As we age, our facial skin loosens and forms jowls or folds, and the muscles of the neck may sag as well. Skin type, ethnic background, basic bone structure, and lifestyle all help to determine the degree of change and at what age. A facelift (rhytidectomy) can address these problems by firming and tightening the skin of the face and neck all in one step. While a facelift cannot stop aging, what it can do is help your face look its best and give you a look of health and a more youthful appearance.
Additional therapies such as laser resurfacing can be used in combination with a facelift to improve and smooth wrinkles and skin texture. Also, since most people lose facial fat as part of the aging process, they may need to add volume using fillers, implants or fat in conjunction with their face lift for best results. And certain patients may require liposuction to remove excess fatty deposits.
Oftentimes, an upper face lift such as a forehead lift or eyelid surgery would be best to create overall balance for total facial rejuvenation.
Making Your Decision
During the preliminary consultation, your surgeon will examine the structure of your face, skin texture and elasticity, take a thorough medical history and assess your mental and emotional attitudes toward the surgery. Photographs will be taken and your surgeon will provide you with realistic expectations using state-of-the-art imaging technology. Individual risks will also be discussed. After the decision to proceed with a rhytidectomy is made, the surgeon will describe the technique indicated, the type of anesthesia, the surgical facility, and the pros and cons to include possible complications.
Understanding the Surgery
The surgeon begins the incision in the area of the temple hair just above and in front of the ear. The incision then continues inside and circles the ear ending in the back of the scalp. The skin is raised outward before the surgeon repositions and tightens the underlying muscle and connective tissue. Some fat may be added or removed, as well as excess skin trimmed. 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 and/or metal clips, which permit surgery without shaving hair from the incision site.
What to Expect After Surgery
Face-lifts can be done with local anesthesia and intravenous (IV) sedation or general anesthesia. The extent of the procedure often determines which kind of anesthesia should be used. Some people undergo face-lifts that are much more involved than others, and what we do to the underlying foundation varies. Following the surgery, the surgeon will apply a compression bandage to protect the entire area where the incisions have been made. Some degree of discomfort, swelling and bruising is unavoidable. You will be prescribed medication for pain management and you will be instructed to use cold compresses and sleep elevated for the first few days to keep swelling to a minimum.
In some cases, a drainage tube may have been inserted during surgery. This, along with compression bandage, will be removed two days after surgery after which a “jaw bra” will be worn for about one week. All sutures and staples are usually removed within 7 to10 days and most patients return to work in 2 weeks. In some cases delayed healing can occur up to 1 month. The skin will remain firm for a period of 3 months until facial remodeling is complete and the skin softens. Scars are usually not noticeable after they mature as they are easily disguised in natural skin creases or in the hair. Makeup may be worn to camouflage until total healing has occurred and scar bandages may be used to hasten the healing process.
Keep all post operative appointments as scheduled. Anything unusual should be reported to your doctor immediately.