Ask the Expert: Facelift Surgery, Recovery + More [Q&A]

Dr. Angela Sturm shares her insight on frequently asked questions about facelifts including what a “facelift” exactly means and the best way to get rid of a “turkey neck.”

Q. What does a “facelift” mean exactly?

A. A frequent question in our office is, “What is the difference between a facelift and a neck lift?” The problem is that a facelift is a misnomer. When we say facelift, this means that we will lift the muscles of the cheeks, jawline and neck. We then delicately redrape the skin so that the appearance is natural and not pulled. It should really be “lower face and neck lift,” but that just doesn’t have the same ring to it.

Q. Can I lift “just the face?”

A. Yes, the muscles in the cheeks can be lifted to address the center of the face and the jowls to a certain extent without doing anything to the neck. This is called an upper facelift, short-scar facelift, mini-lift or MACs lift, among other names. The incision goes in the sideburn, hidden in the ear cartilages and just around the back of the earlobe. In the right patient, this can be very nice. However, this does not adequately address the jawline and obviously does nothing for the neck. A smooth, defined jawline and lifted neck are big factors in having a youthful appearance—as they say, “the neck can give you away.”

Q. What about the forehead? Isn’t that part of a facelift?

A. A brow lift lifts the forehead and brows to open the eyes. This can be performed at the same time as the facelift but does not have to be. The incisions are all hidden in the scalp and with the right techniques gives a rested, natural appearance. Though not everyone’s brows descend with time—the best person for this procedure is a woman with brows that are at the rim of the orbital bone and men with brows that are below the rim of the orbital bone and eyes that look heavy. Also, this person should look at photos of themselves from 10-15 years prior to see if the brows have descended.

Q. What’s the best way to get rid of a “turkey neck?”

A. There are so many techniques and combinations; almost every surgeon has their own way of doing a facelift and their own preferences. In our practice, we have found that we get the best results by performing liposuction because even very skinny people have some fat under the chin with the face/neck lift.

There is a thin, flat muscle on either side of the neck called the platysma, which are attached to one another in most youthful necks. With time, they separate and cause bands in the front of the neck. We reapproximate the front edge of the platysmal muscles to recreate that anatomy and give a hammock effect that creates a beautiful, smooth neck when lifted from the sides.

When you think about the surface area of the neck versus the cheeks, this is the larger part of the procedure with the neck taking the majority of the time. So, when people ask if you can have only a neck lift, technically you can and many surgeons do this on a regular basis.

My thought is that you have already done the larger part of the procedure and lifting the cheeks will give you the defined jawline that makes such a difference. Plus, the youthfulness of the face and neck will match. Jawline definition is not achieved with lifting the neck alone, and this adds several years to how long the procedure will last.

The biggest difference is that the incision is extended as described above for the upper facelift, but these are all hidden by hair and ear cartilages. For me, the benefit that you gain in overall appearance and longevity of the procedure outweighs the concerns of not wanting to do too much.

Q. What is the downtime for a facelift?

A. We recommend taking two weeks off of work and social obligations allowing time for any swelling or bruising to resolve, as well as all of the sutures to be removed. Every surgeon’s post-operative instructions are different, but we have our patients wear a sling under the neck to give extra support for two weeks during the day and at night. After two weeks, you will be able to return to work without the sling and without restrictions. If you have a big event like a wedding or gala, then you should give yourself about four weeks, just in case!

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