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How long will it take to recover?

It varies greatly from patient to patient but I usually tell my patients that most of the swelling and bruising will resolve within 10 days. Some residual bruising and swelling can last longer, even up to 4-6 weeks post surgery. I usually recommend Arnica Montana to help with this.

How much does a facelift cost in Toronto?

The price can vary greatly depending on your geographical location and the skill/credentials of your surgeon. In Toronto, it can easily cost anywhere from $9500 to $20,000 which is a large range.

Are skin lift only facelifts not performed anymore?

They are still performed but if you want a long-lasting improvement then I prefer to tighten the underlying muscle layer (SMAS). The traditional skin only facelift is rarely used today.

How soon after my facelift can I dye my hair?

In my practice, I allow patients to dye their hair 6 weeks after all of the incisions have healed. If done earlier, you run the risk of tattooing your incision lines. In my opinion, it's not worth the risk to dye your hair earlier.

Can men get facelifts? What's different?

The surgical technique for facelifts are very similar for men and women. Men often bleed more and their skin/soft tissues are thicker, but otherwise the actual techniques are the same. Sideburn management is also slightly different in regards to incision placement in men, but that's a minor part of the surgery.

How can I avoid bruising and hematomas after my facelift?

A certain amount of bruising is to be expected. Bruising is called ecchymosis. A hematoma is different - it's an actual collection of blood that forms. In the case of a facelift, hematomas are less likely than ecchymosis. There are several factors that can affect whether you develop a hematoma after a facelift:

  • Surgical technique - Your surgeon must be meticulous about obtaining hemostasis intra-operatively.
  • Your Biology - if you have a coagulopathy, or are taking blood thinners, or are naturally predisposed to bleed more (red-heads), you have a higher chance of developing a hematoma.
  • Hypertension - an elevated blood pressure in the peri-operative period can cause a previously occluded vessel to dislodge a clot and bleed, thus, resulting in a hematoma. Medications such as clonidine can be given in the peri-operative period to keep your blood pressure low. I usually admit by facelift patients overnight and have a nurse monitor their blood pressure.
  • Dressings/Drains - although there isn't any good evidence for this, many surgeons will use drains at least overnight to prevent any pooling of blood. Some surgeons will also apply a compressive dressing around your head to prevent bleeding.
  • As for bruising, I think Arnica has helped reduce the amount of bruising my patients have after surgery. This is certainly not scientifically proven, and not essential.
Can I get a facelift if I'm a smoker?

I think the best facelift for a smoker is NO facelift. The risk of skin necrosis is too high. At the very least, you should be able to stop smoking for 4 weeks before and after a facelift.

How long does a facelift last?

The answer depends on the type of facelift performed. In my opinion, the longest longevity is achieved with facelifts that address not only the skin, but more importantly the muscular layer of tissue beneath the skin (SMAS layer). SMAS stands for superficial musculoaponeurotic system. This layer of tissue is responsible for the age related changes we see in the midface/neck/jaw. By raising this layer and repositioning it, a long-lasting facelift can be achieved. I would expect the results of such a facelift to last 8-10 years. Of course, everyone is different. Sun-loving smokers may not experience such lasting effects.

How do I avoid the Wind-Swept look?

The best way is to choose a surgeon that has shown you pictures of their facelifts, and judge the appearance of these results. The wind-swept appearance occurs from placing the skin on too much stretch. We now know that the skin on the face is not the main cause of jowls and the descent of youthful facial features. The problem is with the underlying layer of tissue known as the SMAS (superficial musculoaponeurotic system).

Most of the lift obtained in a modern facelift is achieved by raising the SMAS. This can be done by either creating a flap in this layer of tissue and re-draping it, or by using sutures to tighten this layer. Regardless of the specific technique used, addressing the SMAS is the key factor in achieving ideal cosmesis in a modern facelift. Once the SMAS has been addressed, the facial skin can then be re-draped, and a minimal amount of skin can be removed. The skin should be inset with very little to no tension. This avoids the wind-swept appearance, and improves scar healing.

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