A facelift usually involves the removal of excess facial and neck skin, with tightening of underlying tissues and the re-draping of the skin. The technique has evolved from short incisions in front and behind the ears to longer incisions into the temple and neck hairline including elevating the muscle deep to the skin and the tissues overlying the facial bones. With the advancement of endoscopic techniques twenty years ago we are capable of performing face and brow lifts through shorter inconspicuous incisions in the hairline or inside the eyelids. The muscles and deeper tissues are thus elevated, stretched and sutured into position with special sutures. Not only does this decrease the visibility and shorten the scar, it also diminishes the likelihood of loss of sensitivity and diminishes swelling. Internal threads when used in conjunction with elevation of skin and muscle help to prolong and improve the results of face and neck lifting.
Bruising, swelling and pain are minimal with patients looking greatly improved upon leaving the office. The procedure is technique dependent and of great value due to the avoidance of deep anesthesia and the years of lasting improvement. When injected with fat, lips however do swell for three days due to the typical need for lidocaine (local anesthetic) injection.