What is a facelift for facial paralysis?

In the setting of facial paralysis, a facelift is a static option for elevating the facial soft tissues and countering the effects of gravity. It typically addresses the area beneath the lower eyelids down to the jawline. By removing excess skin and tightening the underlying muscle layers, a facelift can reduce the facial droop that occurs at the corner of the lip and nose, jawline, and upper neck.

The real difficulty comes from how to achieve these results. This can vary extensively from surgeon to surgeon and with experience. It is important to discuss the goals of a facelift procedure ahead of time and understand the limitations and expectations. Often a facelift is combined with other procedures including a browlift, necklift, or eyelid surgery. The surgical plan is highly individualized to each patient and to his or her goals.

 

How is a facelift performed?

There are several variations to a facelift. These can include regular facelift, short-scar technique, and mini facelift. The goal of each of these options is similar; however, the degree to which each of these options can remedy the specific degree of facial droop can be quite substantial. Generally, the more severe the signs of paralysis or drooping, the longer the scar will be and the closer it will approximate a traditional facelift.  One of the key elements of a facelift is the tightening of underlying facial muscles and SMAS layer (superficial musculoaponeurotic system).  This is achieved in a number of ways, but must be performed in order to elevate the foundation of the face before redraping and tailoring the overlying skin.  The skin is then advanced over the deeper tissues and meticulously tailored.

 

What is the recovery from a facelift?

Following a facelift procedure, the head will be wrapped loosely with bulky bandages to minimize bruising and swelling. Patients are given prescriptions for antibiotics and pain medication routinely. A small thin tube may sometimes be used along the incision behind the ear to drain excess fluid that might accumulate under the skin. This tube is typically removed the following day after surgery and the dressings changed. Recovery may sometimes take longer when combined with additional procedures such as those mentioned above. There is an option for overnight monitoring in a post-surgical facility for those undergoing more extensive procedures simultaneously.

Swelling typically improves over 1 to 2 weeks. Bruising is not always present, but it will also improve during the same time period. Activity is restricted during the first 4 to 6 weeks to light walking and stationary activities. Heavy lifting, contact sports, aerobic exercises, and sex are to be avoided during this time. Most patients elect to take 7-14 days off from work. During this time, make up can be used to mask any bruising.

 

What are the risks and complications of a facelift?

Facelift complications are relatively rare when performed by a qualified and experienced plastic surgeon. However, individuals may vary substantially in terms of health status and genetic predisposition, potentially making them more susceptible to unfavorable results.

These complications can include hematoma (blood collection under the skin), injury to the facial nerve, infection, and adverse reaction to anesthesia. Smokers and individuals with uncontrolled diabetes sometimes demonstrate issues with poor wound healing. Dr. Panossian's staff is available at all times to address any concerns that you may have.

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