Facelift

Rhytidectomy (Surgery of the Face)

Aging of the face is inevitable.  As the years go by, the skin begins to loosen on the face and neck.  Crow's feet appear at the corners of the eyes.  Fine forehead lines become creases and then, gradually, deeper folds.  The jawline softens into jowls and beneath the chin, another chin or vertical folds, known as platysmal bands, appear at the front of the neck.  Heredity, personal habits – especially smoking, the pull of gravity, and sun exposure - contribute to the aging of the face.  As the aging population grows, it is obvious why facelift surgery has become the third most desired facial plastic surgical procedure.

IS A FACELIFT FOR YOU?

As with all facial plastic surgery, good health and realistic expectations are prerequisites. Understanding the limitations of rhytidectomy is crucial and appropriate emotional attitude is vital.  There is no ideal in a facelift.  Rather, the goal is to improve the overall facial appearance. Skin type, ethnic background, degree of skin elasticity, individual healing, basic bone structure, as well as a realistic attitude are factors that will be discussed prior to surgery.  A facelift cannot stop aging, nor can it turn back the clock.  What it can do is help your face look its best and give you a look of health and a more youthful appearance.  An additional benefit is that many patients experience an increase in self-confidence.

Before deciding on a facelift, we will discuss whether the overall effect will be more successful if additional changes are made in the chin and neck areas through other facial surgery.  Many patients decide to have facial liposuction to remove excess fatty deposits in conjunction with a facelift.  If several areas need correction, more than one procedure may be necessary for the best overall result.

UNDERSTANDING THE SURGERY

The surgeon begins the incision in the area of the temple hair, just above and in front of the ear, and then continues around the lobe, circling the ear then returning to the point of origin in the scalp.  The skin is raised outward before the surgeon repositions and tightens the underlying connective tissue known as the SMAS (superficial musculoaponeurotic system).  Some fat may be removed, as well as excess skin.  For men, the incision is aligned to accommodate the natural beard lines.  In all cases, the incision is placed where it will fall in a natural crease of the skin for camouflage.

After trimming the excess skin, the surgeon closes the incisions with fine sutures – some of which will be removed and some will dissolve on their own - which permit surgery without shaving hair from the incision site.  Depending on the extent of the surgery, the process can take from two to three hours.  When performed at our center, the patient is given some Valium to help them relax and pain medication.  Local anesthetic solution is then used to numb the area.  If the patient prefers, the procedure can be performed at an outpatient surgery center under the care of an anesthesiologist who can provide monitored IV sedation or general anesthesia.  Following the surgery, the surgeon will apply a dressing to protect the entire area where the incisions have been made.

WHAT TO EXPECT AFTER THE SURGERY

Individuals have different pain tolerances - most patients experience little pain after surgery, and the most sensitive area tends to be the ears where the incisions lie and the dressing is snug. Your surgeon will prescribe medication to keep you comfortable but some discomfort is to be expected.  Some degree of swelling and bruising is unavoidable, and your surgeon will instruct you to use cold compresses to keep swelling to a minimum.  If a dressing has been applied, it will be removed within one to two days.  The surgeon will also instruct you to keep your head elevated when lying down, to avoid as much activity as possible, and to report any undue discomfort.  Though there are few risks in facelift surgery and thousands are performed every year, some risk exists in any surgery.

In some cases, a drainage tube may have been inserted during surgery. This will be removed on the first or second day after surgery.  All sutures and staples are usually removed within five to 10 days following surgery.  We recommend that patients avoid vigorous activity for at least 2 weeks following surgery.  Patients are encouraged to arrange for post-surgery support from family and friends.

Recovery usually takes two to three weeks, though many patients go back to work in two weeks. Scars are usually not noticeable after enough time has passed for them to mature.  In any case, they are easily disguised in natural skin creases, by the hair, or, in persistent cases, by makeup until total healing has occurred.  Some relaxation of the tissues will occur within the first few weeks and the “tight” feeling will resolve.