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Spa Services Procedures and Treatments » Face Lift (rhytidectomy)

Facelift (rhytidectomy)

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Rhytidectomy literally means surgical removal (-ectomy) of wrinkles (rhytids).  A rhytidectomy or facelift, more accurately called a face and neck lift, rejuvenates the lower face and corrects sagging muscles and excess skin in the cheeks, jaw line and neck.  The midface and forehead lifts address aging of the high cheek, brow and forehead. 

Despite the wealth of new treatments to reverse facial aging, facelifts are still the gold standard, providing the most comprehensive and long-lasting benefits.  The advantage over other procedures is that face lifts address sagging face and neck muscles that are the major underlying cause of aging, as well as the resulting skin surface wrinkles. 

Everyone has seen the results of a poorly performed facelift that leaves a patient’s face looking unnaturally stretched or pulled too tight.  To achieve consistent success that results in a natural, more youthful appearance, there is no substitute for experience.  Dr. Sykes performs more than 150 face lifts each year, or about three per week, on patients across a wide span of ages and with a variety of skin types and facial features.

The individual approach to rejuvenation
A facelift is not a one-size-fits-all procedure.  During your individual consultation, Dr. Sykes will talk with you about the areas of your face that bother you and which procedure is best for addressing those concerns.  In some instances, the doctors may suggest a forehead lift, midface lift or a combination of procedures to correct the issues that bother you.  If they do recommend a face lift, they will explain why they feel it will deliver the best results for you and the type of face lift they will perform. 

Types of face lifts
Facial tissue is made up of different layers.  “Facelift” and even “rhytidectomy” are generic terms that refer to the tightening of any of those layers.  Subcutaneous (skin-only) face lifts address the top layer by removing excess skin.  Superficial musculoaponeurotic system or SMAS face lifts tighten the skin and first muscle layer.  Both can result in an unnatural, windswept look because they only pull out toward the ears and do not reposition facial fat pads that have moved down over the years. 

The third type of facelift is known as a composite or deep plane lift because it addresses the facial muscles that lie closest to the bone, as well as repositioning descending fat pads.  The deep plane lift also provides the benefit of pulling underlying facial muscles up, as well as out, so it actually reverses the natural aging process.   

Dr. Sykes does not perform skin-only lifts because the results do not provide a natural look and they are quickly undone by the uncorrected muscle sagging and falling fat pads.  He may occasionally perform a SMAS face lift on a younger patient whose facial structure has not yet experienced the full force of gravity’s downward pull.  Most often, Dr. Sykes performs the deep plane or composite lift.  The deep plane technique’s uplift rejuvenates the midface, and results in a more natural and longer lasting improvement. 

Very often, facelifts are combined with other procedures, such a neck lift or liposuction, eyelid rejuvenation or others that address your specific concerns.  Recovery time remains the same whether you have a facelift alone or in combination with other surgeries.  So you only have to go through surgery and recovery once, we recommend you undergo all surgical procedures you desire at the same time. 

What to expect
You’ll be given sedation before surgery so you sleep through the procedure and wake after it is complete.  During surgery, the doctor will make incisions along, but behind, your hairline and within the natural creases around your ears.  They will then lift and tighten the deep muscles and reposition your cheek fat pads to where they were when you were younger.  The final step is to trim excess skin so it lies naturally on the new, tighter contours of your facial structure. 

Most patients are surprised to experience very little pain following facelift surgery.  You will be tired and are likely to sleep a great deal of the 48 hours following surgery as the anesthesia moves out of your system.  Because of the long incisions face lifts require, the sides of your face will be wrapped tightly to prevent infection.  The day following surgery, your surgeon will see you in the office to check on your healing and rewrap your bandages. 

Bruising and swelling are expected and normal after a face lift.  You’ll receive a list of instructions that will help you move through this phase with minimal discomfort, but we encourage you to take advantage of the downtime to rest and help speed your recovery.  Though the amount of bruising and swelling varies by individual, you should be able to return to work and social activities after two weeks.  Jill Haynes, our aesthetician, commonly works with surgery patients, providing helpful tips and camouflage makeup to minimize the visible effects of surgery. 

Typical results
You should expect it to take several months for all swelling to dissipate and your final results to appear.  In general, a deep plane face lift will take away 10 to 15 years from your lower face and neck and will cause that area to look refreshed and in better balance with the rest of your features.  If your facelift is being done in conjunction with a forehead lift and eyelid rejuvenation, you can reasonably expect your entire face will look about 10 to 15 years younger.  Patients who undergo face lift surgery at early ages, before the more noticeable effects of aging have set in, should expect more subtle improvements, which can be a benefit to those who do not want others to be aware of the surgery. 

It’s important to remember that face lift surgery does not stop the aging process.  The good news is that even though you will continue to age, you will always look much younger than you would have looked if you have not undergone face lift surgery. 

Facelift Fast Facts
The following are general guidelines only.  Variations are common.

Surgery length:

2 to 4 hours


Office or hospital outpatient surgery suite


Light sedation or general anesthesia, patient is asleep during surgery


External dressings wrapping the side of head to protect incisions

Pain & discomfort:

Some pain for the first few days, most often dull and generalized    

Swelling & bruising:

Moderate, generally peaking by day three.  Bruising typically fades in 10 to 14 days.  Most of the swelling resolves in the first three weeks, though some residual swelling will remain for several months.  

Suture removal:

Typically at one week

Return to work:

Ten days to two weeks

Resume exercise:

Four weeks

Initial results:

One week following surgery, when sutures are removed 

Final results:  

One year or longer


Permanent, though affected by ongoing aging


Jonathan M. Sykes, MD
Professor/Director of Facial Plastic and Reconstructive Surgery
UCDavis Medical Group
2521 Stockton Blvd., Suite 6206
Sacramento, CA 95817
(916) 734-2347
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