Facelift (also known as rhytidectomy or meloplasty) is a surgical procedure to improve visible signs of aging on the face and neck. As individuals age, the skin and muscles of the face region begin to lose tone. The facelift cannot stop the process of aging. It can improve the most visible signs of aging by tightening deeper structures, re-draping the skin of face and neck, and removing selected areas of fat. A facelift can be performed alone, or in conjunction with other procedures, such as a browlift, liposuction, eyelid surgery, or nasal surgery. Facelift surgery is individualized for each patient. The best candidates for facelift surgery have a face and neck line has begun to sag, but whose skin has elasticity and whose bony structure is well defined.
This procedure is usually performed under general anesthesia or local anesthesia with IV sedation on an outpatient basis. Surgery time is at least 3 to 4 hours and recovery time is 4 to 6 weeks.
The face usually portrays the first visible signs of aging. Both gravity and diminished volume result in the facial features of aging. Most patients requesting evaluation for facelift feel that their facial features do not reflect their youthful spirit and energy level. They are looking for ways to refresh and rejuvenate their appearance. There are many different variations of the facelift procedure that smooth the skin of the face and neck, tighten the underlying tissues and muscle, and remove excess skin. Ultimately, the facelift will allow you to turn back the hands of time to better reflect your youthful spirit.
During the pre-operative consultation, your surgeon will perform a history and physical examination. During your physical examination, your facial bone structure, underlying skin structure, skin thickness, texture, and elasticity as well as the extent of facial wrinkles and folds will be assessed. This information will be used to formulate a surgical plan and the goals of the procedure will be discussed. Generally, a facelift is a very versatile procedure, and your surgeon will explain the technique that he or she feels most comfortable with and that offers the lowest risk. Your plastic surgeon will select the surgical technique that he or she feels will obtain the best outcome for you based on your discussions regarding the outcome you wish to achieve.
The facelift procedure continues to evolve. Over the years, the procedure has changed from simple skin lifting to more complex deeper plane lifting techniques. Today, many different techniques exist, with outcomes that are consistently reliable and durable. The facelift procedure usually involves incisions in front of and behind the ear. The incisions may extend into the scalp. Once the incisions are made, various degrees of undermining of the skin are performed, and the deeper layers of the face are ‘lifted’. Muscle tightening as well as liposuction of the neck and jowls may be performed, and excess skin is either removed or repositioned. The results are a reversal of the effects of gravity and tightening of soft tissues of the face to restore a more youthful contour to the face.
Fortunately, significant complications from facelifts are infrequent. Every year, thousands of people undergo successful facelift surgery and are pleased with the results. However, anyone considering surgery should be aware of both the benefits and risks. These are best discussed on a personal basis with your surgeon or one of their qualified staff members. Some of the potential complications that may occur include hematoma (an accumulation of blood under the skin), infection, and reactions to anesthesia. While plastic surgeons are trained in techniques for safely manipulating facial skin and tissues, injury to underlying structures is possible, though usually temporary. Facelift incisions are usually quite inconspicuous; however, this is not entirely predictable due to individual variations in healing. You can help minimize certain risks by following the advice and instructions given to you by your plastic surgeon both before and after surgery.
If you are a smoker, you will be asked to stop smoking well in advance of the surgery. Certain medications that increase the risk of bleeding such as Aspirin, non-steroidal anti-inflammatory medications, and some vitamins/homeopathic regimens should be discontinued prior to surgery. If your hair is short, you may want it to grow out enough to cover your incisions while they heal. Any chemical processing of your hair should be performed prior to surgery since you cannot have any of these procedures for a month of more after surgery. If your facelift will be performed on an outpatient basis, be sure to arrange for someone to drive you home and stay with you for at least the first night following surgery.
Your facelift may be performed in an accredited hospital, free-standing ambulatory facility, or office-based surgical suite. Medications are administered for your comfort during the procedure. You and your plastic surgeon will have decided in advance what type of anesthesia is to be used – either intravenous sedation (twilight) or general anesthesia. For your safety during and after the operation, various monitors are used to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
When surgery is completed, you will be taken into a recovery area. A bandage may be wrapped around your face. Sometimes small tubes will be inserted beneath the skin to drain away fluid that might otherwise accumulate. There is surprisingly very little discomfort experienced after facelift surgery. However, any discomfort you may experience will be controlled with pain medication as needed. You may be permitted to go home after a few hours, although some patients may stay overnight in a hospital or surgical facility.
It is important to realize that the amount of time it takes to recover from Facelift surgery varies greatly between individuals. Elevation of the head is extremely helpful in reducing the initial post-operative swelling. Your surgeon may also advise you to use ice packs intermittently. You should avoid Aspirin and non-steroidal anti-inflammatory medications for the first few days after your surgery. Smoking and exposure to second-hand smoke should be avoided to prevent delays in the healing process.
Once the dressings and drains are removed, puffiness and discoloration may be more pronounced in some portions of the face than others. Do not be alarmed by any unevenness or temporary asymmetry – this is normal. Most swelling is usually noted in the first 24 to 48 hours, and most bruising resolves within 2 weeks. Concealing makeup is usually permitted after the first week. You may experience numbness to the face post-operatively, which usually resolves within several months.
Some patients find that mild swelling persists for many weeks. Most stitches are removed within a week of the surgery. Straining, bending, and lifting should be avoided during the early post-operative period as these activities may predispose you to bleeding.
Your surgeon will give you specific instructions that may include caring for the dressings and incisions, directions for your analgesics and other medications, specific concerns to look for, and when to follow up in the office to monitor your healing process. It may take several months for the swelling to fully resolve, and up to 6 months for the incision scars to fully fade. Avoidance of factors that could reduce the benefits of the surgery, such as excessive unprotected sun exposure and cigarette use, is vital.
The results of your facelift may be subtle or dramatic, depending on your appearance prior to the surgery as well as the specific goals that you and your plastic surgeon have established. Since the healing process is gradual, you should expect to wait several weeks for an accurate picture of your “new look”. Additional minor changes or settling may occur over several months following your Facelift surgery.
Cost is always a consideration in elective surgery. Prices for facelifts vary widely, and are often dependent on the surgeon’s experience and the geographical location.
The fees are often broken down into several components:
You will return to your plastic surgeon’s office for follow up care at prescribed intervals, at which time your progress will be evaluated. Please remember that your relationship with your plastic surgeon does not end when you leave the operating room. If you have questions or concerns during your recovery from Facelift surgery, or need additional information at a later time, you should contact your surgeon.
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