days after surgery.
  • Rest with your head elevated.
  • Follow the postoperative instructions from the doctor carefully.
  • Avoid direct sunlight to protect the post-operative scars and your skin.
  • Always apply SPF to your incisions prior to sun exposure once they’ve healed.

Risks of a Facelift

During your pre-operative consultation, Dr. Greco will discuss potential risks and ways to avoid them. Risks associated with facelifts can include:

  • Infection
  • Conspicuous scarring
  • Reactions to the anesthesia
  • Hematoma
  • Damage to the facial nerves
  • Necrosis
  • Alopecia

Dr. Greco’s experience and skill minimize the chance of such risks.

Facelift Procedure in Philadelphia

Dr. Timothy Greco is Philadelphia’s leading facial plastic surgeon, skilled at all types of cosmetic procedures that help counter the effects of aging. He is double board-certified by the American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) and the American Board of Otolaryngology/Head & Neck Surgery (ABOto). 

Dr. Greco focuses solely on plastic and reconstructive surgery of the face, head, and neck at his in-office, state-certified aesthetic surgical center. If you're looking for a younger, fresher appearance customized to your facial structure, Dr. Greco can help!

Get in touch today to schedule a consultation with Philadelphia’s leading facial plastic surgeon. For appointments, call (610) 664-8830 or check the doctor’s schedule online

2 Bala Plaza | 333 E. City Ave
Suite PL-15
Bala Cynwyd, PA 19004
Phone (610) 664-8830
Fax (610) 664-8812

Mon-Fri 9 am-5 pm
Sat & Sun Closed

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