A facelift can restore definition to the face and neck by addressing sagging skin, excess tissue, and changes in the deeper supporting structures of the face.
At BodyAesthetic Plastic Surgery & Skin Care Center in St. Louis, Dr. C.B. Boswell performs facelift procedures tailored to each patient's facial anatomy, concerns, and goals. He has more than 20 years of experience performing deep plane facelifts and trained with Dr. Jack Owsley, one of the pioneers of the deep plane facelift technique.
What Can a Facelift Improve?
As we age, gravity, sun exposure, genetics, and other factors can change the appearance of the face and neck. Common changes include:
- Deep creases between the nose and mouth
- Wrinkles and folds in the cheeks
- Sagging or loose facial skin
- A less-defined jawline
- Loose skin and fullness beneath the chin
- Changes in the appearance of the neck
A facelift, medically known as a rhytidectomy, is designed to address these visible signs of facial aging. Depending on the patient's anatomy and goals, surgery may involve repositioning or removing excess fat, tightening the underlying facial tissues, and redraping excess skin.
A facelift may be performed on its own or combined with other facial rejuvenation procedures, such as a brow lift, eyelid surgery, or facial fat transfer.
The goal is a refreshed, more youthful appearance while maintaining natural-looking facial features.
Am I a Candidate for a Facelift?
Facelift surgery is highly individualized. Good candidates generally have begun to notice sagging in the face or neck while still having reasonable skin elasticity and an appropriate underlying bone structure.
Although many facelift patients are between 40 and 70 years old, age alone does not determine whether someone is a candidate. Facelift surgery can also be appropriate for carefully selected patients in their 70s or 80s.
During your consultation, Dr. Boswell will evaluate your:
- Facial skin and elasticity
- Underlying facial structure
- Degree and location of sagging
- Wrinkles and folds
- Jawline and neck contour
- Individual goals and expectations
He will then discuss which facelift technique is appropriate for your anatomy and desired result.
Dr. Boswell's Deep Plane Facelift Experience
There are several facelift techniques. They range from procedures that primarily reposition the skin to techniques that address deeper supporting tissues, including the superficial musculoaponeurotic system (SMAS) and platysma muscle.
Dr. Boswell trained with Dr. Jack Owsley, a pioneer in deep plane facelift surgery, and has performed deep plane facelifts for more than 20 years.
With a deep plane facelift, the deeper facial tissues are repositioned rather than relying primarily on tension placed on the skin. The specific technique used depends on the patient's anatomy and the areas being treated.
Facelift: The Surgery
Incisions usually begin above the hairline at the temples, extend in a natural line in front of the base of the ear to just inside the cartilage at the front of the ear, and continue in the crease behind the ear and into the lower scalp. If the neck needs lifting, a small incision may also be made under the chin.
In general, the surgeon separates the skin from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The surgeon then tightens the underlying muscle and fascial tissue and elevates the skin upward and back, then trims off the excess.
The stitches used to secure the layers of tissue and close the incisions are typically removed after 5 to 7 days. Because your scalp may take longer to heal, the stitches in your hairline may be left in a few days longer. Your head will be wrapped loosely in bandages after surgery to minimize bruising and swelling, but they will be removed the following day, as will two small drains placed during surgery. When the bandages and drains are removed, you may shower and wash your hair. Although your face will be pale, bruised, and puffy at first, you’ll look much better in a week or so. If you need it, special camouflage makeup can mask most bruising that remains.
How Is Facelift Surgery Performed?
The exact surgical approach varies from patient to patient.
Facelift incisions generally begin near the hairline at the temples and extend along natural contours around the ear. The incision may continue behind the ear and into the lower scalp. If treatment of the neck includes submental liposuction, a small additional incision may be placed beneath the chin.
During surgery, Dr. Boswell may:
- Separate the skin and underlying tissue from the deeper facial structures.
- Reposition and tighten the SMAS and platysma tissues.
- Address excess tissue or fat when appropriate.
- Improve the contour of the jawline and neck.
- Redrape the skin over the newly positioned facial structures.
- Remove excess skin and close the incisions.
Deep sutures are absorbable and are gradually dissolved by the body over approximately three to four months.
The goal of placing support in the deeper facial tissues is to create a stable foundation rather than relying solely on tension in the skin.
What To Expect After A Facelift
After surgery, your head may be loosely wrapped with bandages to help minimize swelling and bruising. Two small drains may also be placed temporarily and are generally removed the following day.
Once the bandages and drains have been removed, you may shower and wash your hair according to Dr. Boswell's instructions.
It is normal for the face to initially appear pale, swollen, bruised, or puffy. Most patients notice a significant improvement in their appearance during the first week, although swelling continues to decrease over the following weeks and months.
Some temporary numbness is also common. Sensation gradually returns as the nerves recover.
Length of Surgery
4-5.5 hours, depending on the technique
Anesthesia
General anesthesia for a deep plane facelift; selected minimally invasive procedures may use local anesthesia
In/Outpatient
Usually 1 night in the hospital. If multiple procedures are performed, you may chose to spend a second night.
The Side Effects
Temporary side effects can include:
- Bruising
- Swelling
- Numbness
- Skin tenderness
- A tight sensation
- Dry skin
As with any surgery, facelift surgery also carries potential complications. These can include bleeding or hematoma, infection, poor wound healing, unfavorable scarring, asymmetry, changes in the hairline, and temporary or permanent nerve injury.
Facial nerve weakness can occur when the nerves are stretched during surgery. In many cases, nerve-related changes are temporary, but permanent nerve injury is a recognized potential complication.
Men may also experience a change in the direction of hair growth or may need to shave an area behind the ears where beard-growing skin has been repositioned.
Your individual risks depend on your health, anatomy, surgical technique, and whether other procedures are performed at the same time. Dr. Boswell will discuss these risks with you during your consultation.
Severe or persistent pain, sudden swelling, or other unexpected symptoms should be reported to your surgeon promptly.
Facelift Surgery Risks
Injury to the nerves that control facial muscles or sensation(usually temporary but may be permanent). Infection, bleeding, poor healing, or excessive scarring. Asymmetry or change in hairline or ear position.
Facelift Recovery
First few days
Keep your head elevated and limit physical activity to help reduce swelling. Your face and scalp may feel tender, tight, or numb.
First week
Many patients working from home can return to work within approximately 4–7 days, depending on their recovery and the nature of their work.
Sutures are generally removed progressively beginning around six days after surgery, with most removed by approximately day 11. Sutures in the scalp or hairline may remain longer if additional healing time is needed.
1–2 weeks
Most bruising has substantially improved by approximately 10–14 days. Patients returning to an office-based workplace often prefer to allow roughly two to three weeks before returning.
Around 3 weeks
A substantial portion of the swelling has typically subsided, although residual swelling can remain.
4–6 weeks
Patients can gradually resume more strenuous exercise according to their surgeon's instructions.
6–8 months
The final appearance of the face may continue to evolve as residual swelling resolves and the tissues settle.
Individual recovery times vary, so Dr. Boswell will provide specific instructions based on your procedure and healing.
Returning to Exercise
Walking is generally encouraged beginning the day after surgery, provided it is comfortable and approved by your surgical team. Initially, activity should remain light.
Dr. Boswell's typical guidelines include:
- First 2 weeks: Avoid lifting more than 10 pounds.
- Weeks 3–4: Lifting may gradually increase to approximately 20 pounds.
- Around 4 weeks: The elliptical machine and exercise bike may be introduced when appropriate.
- Around 6 weeks: Unrestricted exercise may be resumed when healing permits.
Always follow the postoperative instructions provided specifically for you.
When Can I Drive After a Facelift?
Many patients can resume driving at approximately one week, although the timing varies.
Before driving, you should:
- Be off narcotic pain medication.
- Be able to turn and move comfortably.
- Be able to react safely to other vehicles and road conditions.
- Feel alert and physically capable of driving.
Your surgeon should clear you before resuming driving.
Duration of Results
A facelift does not stop the natural aging process. Your face will continue to change over time after surgery.
Dr. Boswell describes a deep plane facelift as producing results that can last approximately 10 years. This does not mean that the results suddenly disappear at the 10-year mark. Rather, the procedure can create a significant improvement that gradually changes as the face continues to age.
A skin-only facelift generally has a shorter duration of benefit because skin is elastic and can relax more quickly than deeper supporting tissues.
Lifestyle factors can also affect how the face ages. Protecting your skin from excessive sun exposure, avoiding smoking, maintaining a consistent skincare routine, and using appropriate treatments may help maintain the quality and appearance of your skin.
Dr. Boswell can also discuss nonsurgical treatments, such as neuromodulators and dermal fillers, when appropriate.
Why Choose BodyAesthetic for Facelift Surgery?
Facelift surgery requires an individualized approach because every face has different anatomy, proportions, skin characteristics, and aging patterns.
Dr. C.B. Boswell has performed deep plane facelifts for more than 20 years and brings extensive experience in facial rejuvenation surgery to patients in St. Louis and the surrounding area.
During your consultation, he will examine your face and neck, discuss your concerns and goals, explain your surgical options, and develop a treatment plan appropriate for you.
Schedule a Consultation for a Facelift in St. Louis
If you are considering facelift surgery in St. Louis, a consultation is the first step toward understanding which approach may be appropriate for you.
Dr. Boswell also offers other facial rejuvenation procedures, including:
- Brow lift
- Eyelid surgery
- Liquid facelift
- Facial fat transfer
- Skin resurfacing
BodyAesthetic also offers body contouring and breast procedures, including tummy tuck, circumferential body lift, breast lift, and breast augmentation.
Facelift FAQs
What is a deep plane facelift?
A deep plane facelift is a surgical facelift technique that addresses deeper facial tissues rather than relying primarily on tension in the skin. The technique may be used to reposition tissues of the midface, lower face, jawline, and neck depending on the patient's anatomy and surgical plan.
How long does facelift surgery take?
Surgery typically takes approximately 4 to 5.5 hours, depending on the technique and whether additional procedures are performed.
Will I have scars after a facelift?
Facelift incisions are placed along natural contours around the ear and, when appropriate, within the hairline or scalp. Scars are permanent, but they generally fade with time and are designed to be as inconspicuous as possible.
When can I return to work?
Patients working from home may be able to return within approximately 4–7 days. Patients returning to an office environment often prefer approximately two to three weeks, depending on their recovery and comfort level.
When can I exercise after a facelift?
Light walking is generally encouraged early in recovery. More strenuous activities are introduced gradually, with unrestricted exercise typically around six weeks when healing permits. Your surgeon will provide individualized instructions.
When can I drive after facelift surgery?
Many patients can resume driving at approximately one week, provided they are no longer taking narcotic pain medication and can safely respond to traffic and road conditions.
How long does a facelift last?
A facelift provides long-lasting improvement but does not stop the natural aging process. Dr. Boswell describes a deep plane facelift as typically providing approximately 10 years of benefit, although individual results vary.
Will I look natural after a facelift?
The goal of a facelift is to rejuvenate the face while preserving your individual facial characteristics. The final appearance depends on your anatomy, surgical technique, healing, and other individual factors.
Can a facelift be combined with other procedures?
Yes. Depending on your goals, a facelift may be combined with procedures such as eyelid surgery, brow lift, or facial fat transfer.
Is a facelift painful?
Patients commonly experience tightness, tenderness, swelling, and numbness during early recovery. Typically, a facelift is not a painful procedure and most patients only require Tylenol for their pain within 2-3 days after surgery. Your surgeon will provide postoperative instructions and appropriate pain-management recommendations.