Dr. Bentkover's initial consultation will take about an hour.  He will carefully evaluate your face and discuss with you what you might realistically expect from a facelift.  His objective is to create a natural appearance that is pleasing to you, not an operated or overly “pulled” look.  He may also take some digital photos of you and simulate a facelift with our imaging software.

Our staff will give you specific instructions on how to prepare for surgery, with guidelines on eating and drinking, smoking, and medications. If you smoke, we will ask you to quit for at least 1 month before and after your surgery, since smoking can have an effect on how well you heal. A smoker has a higher risk of infection, swelling and actual loss (slough) of skin near the incisions! You must stop anticoagulant medications and herbal preparations such as aspirin, ibuprofen, vitamin E, Gingko, St. John's Wart, garlic, or Ginseng 10 days prior to surgery. However, we will usually give you Arnica and recommend pineapple juice (for its Bromelein content) before and after surgery. These are herbal preparations that we think decrease swelling and bruising.  You will be required to take antibiotics to prevent infection. You should shampoo your hair the night before surgery.

The Procedure

A facelift is frequently performed in conjunction with a blepharoplasty (eyelid surgery), forehead lift, chin augmentation, facial resurfacing, and/or liposuction to create an overall rejuvenation of the face. The procedure may need to be repeated a number of years later, since the effects of aging and gravity continue. You will be the judge of when or if you need further surgery.

Facelifts are most commonly performed in the Same Day Surgery Unit of Saint Vincent Hospital at the Worcester Medical Center.  We also operate at the Massachusetts Eye and Ear Infirmary. General anesthesia or local anesthesia with intravenous sedation is required. Dr. Bentkover will make an incision that starts at or inside the hairline at the temple and continues in front of the ear, then around the earlobe and behind the ear, ending at the scalp area. These incisions are placed in such a manner that they generally hide very nicely.  Most women can wear their hair up in a few months without worry of unsightly incisions.  Excess skin is removed and sagging muscles and connective tissues (called the SMAS) are tightened.  Incisions are closed carefully and every effort is made to hide them as much as possible. The procedure may take up to 5 hours, depending on whether any other procedures are performed at the same time.

Recovery: What to Expect

You will be given explicit pre- and post-operative instructions. By following these instructions you will minimize potential problems. It is necessary to have someone drive you home and stay with you for the first 24 hours. There is also a hotel across the street from the hospital that is very accustomed to hosting our patients. Initially you will have a large dressing wrapped around your head, and your neck will feel very tight. You might have surgical drains. These will be removed in approximately 24 hours. Often there are no drains. Stitches around the ears will be removed in a few days or dissolve on their own. The scalp sutures or staples will be removed in 7-10 days.

Generally scars fade satisfactorily over a number of weeks, but maximal fading may take a few months. Most swelling and discoloration generally decreases within two to three weeks, but some in some areas it may take months to subside.  You are usually "presentable" in 2 weeks. If a midface lift is also performed, the mid facial swelling will persist longer. Tightness in your face and neck will be present for several weeks, and there may be slight changes in your hair pattern around the incision.  Dr. Bentkover will discuss all these details with you and show you the location of the incisions.  If you have had a facelift previously, your hairline may be a bit high at the sideburn area.  Dr. Bentkover may need to alter the incision to prevent further elevation of you sideburn.

We recommend that you avoid the sun after surgery. Also, remember that one of the major factors that led to you having the surgery was probably sun exposure. In order to preserve the results of your surgery and prevent unwanted thick scars, we actively discourage excessive sun exposure and encourage high SPF sun protection. SPF 45-75.

Complications following facelift are very rare but can happen.  They may include bleeding, infection, loss of a small amount of skin near the ears, facial nerve injury, discoloration of the skin, numbness, asymmetry and excessive scarring. Infection is rare due to the large blood supply to the face. The risk of bleeding is greater if you take aspirin or blood thinners within 10 days of the surgery. The risk of wound complications is higher in smokers, diabetics, persons with a history of radiation and autoimmune or collagen diseases.

The healing process is gradual, so you may not appreciate the final result for up to 6 months. A single procedure usually achieves the desired results. Most patients do not have another facelift later in life, but the number of patients having second facelifts is definitely growing.  Most patients who have had facelifts are pleased with their new, more youthful appearance.  They appreciate the return of a more youthful jawline and neckline.