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• Facelift

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Facelift

Any one or combination of the following conditions may indicate that you are a good candidate for a face and/or neck lift:

* a deep line, or fold, running from the corner of your nose to the corner of your mouth.
* jowls, or loss of a well-defined jawline associated with youthfulness.
* deep wrinkles in the cheeks and sagging of the “highlight” areas of the cheekbones.
* loose skin, wrinkles, vertical “cords” or excess fatty tissue in the neck.

A face and/or neck lift can improve all of these problems. It cannot, however, correct conditions such as sagging eyebrows, excess skin and fatty deposits in the upper and lower eyelids, or wrinkles around the mouth. Your plastic surgeon can provide further information if you have an interest in other procedures to treat these areas.

YOUR PERSONAL CONSULTATION
Your surgeon will guide you as to what procedure will best address your concerns. During the initial consultation, you doctor may ask you to look in a mirror and point out exactly what you would like to see improved. Sometimes, patients may focus their attention on excess skin in the upper eyelids and not realize that sagging of their eyebrows contributes to this skin redundancy. You should be very frank in discussing anything about your appearance that bothers you, as well as what you hope to achieve with surgery. This will help your surgeon to understand your expectations and determine whether they can realistically be achieved.

In evaluating you for face and/or neck lift surgery, we will assess the thickness, texture and elasticity of your skin, and the severity of wrinkles and folds. Your hairline will be examined to determine where incisions can be discreetly placed. All of these factors, as well as your bone structure and underlying tissues, will be considered in developing an individual surgical plan. We feel that each procedure should be customized to the needs and desires of the patient. Too many surgeons perform sugery on the brows, lids, neck and face whether the patient needs or wants all these procedures. We explain all the options and offer all the procedures, but we tailor the total operation individually to each patient.
Often we will suggest additional procedures which will improve the outcome of your face and/or neck lift, such as peels, dermabrasion laser resurfacing, or injectables.

HOW FACELIFT/NECK LIFT SURGERY IS PERFORMED
In order to understand how a facelift procedure is done, we must first understand what anatomic elements must be corrected. The changes that we see in our faces are from sagging of both the skin as well as the underlying layer of connective tissue called the SMAS layer. In order to achieve the most natural looking facelift, we must lift and tighten both these layers.

The incisions that are made in order to do a facelift are hidden in the scalp and in natural contours of your ear. There may also be a small incision hidden under your chin (Figure 1). Through these incisions, the skin is lifted up to expose the SMAS layer and the neck muscles. These deeper layers are then repositioned in order to restore a more youthful contour to your face. The skin is then repositioned and tightened, and some extra may be removed. In some patients it may be also necessary to remove some of the fatty tissue under the chin and/or further smooth the neck structures. We can perform this through a small incision under the chin. For those patients who desire only tightening in the neck, this basic surgery can be modified slightly to more specifically target the neck area. The incisions, however, may not be any shorter in length, depending upon your anatomy. Your surgeon can better advise you about this during your consultation.

YOUR SURGICAL EXPERIENCE
We recommend that facelifts be done under a general anesthetic in the hospital by a fully licensed anesthesiologist. After the surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. You may have a bandage wrapped around your face and ice packs on your eyes. You may also have some small tubes that have been inserted beneath the skin to drain away fluids that might otherwise accumulate. These are generally removed by your surgeon the next morning. You should not notice these drains at all. In fact, you will notice that you have surprisingly little discomfort from the surgery. After a few hours, some patients may be permitted to go home with supervision. In general, however, we recommend an overnight stay in the hospital. This will permit us to more closely monitor your surgical result and will allow you to relax as much as possible. The less activity that you do during the first 24 hours greatly lessens the chance of complications and speeds up your overall recovery time. The next morning, your surgeon will see you, remove your drains, and permit you to go home with supervision.

THE RECOVERY PROCESS
It is important to realize that the amount of time it takes for recovery varies greatly among individual. It is also important to realize that the amount of puffiness and bruising changes from day to day and might show up in an asymmetrical fashion. This is perfectly normal and we encourage you not to focus on how your face looks in this initial recovery process. Generally, the greatest amount of swelling occurs 24 to 48 hours after surgery, but it may take several weeks before all the puffiness is resolved. We recommend that patients take approximately 2 weeks of from work to allow all of this initial healing to occur. At this time most, if not all, of the bruising will be resolved, and a majority of the swelling will be resolved. Most patients feel comfortable interacting with others at this time, especially with a little makeup. The final swelling and settling may take several weeks more, and the scars will take 6 months to a year to fully mature. Some patients may experience persistent areas of numbness. This, however, should not pose any lingering problems as the body adapts to the new nerve patterns. Follow-up visits during this recovery period will vary from patient to patient and from surgeon to surgeon. We encourage you to discuss this with you doctor.

WHEN CAN I RESUME MY NORMAL ACTIVITIES?
Straining, bending and lifting should be avoided during the early postoperative period. In many instances, you will be able to resume most of your normal activities within two weeks and begin to exercise three to four weeks after surgery. You will be instructed to temporarily avoid exposure to direct sunlight and, for the long-term, to be conscientious about the use of a sunblock to protect your skin.

THE RESULTS OF YOUR FACE AND/OR NECK LIFT SURGERY
The results of your face and/or neck lift may be dramatic or subtle, depending on how you look before 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 at least several weeks for an accurate picture of your “new look.” Additional minor changes, or settling, may occur over several months. Your facelift results should be very long-lasting, and most people will not ever feel the need to repeat this procedure, as they will age more gracefully.

UNDERSTANDING RISKS
The subject of risk and potential complications of surgery is best discussed on a personal basis with your surgeon. Some of the potential complications that may be discussed with you include bleeding after surgery that causes a hematoma (an accumulation of blood under the skin that may require removal), infections, and reactions to anesthesia. Injury to underlying structures, such as nerves, is possible, although extremely rare and most often temporary. Although most facelift scars heal inconspicuously, this is not entirely predictable. These problems are usually minor and can most often be treated with simple procedures in the office.

You can greatly help to minimize certain risks by following the advice and instructions of your plastic surgeon both before and after surgery. Fortunately, significant complications from facelift surgery are infrequent, and most of the complications that may occur are easily remedied. As a result, facelift surgery is one of the most positive things that you can do to enhance you appearance and your confidence.

HOW SHOULD I PREPARE FOR SURGERY?
Your doctor will ask you to stop all aspirin products and anti-inflammatory drugs, such as Motrin and Advil, 2 weeks before surgery, as they interfere with blood clotting. We will provide you with a more comprehensive list of medications that you should stop before surgery. We also ask that you stop all non prescription herbs and remedies that you may be taking, as some of these interact with anesthesia or can cause bleeding. If you are a smoker, you must first stop smoking for several weeks prior to and after surgery. This is something that you need to discuss in detail with your surgeon, as smoking greatly increases you chance for certain complications. Your surgeon may also ask that you have a preoperative medical checkup with your internist. If you have high blood pressure, this should be optimized by your doctor prior to surgery. Routine blood work and an EKG may be required to complete your checkup. Your surgeon will provide you with a more complete list of preoperative information prior to surgery.

 

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