When one thinks about this it makes sense however, because these people have been validated about their appearances for their entire lives and, like it or not, it’s an important part of their self image. When signs of aging appear and they no longer receive those compliments that they’ve grown so accustomed to, it can be devastating. This is particularly true for individuals that have relied heavily on their appearances to define themselves.
Let me be clear about something: No one needs a facelift. It’s done in order to make someone feel better about themselves. Therefore the question of when a person should have surgery has very little to do with what they look like, but rather how they feel. At social gatherings I’ll often be backed into a corner by one or two women who have their hands up to their cheeks thrusting them backwards towards their ears in that universal facelift sign asking, ‘Am I ready yet”?…and my standard reply is that they will be ready when the desire to improve their appearance outweighs their fear of doing so. It is best to time surgery before the skin has lost too much of its elasticity and when the person is within 10-15 pounds of their ideal weight. It is also crucial that they are not smoking, as this can cause significant scarring.
There are different philosophies about the timing of a lift: Some people wait until everything is virtually hanging to the floor (like a bloodhound) and do everything at once, adamant that they’ll never do surgery again. Others wish to do surgery when they are just beginning to show signs of aging so that they don’t look much different afterwards and can ‘get away with it’ more readily. These people may end up having surgery several times to ‘maintain’. Some people feel that they will get more value out of a facelift when they are younger and more socially active as opposed to when they are a few years older. There are also a few milestone events, such as class reunions and weddings that are powerful incentives for people to undergo surgery. While a recent divorce may incentivize someone to reinvent themselves, this may also be a time of emotional instability and not necessarily a good one for having surgery.
Once the decision has been made to have a facelift and any other procedures that will help rejuvenate the face such as eyelid surgery, brow lifts, etc… then it should be timed to fit into the patient’s calendar. It usually takes two to three weeks to look good enough for “threatening social interactions”. While most patients should look better than they did before the operation within 3-4 weeks, it generally takes about six months before things look optimal. Sometimes laser treatments can be done to make the bruising and redness diminish more quickly but otherwise there is very little to move things forward except the passage of time. I allow patients to return to mild exercise, such as walking on a treadmill, the very first week after surgery. I have them refrain from heavy exertion or any type of inversion, such a yoga or Pilates, for three weeks. The pain is usually quite tolerable with most people discontinuing their need for pain pills by the third or fourth day.
Many people feel a bit depressed sometime in the second week after surgery because their energy levels are low due to the high requirements of the healing process. This tends to pass after a few days and is replaced by very positive feelings about the way things are looking. Some firmness in the tissues of the lower face and neck are typical for three months until the swelling resolves and things become more pliable.
There is no denying that there are some awful looking facelift results out there. I can’t tell you how often I hear someone tell me “I can always tell a facelift and I’d never have one because they always look so weird”. Unfortunately this belies the fact that good facelifts are natural looking and therefore do not call attention to themselves. Hence, only the bad ones are recognized; which is a shame. It is the goal of most of my patients that the surgery “cleans things up” and makes them look less tired yet doesn’t change the essence of who they are. With careful planning and proper execution this is achievable.
The first emotion that most patients have once they’ve come through the operation is purely relief. As the days pass this turns into appreciation and finally a real excitement as they regain a sense of self confidence. Having a facelift is a stressful ordeal for most patients and it is flattering that people entrust me with something that is so significant for them. It is extremely satisfying for me to take a person through this process and deliver such a unique gift to them. The human connection is a gift to me….
After all, the shortest distance between two people is a smile.