Facelift Complications
Serious complications from facelift surgery
are extremely rare. Facial plastic surgery complications
with significant impact on a patient’s health are
usually anesthesia-related. Therefore, it is important to
consider anesthesia choices when undergoing a facelift procedure.
As with any surgical procedure, complication risks can often
be minimized if the operation is performed by an experienced
physician; for your facelift this would be a skilled facial
cosmetic surgeon. Although there are many rare theoretical
problems that could result from a facelift, below is a list
of complications you may want to know about before you make
your final decision.
Bleeding
Bleeding is probably one of the more common
situations that can lead to a setback in the recovery. Most
commonly, oozing after a facelift results in bruising; sometimes
more than expected. This will not have a significant impact
on the final facelift result but the bruising may take more
time to disappear. Commonly, bleeding during the facelift
itself is minimal; it is the collection of blood under the
elevated skin that may form a hematoma. The likelihood of
a hematoma forming ranges from less than 1% to 5% or more.
Ask your cosmetic surgeon about his hematoma rate. Some
plastic surgeons may place large plastic tubing in your
face and neck region to prevent hematomas from occurring;
other physicians do not.
Infection
Although a serious concern to surgeon and
patient alike, facelift infections are very rare. Sterile
surgical technique, the use of prophylactic antibiotics
and the rich blood supply of the face contribute to the
extremely rare incidence of facelift infections. An infection
may present with increased redness, swelling and pain. Rarely,
pus may be found. Your plastic surgeon likely will treat
you with antibiotics; sometimes infection fluid will need
to be drained.
Scaring
A common concern before a facelift is the
scaring afterwards. Although one may always be able to find
the small incisions, these lines are usually not a cosmetic
concern for the patient. Hidden around the ears and in the
hairline, these incision scars usually blend in with natural
skin creases and may virtually disappear. Abnormal scaring
is more commonly found in darker-skinned people but it is
extremely rare on the face. If you had this happening in
the past, you certainly want to address this issue with
your surgeon. Unsightly scars usually can be improved with
little touch-up procedures.
Hair Loss
We all loose some hair as we age; therefore
it is of utmost importance to limit any additional hair
loss. Although it bears importance for the patient, hair
loss is probably one of the least talked about problem after
facelift surgery. Hair loss can be the result of scaring
and can go along with alterations in the normal hairline.
This commonly includes elevation of the normal hair tuft
in the temple regions right in front of the ears and the
hair behind the ears. Sometimes, the hair line behind the
ears can show a step-off; this may make it difficult for
patients wearing the hair up after the facelift. Talk to
your cosmetic surgeon about these issues and ask about his
approach to preserve hair and what he does to prevent this
from happening.
Earlobe Changes
The normal facelift incision is placed in
a natural crease around the earlobes where it is hidden
and heals well. The position of the ear itself will not
change after a facelift but the shape of the earlobe may
be altered after a facelift. Although most people are not
aware of the position and contour of their earlobes, some
certainly are because of placement of earrings. The earlobe
may become longer after a facelift. Commonly, this situation
can be prevented by the surgeon. If the earlobes change
after the facelift, they can be improved if their appearance
represents a cosmetic concern for the patient.
Nerve Damage
The face has a rich anatomy including blood
vessels and nerves. These nerve structures are responsible
for our facial sensations and muscle movements. As a routine
part of the recovery after facelift procedures, you can
expect numbness around the ears and in the neck region.
This rarely presents a problem for the patient as long as
you know that this is normal and usually improves over a
few months. You may also notice numbness of the earlobe
and the ear which usually recovers with time as the nerve
fibers regenerate. More concerning is interference with
normal facial animation due to injury to the facial nerve.
This can be temporary but it may be permanent if the facial
nerve branch is severed. Your surgeon’s thorough understanding
of the facial nerve anatomy will ensure that risking damage
to the facial nerve is kept at a bare minimum. As qualified
facial cosmetic surgeons perform facelift surgery, this
feared complication has been extremely rare.
Cosmetic Result
Although not a complication in a pure medical
sense, the initial consultation with your cosmetic surgeon
should thoroughly inform you about realistic goals of the
procedure as well as limitations. An experienced facelift
surgeon will know within certain limits what he can do for
you and what he cannot achieve after the facelift. Have
an honest discussion with your facial plastic surgeon and
mention areas of concern. Then ask him to show you on your
face what he thinks the final result might be. Although
computer animation systems appear sleek, they may not be
best for facelift surgery. Only when both, you and your
cosmetic surgeon can agree on a realistic final result,
you have a good chance to be happy at the end.
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