What is
Face Lift
The Ideal Candidates
Changes
After Face Lift
Complications
Face Lift Techniques
What is
Face Lift
As people age, the effects of gravity, exposure to the sun, and the stresses
of daily life can be seen in their faces. Deep creases form between the nose
and mouth; the jawline grows slack and jowly; folds and fat deposits appear
around the neck.
A facelift (technically known as rhytidectomy) can't stop this aging process.
What it can do is "set back the clock," improving the most visible signs of
aging by removing excess fat, tightening underlying muscles, and redraping
the skin of your face and neck. A facelift can be done alone, or in
conjunction with other procedures such as a forehead lift, eyelid surgery, or
nose reshaping.
The Ideal Candidates
The best candidate for a facelift is a man or woman whose face and neck
have begun to sag, but whose skin still has some elasticity and whose bone
structure is strong and well-defined. Most patients are in their forties to
sixties, but facelifts can be done successfully on people in their seventies or
eighties as well.
A facelift can make you look younger and fresher, and it may enhance your
self- confidence in the process. But it can't give you a totally different look,
nor can it restore the health and vitality of your youth.
Changes After Surgery
There isn't usually significant discomfort after surgery; if there is, it can be
lessened with the pain medication. (Severe or persistent pain or a sudden
swelling of your face should be reported) Some numbness of the skin is
quite normal; it will disappear in a few weeks or months.
Your head should be elevated and as still as possible for a couple of days
after surgery, to keep the swelling down.
If you've had a drainage tube inserted, it will be removed one or two days
after surgery. Bandages, when used, are usually removed after one to five
days. Don't be surprised at the pale, bruised, and puffy face you see. Just
keep in mind that in a few weeks you'll be looking normal.
Most of your stitches will be removed after about five days. Your scalp may
take longer to heal, and the stitches or metal clips in your hairline could be
left in a few days longer.
GETTING BACK TO NORMAL
You should be up and about in a day or two, but plan on taking it easy for
the first week after surgery. Be especially gentle with your face and hair,
since your skin will be both tender and numb, and may not respond
normally at first.
We will give more specific guidelines for gradually resuming your normal
activities. They're likely to include these suggestions: Avoid strenuous
activity, including sex and heavy housework, for at least two weeks (walking
and mild stretching are fine); avoid alcohol, steam baths, and saunas for
several months. Above all, get plenty of rest and allow your body to spend
its energy on healing.
At the beginning, your face may look and feel rather strange. Your features
may be distorted from the swelling, your facial movements may be slightly
stiff and you'll probably be self-conscious about your scars. Some bruising
may persist for two or three weeks, and you may tire easily. It's not
surprising that some patients are disappointed and depressed at first.
By the third week, you'll look and feel much better. Most patients are back
at work about ten days to two weeks after surgery. If you need it, special
camouflage makeup can mask most bruising that remains.
YOUR NEW LOOK The chances are excellent that you'll be happy with your facelift-especially if
you realize that the results may not be immediately apparent. Even after
the swelling and bruises are gone, the hair around your temples may be thin
and your skin may feel dry and rough for several months. Men may find
they have to shave in new places-behind the neck and ears-where areas of
beard- growing skin have been repositioned.
You'll have some scars from your facelift, but they're usually hidden by your
hair or in the natural creases of your face and ears. In any case, they'll fade
within time and should be scarcely visible.
Having a facelift doesn't stop the clock. Your face will continue to age with
time, and you may want to repeat the procedure one or more times-perhaps
five or ten years down the line. But in another sense, the effects of even
one facelift are lasting; years later, you'll continue to look better than if
you'd never had a facelift at all.
Complications
Individuals vary greatly in their anatomy, their physical reactions, and their
healing abilities, and the outcome is never completely predictable.
Complications that can occur include hematoma (a collection of blood under
the skin that must be removed by the surgeon), injury to the nerves that
control facial muscles (usually temporary), infection, and reactions to the
anesthesia. Poor healing of the skin is most likely to affect smokers.
You can reduce your risks by closely following your surgeon's advice both
before and after surgery.
Face Lift Techniques
PLANNING YOUR SURGERY
Facelifts are very individualized procedures. In your initial consultation we
will evaluate your face, including the skin and underlying bone, and discuss
your goals for the surgery.
We will check for medical conditions that could cause problems during or
after surgery, such as uncontrolled high blood pressure, blood clotting
problems, or the tendency to form excessive scars. Be sure to tell us if you
smoke or are taking any drugs or medications, especially aspirin or other
drugs that affect clotting.
If you decide to have a facelift, we will explain the techniques and
anesthesia he or she will use, the type of facility where the surgery will be
performed, and the risks and costs involved.
PREPARING FOR YOUR SURGERY
We will give you specific instructions on how to prepare for surgery,
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. If you smoke, it's especially important
to stop at least a week or two before and after surgery; smoking inhibits
blood flow to the skin, and can interfere with the healing of your incision
areas.
If your hair is very short, you might want to let it grow out before surgery,
so that it's long enough to hide the scars while they heal.
Whether your facelift is being done on an outpatient or inpatient basis, you
should arrange for someone to drive you home after your surgery, and to
help you out for a day or two if needed.
ABOUT THE OPERATION
Depending on what to do the operation can be performed under general or
local plus sedative anesthesia. I prefer the patient to be in the clinic for one
or two days.
A facelift usually takes several hours-or somewhat longer if you're having
more than one procedure done. For extensive procedures, sometimes we
have to schedule two separate sessions.
The exact placement of incisions and the sequence of events depends on
your facial structure and technique chosen.
Incisions usually begin above the hairline at the temples, extend in a
natural line in front of the ear (or just inside the cartilage at the front of the
ear), and continue behind the earlobe to the lower scalp. If the neck needs
work, a small incision may also be made under the chin.
In general, we separate the skin from the fat and muscle below. Fat may be
trimmed or suctioned from around the neck and chin to improve the
contour. Then the underlying muscle and membrane is tightened, pulls the
skin back, and removes the excess. Stitches secure the layers of tissue and
close the incisions; metal clips may be used on the scalp.
Following surgery, a small, thin tube may be temporarily placed under the
skin behind your ear to drain any blood that might collect there. The
surgeon may also wrap your head loosely in bandages to minimize bruising
and swelling.
A type of facelift is designed to improve the middle third of the face and
reposition the tissues to restore youthfulness to the malar bone and
periorbita. This is achieved through incisions within the hair and the mouth.
The lines from the nose to the mouth are greatly improved with this
technique.
Fat grafting is usually done to fill and enhance some areas like mandible
line, malar areas, lips and lines from the nsoe to the mouth.
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