Face and Neck lift


Facelift and Neck Lift Surgery in South Florida

As all men and women know that some of the most visible signs of aging first appear on the face and neck. Although the changes appear gradually, there may come a day when you look in the mirror and feel as though your appearance doesn’t reflect the way you feel about yourself. Fortunately, there’s a quick and easy way to look as good as you feel: a face lift or neck lift. Also known as rhytidectomy, a facelift tightens the loose skin on your face and neck, as well as the underlying tissues, and removes excess fat. A safe and common procedure for men and women today, a facelift leaves your face appearing firmer and fresher, and leaves you feeling great.

South Florida board certified surgeon, Dr. Wigoda, and his team of cosmetic surgery professionals specialize in facelift and neck lift procedures in Fort Lauderdale, extending his services to patients in Miami and other parts of South Florida. Learn more about these procedures below, and contact our staff today to see if you’re a candidate for a facelift.

How Is A Facelift Performed?

The technique chosen for your surgery depends on your features, Dr. Wigoda’s preferences and your desired results.
There are many variations to the facelift procedure. However, the incision is typically hidden in the natural contour of your ear, and then extends around the earlobe and back into the hairline. Following surgery, the incisions are easily concealed by your hair or with makeup. There also may be a small incision hidden beneath your chin.

Working through these incisions, Dr. Wigoda frees the facial skin from its underlying tissues and pulls it upward and back. The excess skin is then removed. In some cases, the deeper tissues may also be repositioned to restore a more youthful contour to your face. If necessary, an incision under the chin allows Dr. Wigoda to remove fatty tissue in that area and smooth the cord-like structures of the underlying muscle in the neck.

For frequently asked questions about this procedure, see our cases and video testimonials below.

Who is a Candidate for Facelift Surgery?

You may be a good candidate for a facelift if you have any of the following types of conditions:
• A deep line that runs from the corner of your nose to the corner of your mouth
• Loss of a well-defined jawline
• Deep wrinkles in the cheeks and sagging skin near the cheekbones
• Loose skin, wrinkles or excess fatty tissue in the neck

Both men and women may be candidates for a facelift. Patients may request a facelift beginning in their 40s all the way up to their 80s. In general, patients want to have a facelift to look younger. That is certainly nothing to be ashamed of. Patients often tell me they feel young, healthy, and energetic, but look much older. They may feel or even be told that they look tired, angry, or displeased when in fact they feel energetic and happy.

It’s becoming more common that men will see a plastic surgeon because they are concerned about job security. While on one hand, they are being as productive as ever, on the other, they appear old, and possibly, less productive as compared to their younger colleagues. Even though age discrimination is illegal, unfortunately, it is common. In addition, men in their late 40s or 50s who lose their job and are looking for a new one, often find it is much harder than they expected.Age discrimination certainly occurs with women as well, and the same hold true for them. A facelift can make you look younger, fresher, and more energetic. Your self-confidence may be boosted. If you are considering a facelift, think about your true motives and whether a facelift is the answer. Be honest with your surgeon so that he may advise you with your decision.

Who Is Not a Candidate for Facelift Surgery?

A facelift is a lengthy and complex procedure. It also demands relatively healthy skin if serious complications are to be avoided. Because of this, patients with any significant medical problems including heart, lung, or kidney disease, vascular disease, diabetes mellitus, or autoimmune diseases should not have this procedure performed. There are a few rare skin disorders where facelifts should also be avoided. These include progeria, Werner’s syndrome, and Ehlers-Danlos syndrome.

Smokers, no matter how few cigarettes they smoke, should not have a facelift performed unless they completely abstain from cigarettes both before and after surgery. The length of time to abstain will vary depending on the surgeon, but will be at least four weeks before and four weeks after surgery. A nicotine patch is just as harmful as a cigarette and cannot substitute for abstinence. A smoker who wishes to have a facelift must be honest with themselves and their surgeon or horrible complications can result, including loss of a large portion of the skin on the face, which would then require reconstructive surgery.

Finally, patients with unrealistic expectations should avoid this procedure. As discussed above, a facelift is not the answer for major problems occurring in your life. In addition, while it may make you look younger and refreshed, you will not look like a teenager. In addition, it will not make you more beautiful or attractive than you ever were. It simply reverses some of the changes that have occurred because of aging. The only way to know if you are being realistic is to talk honestly and openly with your surgeon. You do not want to go through the expense, pain, and risk of surgery only to find that you did not achieve your goal.

What Should I Avoid Before Facelift Surgery?

You will need to avoid aspirin and any products containing aspirin for 2 weeks before surgery. You must completely quit smoking at least four weeks before surgery. You should avoid getting a suntan as well. If you use skin rejuvenation creams like Retin-A or Renova, stop using these 1-2 weeks before surgery.

What is the Typical Facelift Surgical Process?

You will first have a consultation with Dr. Wigoda to discuss your case. Once you have decided to proceed with the surgery and have scheduled a date, you will return for a second visit, at which time Dr. Wigoda will review the surgery with you, photos will be taken, consent forms will be signed, and further instructions and prescriptions will be provided. Full payment is made prior to surgery (or financing is arranged). You will have lab tests drawn and an electrocardiogram done by your primary care physician (or we will recommend where to do this) one to two weeks prior to the surgery. A medical clearance may be needed.

On the day of surgery, you will arrive at the office surgery center. You will not have eaten or drank anything since midnight the night before. You will be checked in and your vital signs will be taken. You will put on a gown. An intravenous line will be started. Dr. Wigoda will mark your face with a marker. You may be given a sedative in your I.V. to help you relax before you are taken back to the operating room.

Immediately following surgery, bandages and dressings will be placed. You will go to the recovery room for 1 to 2 hours. Your vital signs will be monitored. Once you are stable you will be taken home (or to a hotel) by your friend or family member. You will want to stay relaxed and primarily in bed for the first few days. You will need to keep your head elevated and relatively still. You do not want to use any pillows directly behind your head for a few days (that flex your head down onto your chest). You should, however, begin to start walking, eating, and using the restroom the day after surgery. Your dressing and drains will be removed after 3 to 5 days. Your activity can slowly increase each day, but it will take up to 2 weeks before you start to feel like yourself again. You should avoid any strenuous activity for 4 weeks.

What Are the Potential Risks during a Facelift?

The most common and significant complication of a facelift is a hematoma – a collection of blood under your skin that develops from a bleeding vessel. It occurs in 1-5% of facelifts. Dr. Wigoda will try to keep your blood pressure low during and after surgery to try to prevent this from happening. He will also try to keep you relaxed and comfortable. If you do get a hematoma, you may have to go back to the operating room to remove the blood collection.

The most dreaded complication of a facelift is an injury to the facial nerve. This nerve stimulates all the muscles in your face that allow you to make facial expressions like smiling, frowning, kissing, etc. The most common injury is to a branch of the nerve which allows you to smile. Most of the time, the nerve injury is temporary. It may take anywhere from a few days to a year for the nerve to recover, depending on the extent of injury. If the nerve is cut, the injury will likely be permanent. Luckily, this complication is rare and usually resolves with time. Other potential complications with this procedure are uncommon but can include infection, loss of skin, unattractive scars, asymmetry, pulling the earlobe down, and deep scar formation. Dr. Wigoda has developed his facelift procedure whereby he remains distant from the facial nerve with a minimal risk of causing injury to it.

What Type Of Anesthesia Is Used for Facelifts?

Dr. Wigoda uses general anesthesia for this procedure. You will be completely asleep and not feel anything. Some surgeons are comfortable doing the procedure under local anesthesia with sedation. There may be some discomfort when the surgeon injects the local anesthetic and it may be difficult to lay still for many hours at time.

Where Is The Incision Made?

Incisions are generally made starting approximately 1 inch above your ear, going down in front of your ear, around to the back of your ear, and then into your hair. The incision in front of the ear is often partly hidden by placing it behind the tragus. (The cartilage “bump” in front of the ear opening). The incision behind the ear is sometimes continued along the hairline in cases where a lot of skin is removed from the lower face and neck. These incisions are made on both sides of the face. Often, an additional incision is made under the chin to tighten the muscles in the neck and remove some of the fat in the neck. These incisions will leave scars. However, if placed well, they are often difficult to see.

What Are The Different Techniques Used?

Each surgeon uses his own technique; the one he or she is most comfortable with. However, there are basic principles and philosophies which are followed. The surgeon needs to decide what the “problem areas” are and how he will improve them. All surgeons will remove some extra skin and tighten the remaining skin. What varies, is what, if anything is done to the deeper structures. The primary deep structure which the surgeon will address is called the SMAS (SubMuscular Aponeurotic System) This is a fascial layer under the skin. Today, most surgeons will tighten the SMAS with the belief that this gives a better and longer lasting result. Even though more structures are being pulled, the patient is actually left with a less “pulled look” (which nobody wants). In previous years, when only the skin was pulled, surgeons would put a lot of tension on it, worried that the skin was going to stretch back some. Now, since the deeper structures are pulled as well, the skin does not have to be pulled as much. The “pulled look” is avoided and the patient looks better. Surgeons who claim they can get you back to work in a few days or a week may be telling the truth, but you may have to come back every year or two to get redone because the technique does not produce long lasting results.

Dr. Wigoda was fortunate to train with many pioneers of facelift procedures in Dallas. He has combined the best aspects of each technique to create his own facelift procedure. The technique he uses causes minimal pain, has natural results, and is long lasting. The vast majority of patients are quite surprised afterward at how little discomfort they have and how quickly they return to normal activity. Most patients have minimal bruising. Finally, with Dr. Wigoda’s technique for skin closure, scars are typically minimal and are often difficult to see once they have fully matured.

How Long Does Facelift Surgery Take?

A facelift will take anywhere from 2 to 6 hours depending on how much is done and the surgeon’s experience. A faster facelift is not necessarily a better one.

How Much Bruising, Swelling, And Pain Is There?

After surgery, it is expected that the face will have a moderate amount of swelling. Most of the swelling will resolve over 2 to 4 weeks. The amount of pain post-operatively is very patient dependent. Some patients will experience mild discomfort. It is unusual to have significant pain. The vast majority of patients report the pain as tolerable. For the most part, all of the pain and discomfort resolves completely with time, generally 1 to 2 weeks.

Will There Be Stitches That Have To Come Out?

Dr Wigoda will remove the sutures after approximately 7 days.

Are Drains Placed?

Yes. Dr Wigoda will place one or two drains. The drains come out in the hair behind the ears. The drains are usually removed after 3 to 5 days.

Will I Have to Change Any Bandages?

Dr. Wigoda will change your dressings during the first week after surgery. In the second week, most patients no longer require dressings.

When Will I See The Final Results?

Depending on the technique used, you may have swelling and bruising for as little as two weeks or up to a few months. Most of the swelling, regardless of technique, will resolve in the first month. For the techniques in which the goal is to obtain a long-lasting result, where the deeper structures are manipulated, the swelling will last longer. It will take 3 to 4 weeks for most of the swelling to resolve and probably 3 to 6 months for all if it to resolve. After this you should have a reasonably good idea of what the final look will be.

How Long Do the Results of Facelift Surgery last?

This depends on what is done, on the patient’s skin and tissue quality, age, habits (sun exposure and smoking) and overall health. When the deeper structures are tightened, the results are longer lasting. In my opinion, this is what the goal should be for the majority of patients. Everyone will continue to age, but will always look younger than had they not had the procedure.

When Can I Get Back To Work?

You should plan on being off work for at least two weeks. If your work is strenuous, you will need more time off. After two weeks, it may still be obvious that you had surgery (depending on what was done). If you don’t want anyone to know you had surgery, or you at least want all the bruising and swelling gone before going back to work, ask Dr. Wigoda what the average time for this to occur is in his patients.

When Can I Resume Sexual Relations?

You may want to wait at least two weeks until your incisions are well on their way toward healing. Early sexual activity may prolong your soreness and discomfort.

A Facelift’s Ultimate Goal

The goal of a facelift surgery is to help men and women “set the clock back” on their appearance in a safe way. Many surgeons use different methods to their facelift surgery, which is why it’s important to talk with your surgeon about his or her experience and their approach. Dr. Wigoda’s 18 plus years of cosmetic and plastic surgery experience, along with hundreds of happy testimonials show his tried-and-true approach to facelift surgery is successful and safe. Call us today to schedule a facelift consultation, and talk to Dr. Wigoda about your options for a face or necklift in the south Florida area.


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