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.
Scarring
A common concern before a facelift is the scarring 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 scarring 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 scarring 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.
