As people age, the effects of gravity, exposure to the sun and the stresses of daily life can be seen in their faces. Deep creases form by the nose and mouth, the jaw line "sags" and folds and fat deposits form around the neck. A facelift can improve the signs of aging by removing excess fat, tightening muscles and redraping the skin. The result is a younger and fresher look.

BEST CANDIDATES
A man or woman whose face and neck have begun to sag, but whose skin still has some elasticity.

PREPARING FOR SURGERY
If you smoke, stop smoking two weeks prior to and following surgery, since smoking prohibits blood flow which can affect the healing of your incisions, If your hair is very short, you may want to let it grow out long enough to hide the scars until they heal. Make arrangements for someone to drive you home and to help you out for a few days.

ANESTHESIA
Your surgery will be performed at an outpatient surgical facility. Facelifts are performed under local anesthesia, where you will be awake but relaxed and insensitive to pain, or general anesthesia, in which case you will sleep through the procedure.

THE SURGERY
A facelift usually takes several hours. Placement of incisions depends on your facial structure, but they usually begin above the hairline at the temples, extend in a natural line in front of the ear, and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may be made under the chin.

The skin is separated from the fat and muscle. Fat is then trimmed or suctioned from around the neck and chin. The underlying muscle is then tightened, the skin is pulled back and the excess skin is removed. Stitches are used to secure the tissue and to close the incisions.

After surgery, a small, thin tube is temporarily placed under the skin behind the ear to drain any blood and the head is wrapped loosely in bandages to minimize bruising and swelling.

RECOVERY
Discomfort after surgery is not significant and can be controlled with medication. You will probably experience some numbness of the skin which should disappear in a few weeks or months. For a couple of days after surgery, keep your head elevated and still to reduce swelling. The drainage tube is removed two days following surgery and bandages are removed in one to five days following surgery. At first, your face will be pale, bruised and puffy, but in a few weeks, your face will be looking normal. Stitches are removed after about five days. Stitches in the scalp may be left in for a few days longer.

HEALING
Take it easy for the first weeks after surgery because your skin will be tender and numb. Avoid strenuous activity for at least two weeks; avoid alcohol, steam baths and saunas for several weeks; limit exposure to the sun for several months. In the beginning, your face may look and feel strange due to the swelling. Bruising may last for two to three weeks, but by the third week, you should look and feel much better. Most patients are back at work within ten days to two weeks. You will have some scars from your facelift, but they are usually hidden by your hair or in the natural creases of your face and ears. They will fade with time and should become scarcely visible.