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FACELIFT
(RHYTIDOPLASTY)

Rhytidoplasty and rhytidectomy are the medical terms used to describe the facelift operation, designed to rejuvenate the face by reducing sagging skin and improving wrinkles. Rhytidoplasty is accomplished by lifting and tightening the lax muscles and fatty tissues of the face and neck and removing loose, sagging skin. The facelift is divided into three components: the temporal lift, the cheek-jowl lift, and the neck lift. Some patients require a full forehead lift in conjunction with a facelift, while most patients require a lifting of all three components. In selected patients, only two of the three procedures are recommended. I will advise you what is best in your particular situation.

Candidates

Not everyone seeking facelift surgery is an acceptable candidate. Those patients with serious systemic and medical diseases are excluded. Patients who have unrealistic goals are also not accepted for facelift surgery. Patients who have short, thick necks are not good candidates for facelift surgery because they will not gain the improvement they are seeking from the operation alone.

Most people who seek a facelift have one or two motivating factors: either they want to reduce the advance of the aging process, or they seek to reverse the already present signs of aging. Both types of patients share a common goal: to appear more youthful.

How Much Improvement? How Long Will It Last?

Each patient who considers a facelift wants to know how much improvement they can expect and how long it will last. As mentioned in an earlier section, the amount of improvement depends on the amount of tissue sagging and wrinkling that is present preoperatively. If the operation is completed early in the aging process, a patient can anticipate a look which is refreshed, and less tired-looking. A person who has waited can expect more dramatic results, especially if there is significant wrinkling and sagging. However, more initial rebound-relaxation will occur the farther along the initial problems of sagging skin and fat has occurred.

Secondary Facelift

When the aging process causes the sagging to reappear, a secondary facelift, or facial tuck-up, may be performed. This often provides more dramatic and longer lasting improvement. In some individuals, it may be necessary to perform this procedure as soon as six months to one year after the initial facelift. I may even suggest that a small tightening under the chin may likely be required within the first year to achieve the desired lasting effect. The secondary facelift is recommended for patients who have a severe degree of sagging preoperatively and experienced an accelerated aging process. (Please review section on Facial Tuck-Up).

The S-lift, Minilift, and Other Modified Face and Neck Lifts

Recently there have been several modifications of facelifting techniques that allow a significant improvement for our patients, but with shorter recovery times and smaller incisions. These procedures are usually less extensive than traditional facelifts and at times can even be done in the office. (See at bottom of page)

Surgery

Patients who choose to schedule surgery should be advised they will be given special medications and instructions to follow before arriving at one of our surgical facilities. Twilight anesthesia is most commonly used during the procedure.

In preparing for facelift surgery, no hair is shaved. Hair is not shaved for the forehead lift either, where the incision is hidden well behind or at the hairline. The incisions are made in front of and behind the ear, and curved naturally into the hairline. The resulting thread-thin scars will blend into the natural creases of the skin and into the hair-bearing areas of the scalp. Occasionally, there may be some thinning of the hair for a short distance on either side of the incision line. This should be temporary and resolves itself within six months. If a temporal brow lift or forehead lift is required and excessive sagging is present, the hairline may be rotated superiorly. If you already have a high forehead, we can make the incision blend into the frontal hairline and not raise the hairline or enlarge the forehead at all.

Immediately Following Surgery

The facelift operation is not painful, although patients may experience minimal pain in the postoperative period. A turban-style bandage is worn around the head and face until the morning following surgery, and will be replaced with a lighter dressing. The bandage worn immediately following surgery helps to prevent any swelling or collection of fluid under the areas operated upon. Minimal swelling and discoloration may appear around the ears, and sometimes in the neck, but this condition subsides in one to two weeks. I recommend patients be out of bed within the first twenty-four hours following surgery. Most are usually in the shower and ready to assume some level of normal activity the following day.

Any clips in the hairline or sutures around the ear that remain are usually removed within the first week following surgery. Women may resume wearing make-up after ten days, and all patients are usually permitted to drive the second week after surgery. Patients may also return to work at this time.

Patient Example

Click here to view the facelift gallery.

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