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Facelift, Face

The 10 Potential Health Risks of Facelift Surgery

Age and gravity are often unkind to the body. Areas that used to be firm and smooth become wrinkled and start to sag. More often than not, you probably feel much more youthful and energetic on the inside than your body may portray on the outside. As a result, your self-confidence and social life may take a hit.

Your face is something you show to world. You want your face to accurately represent the way you feel inside to those around you and be something you're confident in. Thousands of facelift procedures are done each year for satisfied patients. The facelifts of the past have often been associated with negative results and a stretched, windswept look.

Today, highly skilled plastic surgeons are experienced in a variety of techniques that produce beautiful, natural-looking results. However, as with any surgical procedure, there are some risks that should be considered before you make the final decision to proceed with your facelift.

Potential Risks of Facelift Surgery

Facelifts are considered a safe procedure, and with the right surgeon, you'll be happy with your beautiful results. Be sure to talk to your doctor about the realistic expectations and to find out if you're a good candidate for a facelift. If you're unsatisfied with the wrinkles and lines, lost volume, or sagging brought on by age and you're considering this procedure, here are 10 potential risks to be aware of.

1. Bleeding / Hematoma

Abnormal bleeding after surgery may develop into a collection of blood called a hematoma. There are many causes of hematoma including elevated blood pressure, altered blood clotting, and strenuous activity. A hematoma may show itself as the development of sudden swelling, tenderness, bluish-purple skin discoloration, a painful lump, or bruising that worsens instead of improving.

Hematoma is the most common complication after facelift surgery, occurring in 1-5% of procedures. Even the best facelift surgeons in the world experience hematomas, despite meticulous care. Fortunately, with prompt attention, a hematoma is easily managed by your surgeon and generally doesn't cause long-term problems. Small blood collections can usually be observed and will be absorbed by the body. Larger collections may require surgical treatment including evacuation or drainage.

It's important to seek immediate medical attention if you suspect a hematoma because they can interfere with healing if untreated. Most hematomas occur within 24 hours after surgery, but they may occur several days afterwards. Untreated hematomas can cause delayed healing, contour issues, increased scarring, darkening of the skin, infection, and rarely even skin necrosis.

2. Infection

Surgical incisions are a potential entry site for bacteria, introducing the possibility of infection following surgery. The risk of infection is about 1% after a facelift in healthy people. This risk is higher in people who are diabetic, smoke, take steroids, or have other medical conditions.

The symptoms of infection include fever, redness, pain, tenderness, warmth, discharge, and/or a foul smell. If you suspect an infection, it's important to notify your surgeon right away so that you can get prompt attention.

If the infection is serious enough to keep the incision from healing properly, the final results of your facelift could be affected, and scars could be more visible.

3. Scarring

Every surgical procedure involves scars, and facelifts are no different. The face typically heals well, and scars are placed in specific locations around the hairline and ears to minimize visibility. Talented surgeons use specific techniques to make the scars virtually imperceptible, including precise closure and use of multiple layers to eliminate tension on the skin. By carefully following your doctor's post-surgery instructions, you will encourage healthy healing and reduce the risk of visible scarring.

Those with darker skin such as Hispanics, Asians, and African Americans, are more prone to developing thicker scars such as hypertrophic scars and keloid scars, but the overall risk is still very low. If you are prone to keloid scarring, talk to your plastic surgeon about your options and realistic expectations involved with a facelift procedure.

4. Adverse Reaction to Anesthesia

Facelifts may be performed under general anesthesia, twilight sleep, or local anesthesia. Temporary grogginess, nausea, or sore throat are common side effects and generally subside within a day or two. Complications from anesthesia such as an allergic reaction may occur rarely.

Some patients have an intrinsic fear of anesthesia and are worried either that they "will not wake up from surgery" or, conversely, that they "will wake up during surgery." Rest assured, both of these occurrences are extremely rare with modern anesthesia performed on healthy patients.

Your surgeon will discuss with you the best approach for your anesthesia.

5. Delayed Healing

Everyone heals at their own pace. Some are rabbits, other turtles. This means that your recovery time will vary, depending on your age, genetics, skin type, overall health, and type of procedure performed. Some patients may experience may experience delayed healing which could result in prolonged swelling and other side effects. In some instances, skin slough or wound breakdown may occur.

6. Tissue Loss

All surgery involves the cutting of tissue, which can compromise the blood supply to tissues. In general, the face has a very robust blood supply, so facelift procedures are readily tolerated. In rare instances, the circulation to the skin, fat, or muscle could be impaired, resulting in tissue necrosis. Tissue necrosis could result in skin slough, wound breakdown, increased scarring, and/or contour deformities.

Smokers are at a much higher risk of tissue loss because smoking compromises the blood supply to the tissue. If you are a smoker, talk to your surgeon and follow all instructions to stop smoking before and after your procedure within the instructed timelines to reduce your risk.

7. Damage to Underlying Structures

There is a small risk of damage to underlying structure such as nerves, fat, muscles, blood vessels, and salivary glands.

Temporary altered sensation including numbness, tingling, sensitivity, and itching is expected after a facelift. Facial motion can also be temporarily affected, such as eyebrow, eyelid, or mouth movement. These symptoms usually dissipate on their own after several weeks to months.

However, in rare instances, permanent damage may occur. The risk of permanent nerve damage after a facelift is less than 1%.

8. Seroma

Following surgery, fluid may build up under the skin and look like a swollen lump or cyst. This may occur at the site of an incision or where tissue has been moved or disrupted. This collection of fluid is called a seroma. The buildup of fluid doesn't always occur immediately following surgery; it can begin to build and swell over the course of days or even weeks after your surgery.

Small drainage tubes are often used right after your procedure to help prevent any build up of fluid. However, there is a chance that fluids will collect after the drainage tubes have been removed. Small collections of fluid are fairly common after a facelift and are typically drained with a needle or absorbed by the body. In rare circumstances, a collection of fluid that does not resolve may require a drainage procedure.

9. Allergic Reactions

Some patients may experience an allergic reaction to some of the medications or materials used during or after surgery. Most reactions are minor and can be treated by discontinuing the offending agent. In some instances, allergic reactions can be more severe and require additional treatments. In extremely rare instances, allergies to medications could cause shock.

If you have any known allergies, be sure to discuss them with your surgeon prior to your procedure.

There may be some redness and irritation as your sutures dissolve. This is a normal reaction and should be confused with an allergic reaction. Contact your surgeon with any concerns you have and follow his advice as your body heals.

10. Unsatisfactory Results

Skilled plastic surgeons perform facelifts with a very high probability of success, but there is a small chance you may be unhappy with the result. The practice of medicine and surgery is not an exact science, and therefore reputable surgeons cannot guarantee results.

In some cases, unsatisfactory or poor results may require additional procedures.

The best way to reduce the risk of unsatisfactory results is to carefully choose a reputable, Board Certified Plastic Surgeon who is very experienced at performing facelifts.

Conclusion

No surgery is without its risks and facelifts are no different. The risks involved are rare and many can be greatly reduced by doing some research, talking to your doctor, and following instructions both before and after your surgery.

Beautiful, natural-looking facelift results are possible for you. If you'd like to learn more, schedule a free consultation with Dr. Larry Fan or take our online self-assessment to see if you're a good candidate for a facelift.

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About the Author

Dr. Larry Fan is a Harvard educated, Board Certified Plastic Surgeon in San Francisco, CA. He is a Master Artist who is known for creating beautiful, stunning, and natural results. Dr. Fan has been named One of America's Top Plastic Surgeons for the past 10 years running and has received several national awards for his work in Plastic Surgery. He has successfully performed more than 10,000 cosmetic procedures of the face, breasts, and body over a 20 year period. Dr Fan has been an invited speaker at the American Society of Plastic Surgeons and the American College of Surgeons, and has been featured in national media outlets such as CNN, NBC, and ABC.

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