Many factors cause the facial skin to wrinkle and sag with sun exposure and gravitational changes being the primary cause with genetic makeup being a strong influential factor. Children and young adults have smooth, round faces due to normal fatty tissue that is evenly distributed throughout the contours of the face. As one experiences aging, fat volume is lost and elastic and collagen fibers stretch and muscle attachments loosen causing the skin to sag and fit more loosely on the facial skeleton. This results in soft tissue folds that are prominent around the chin, jaw line and the neck.
A facelift or rhytidectomy is a procedure used to correct these conditions and restore a more youthful appearance. A facelift involves tightening of the face and neck muscles and removal of any excess skin. This procedure is often performed in conjunction with additional cosmetic surgeries such as an eyelid surgery, forehead/browlift, chin augmentation and facial fat augmentation procedures. These procedures can be performed any time after signs of aging appear in order to attain a more youthful appearance. There are basically two state of the art rhytidectomy procedures; one is a short scar facelift and it goes by many names: Lifestyle lift, MACS lift and weekend lift. This facelift procedure has very specific indications and is generally limited to patients who have early signs of facial aging that include early to moderate jowl formation, excess submental neck fat and slight to moderate neck/skin laxity. This procedure entails an incision that begins in the hair tuft in front of the ear and courses inferiorly in front of the ear at the junction of the ear and the cheek skin and ends at the earlobe, thus its name short scar facelift. The second type of rhytidectomy procedure is classified as a conventional or comprehensive facelift procedure and is reserved for patients who exhibit more advanced signs of aging which have the characteristics of significant jowling, advanced neck/skin laxity, platysmal banding and complete loss of neck/throat definition. It entails an incision that begins in the tuft of the hair in front of the ear, courses inferiorly in the front of the ear at the junction of the ear and cheek skin and proceeds around the earlobe and vertically in the posterior aspect of the ear and then tapers off into the hairline. This procedure affords a much more comprehensive correction and is recommended for patients who have moderate to advanced signs of lower facial aging.
While a facelift procedure will tighten sagging muscular and fascial tissues and will have a significant rejuvenational result, it has minimal effect on facial skin quality which is corrected with proper skin care and/or laser resurfacing procedures.
During your consultation, we will address your individual concerns and what you can expect from a surgical procedure. Your health is important to us, so a comprehensive consultation regarding your overall health will be obtained. The pre-operative workup will include photographs and clinical examination to document the facial aging that is present and the anticipated improvement that can be realistically obtained through surgery.
We will provide you with preoperative instructions that may include the elimination of specific drugs containing aspirin, Vitamin E or non-steroidal anti-inflammatory drugs several weeks before surgery to minimize excess bleeding. Antibiotics may also be prescribed to prevent infection. We will provide you with an antimicrobial shampoo to be used the night before and the morning of surgery and you should refrain from wearing make-up the day of the surgery. A small amount of hair may be shaved around your ears and temples.
Rhytidectomies are performed under I.V. sedation or general anesthesia in our state-of-the-art surgical facility. Pre-medication is administered for relaxation. This procedure may take up to five hours depending on whether any other procedures are performed at the same time.
What can I expect?
Bandages are applied to the area of surgery and are removed within a few days. Drains are often used to prevent build up of fluids and blood which can adversely affect the final outcome. These are usually removed within the first one to two days post-op. Pain is minimal to moderate and is well controlled with oral medications. Your sutures will be removed within 5 to 7 days. In order to minimize scarring, the doctor may remove the sutures in stages. Swelling and discoloration will be present but gradually resolves over the first one to two weeks. You will feel tightness in your face for several weeks and there may be slight changes in your hair pattern around the incision.
It is important that you avoid sun exposure for several months after surgery as this can have a detrimental affect on scar formation and healing. Healing is gradual so you will not notice the final result for up to 6 months. Improvement varies, depending on your initial condition. In most cases, a single procedure achieves the desired result but occasionally a touch-up procedure may be necessary. Most patients who have had facelifts are pleased with their new, more youthful appearance.
Our goal is to create a natural rejuvenated appearance that is pleasing to you.