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Asymmetric Facelift



A facelift is classically performed to correct signs of facial aging including sagging of the skin in the face; deepening of the lines between the nose and corner of the mouth (aka laugh lines, smile lines); fat that has fallen in the face; jowling in the cheeks and jaw; and loose skin and excess fat in the neck. While surgeons at the Facial Nerve Center sometimes perform facelifts for cosmetic purposes, we also frequently perform an asymmetric facelift on the affected side of patients with facial palsy. This procedure is usually covered by insurance on the affected side.

              Facial palsy frequently leads asymmetric aging, with the affected side either looking more youthful or, at times, more aged than the unaffected side. An asymmetric facelift can be performed on the affected side to tighten the facial skin and reposition the soft tissues to improve facial symmetry. If a patient would like to tighten the facial tissues on both sides of his or her face, this can be discussed during a consultation visit.

              The facelift procedure is typically performed in the Facial Nerve Center clinic under local anesthesia only, although if being performed alongside other procedures or if the patient wishes, we also perform facelifts under general anesthesia. An incision is made in the temporal tuft of hair, along the crease in front of the ear, and often times behind the ear and along the hairline depending on the extent of facelift required. The incision is placed in a way so that when it heals, the scar is well-camouflaged. The skin is then raised over the cheek and neck and the underlying fascia (aka SMAS layer) is tightened to re-suspend the facial soft tissues. Finally, the skin is re-draped and the excess trimmed to give the face a more youthful, but still natural appearance. 

              Patients typically go home the same day as surgery, even if being performed under general anesthesia. They may have a small drain in the face, which will be removed in clinic the next morning, and the head will be wrapped in a specialized dressing and ACE bandage to facilitate healing. The stitches will be removed 1-2 weeks after surgery. Depending on the extent of the facelift procedure, postoperative bruising and swelling typically resolve after a few days to 2 weeks following surgery.

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