What is a facelift?

FACE-LIFT - RHYTIDECTOMY

Over time, the aging process, gravity, years of exposure to the sun, and the stresses of daily life can make us appear older and more tired than we are. We may see deep creases begin to show between the nose and mouth, the jaw line is not as tight and firm as we remember, and the skin around our neck can become loose and "crpe." Each face ages differently, and even different parts of the same face begin to show age at different rates, due to heredity and how we have maintained or abused our skin.

Rhytidectomy, 'facelift surgery' can help rejuvenate a face by repositioning and/or removing excess fat, tightening underlying muscles and lifting the skin to a more youthful position on your face and neck. Often men and women in their mid-forties to late sixties opt for facial rejuvenation, a refreshed and vibrant appearance, so that they look more like they feel, rather than their actual age. This surgery is performed on people as early as the late thirties and as late as the mid-seventies.  A face-lift corrects sagging tissue of the middle face, jaw line and neck, not the fine wrinkles, crow's feet, or the lines around the lips.  Traditional face-lift only minimally affects the nasolabial folds (deep vertical creases that run between the nostrils and the corners of the mouth). Newer technique in face lifting remodel the fatty layer and corrects the deep nasolabial fold to its youthful appearance. Mid-face lift is newer techniques that address the premature aging of the mid-face, mainly the deep nasolabial fold, and the sagging check.  Face-lifts do not affect the texture of the skin. However, improving the texture of the skin compliments the facelift results, and the restoration of youth. A skin care program can restore youth and glow to the skin. Combined with chemical peel or laser resurfacing it improves on the fine wrinkles, texture and quality of the skin.  Face-lifts are often performed in conjunction with Blepharoplasty (eyelid surgery), Rhinoplasty (nose surgery), brow/forehead lift, and fillers or fat transfer.

ALTERNATIVES TO SURGERY

Only surgery will actually tighten and remove excess skin. However, soft tissue fillers, fat transfer, or other implant devices may be an option for those who wish to postpone face lift surgery. Laser skin resurfacing can tighten the skin, and at the same time smoothen and rejuvenate the skin to its vibrant texture. There is no substitute for taking good care of your skin. Find out more about the variety of light peels, skin care products that have been proven to enhance the appearance of the skin and reduce fine lines and wrinkles. With or without an interest in surgery, good "skin care " will always make a positive impact on your appearance.

PREPARING FOR SURGERY

During the consultation, there will be an evaluation of the face in conjunction with the laxity and position of the boney structure and the soft tissue of the face. Brow or forehead lift, eyelid surgery (Blepharoplasty), chin or cheek implants, and/or laser resurfacing in combination with the face-lift may be considered to achieve the desired results. It is critical to have a thorough assessment. Several important decisions regarding the location of the incisions and your desired look are discussed. You will also be given more specific instructions, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

THE PROCEDURE

Facelift incisions are usually hidden in the natural folds and creases of the skin. They usually begin in front of the ear, and extend around the curves of the ear and back out under the earlobes and behind the ear into the hairline. If the neck needs attention, a small incision may also be made under the chin. The skin is separated from the underlying tissues below. Fat may be trimmed or suctioned from underneath the neck and chin to improve the neck and jaw line. Fat that has descended with age and gravity is replaced back to its normal position. Lost facial volume is replaced. The surgeon then tightens the muscle and tissues and places the skin in its new position and trims the excess. The incisions are closed. A drain may be temporarily placed under the skin to allow any fluid to drain.

Anesthesia

The type of anesthesia used during a facelift is dependent on the extent of the procedure to be performed. In most cases, a facelift is performed under local anesthesia along with intravenous sedation. General anesthesia is also commonly used, and might be more comfortable to the patient.

Length of Procedure

Facelift surgery is usually performed on an outpatient basis and takes two and a half to five hours. If you are having more than one procedure done, the surgery may take longer.

Level of Pain/Discomfort

Generally, with a facelift there is minimal to moderate discomfort during the postoperative period. Some people experience absolutely no discomfort at all.

PRE- AND POSTOPERATIVE INSTRUCTIONS

The following instructions are intended to make you feel more comfortable and help you heal during the post operative period: 

Stop smoking,

Discontinue the use of alcohol, and stop taking vitamin E and any medications containing aspirin or ibuprofen (three weeks pre- and postoperatively)

Check with your doctor regarding any other medications (including homeopathic/herbal products) that you are currently taking. 

If you want to color your hair or have a permanent, do it at a minimum of ten days prior to surgery. It will probably be about four to six weeks until you can color your hair or have a permanent again. 

If you wear your hair short, do not have it cut prior to the procedure. In that way, the longer hair will help cover the incisions until they heal.

Have someone stay with you the first day after surgery (the first forty eight hours, optimally). 

Follow directions regarding any ointments to be applied and/or cleansing of incisions. 

Sunbathing and tanning beds must be avoided for a minimum of four weeks prior to surgery.

After surgery, if you must be in the sun, protect your face. 

Keep the head elevated above the level of your heart at all times for at least the first week, optimally two weeks. 

For about a week, avoid excessive talking, laughing, and heavy chewing (stay on a soft diet). 

Expect some numbness in the areas treated for eight to twelve weeks.

Be careful when using a hair dryer or curling iron, because you may not feel the heat. 

Cold compresses: apply cold compresses for twenty minutes every hour for a minimum of forty-eight hours.

RECOVERY

If you have had a drainage tube inserted, it will be removed one or two days after surgery. Most of your stitches will be removed after about five days. The swelling may shift over your face and neck area for the first few weeks. It will usually lessen daily, with some minor swelling remaining for almost twelve weeks. The bruising can last, on the average, anywhere from five days to several weeks but should diminish daily. Some patients have reported that the bruising dropped as low as the chest area. You can apply makeup after the sutures are removed. Once healing has occurred, you will look natural, not an operated on look. This is the art of newer methods of face lifting.

RISKS/COMPLICATIONS

All surgery carries some uncertainty and risk. Of course much depends on physician selection, how well you comply with pre-and postoperative instruction, and your body's ability to heal. Complications are rare but do occur. You must be aware of the risks associated with your particular procedure. Complications that can occur include hematoma (a collection of blood or fluid under the skin), damage to the nerves that control movement of the face temporary or permanent, infection, and reactions to the anesthesia. Deep venous thrombosis and pulmonary emboli. Poor healing of the skin, usually associated with smokers, and scarring.

NEW_YOU ONLY BETTER

A facelift won't make you stop aging, but once the healing period is complete, you will present a fresher more youthful face to the world. You will always look younger than if you didn't have the face lift at all, but that doesn't mean the hands of time have stopped completely. The day you have your face lift, you still are continuing to age but those around you might wonder how you are able to keep your young and vibrant look.