I typically do not make any incisions for a facelift that are actually in the hair but all of my incisions are either hidden around the creases of the ear or they are along the edge of the hairline.  The incisions that are placed along the hairline are beveled so that the incision is actually cutting through the first few hairs and, as it heals, hairs should grow directly in front of and within the scar itself helping to camouflage it.  When the procedure is performed appropriately and little to no tension is placed on the actual skin closure, these scars from a facelift can heal incredibly inconspicuously so that, even in patients with very little or thinning hair, these incisions are not noticeable and the patients overall are very happy with the appearance that they have after the facelift procedure.

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Well, I personally perform 2 different styles of facelift or neck lift.  One is what I call a mini lift, which is a SMAS imbrication lift that is performed in the office setting under local anesthesia.  I place a light pressure dressing on the patient that they can remove the following day and, if the bruising is rather minimal, patients can typically go back to relatively normal nonstrenuous activity within a day or two.  The sutures are removed in 6 to 7 days and, within 2 weeks, they can resume strenuous activities.  I also perform a much more sophisticated and more rejuvenating extended SMAS deep plane facelift in the operating room setting.  With this type of a facelift, the patient spends one night in my private surgical center and, the following day, a small drain is removed as well as the light pressure dressing.  At that point in time, the patient looks relatively good, depending on the amount of bruising that they have and, again, can typically go back to very light activities within a few days.  Once again, the sutures are removed in 6 to 7 days, and strenuous activities can be resumed in 2 weeks.  So, as you can see, both facelift styles have a similar downtime, though the more sophisticated and more technically demanding intraoperative extended SMAS deep plane facelift may have an extra day or two of downtime compared to the less sophisticated mini lift that is performed in the office.  Ultimately, I would recommend a consultation with a board-certified facial plastic surgeon so that all of your options can be discussed and the appropriate treatment can be planned that will fit your lifestyle.

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Laser skin resurfacing can certainly help with fine wrinkling of the lower eyelids and even cause some rather significant-appearing skin tightening but it really does not do a lot for the herniation of fat or the bag that is underneath the eyelid.  There is an exciting possibility in the near future regarding noninvasive treatment of the lower eyelid bags and that would be with the Ultherapy device, which is an ultrasound-based, noninvasive, no-downtime rejuvenation technique that can injure the tissue deep to the skin and cause contracture or tightening of this tissue.  We have seen some rather significant effects in the lower eyelids despite the fact that we have not been directly treating the lower eyelid fat at this stage of the game.  I have asked the company to start researching and developing a pencil tip-type transducer that can be used directly on the lower eyelid, as I feel that the device is more than likely going to be able to tighten the orbital septum, which will then push back the pseudoherniated fat and help alleviate the appearance of the lower eyelid bag.  However, at this point in time, this is unavailable.  I would highly recommend an evaluation by a board-certified facial plastic surgeon so that an appropriate customized treatment plan can be created regarding your specific anatomy of your lower eyelids.  After discussion, you may find that a lower eyelid blepharoplasty is something that you would desire due to the fact that these typically have very minimal downtime as well as relatively minimal risk and can provide fantastic rejuvenation to this area of the face.  In select cases, I can actually perform these procedures in the office setting under local anesthesia.

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Recovery from just having a browlift performed is typically rather minimal.  I have actually had many patients tell me that they could have gone to work the following day.  I do, however, mention that there are also many patients who said that they could not go back to work for approximately a week, so it is really dependent on the individual and is also dependent on whether or not they have any bruising that occurs around the eyes.  As far as the swimming goes, I would recommend taking a full week off before swimming but you can certainly get your hair wet and shower normally the day after the procedure.  I just do not want the incisions to get soaking wet as they would in a swimming pool for approximately one week.  After that, you should not only feel good enough to go back to your routine of swimming but it should also be safe for your scalp to get soaking wet at that time.

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I personally feel that the way to find out which technique is right for you is to have a consultation with a board-certified facial plastic surgeon who can go through the various treatment options with you.  The right option is really dependent on your anatomy and, with someone with drooping eyelids, maybe an upper lid blepharoplasty would be better than a browlift.  If you are a candidate for a browlift, the majority of my patients are good candidates for an endoscopic technique where the incisions are simply placed up in the scalp in the hair so that, once it is healed, the scars are not visible whatsoever.  Many patients require a browlift and an upper lid blepharoplasty, and these can be performed at the same time.  Again, I feel a consultation with a board-certified facial plastic surgeon would allow you to go over the various techniques that are available to give you the look that you desire.

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