Face Lift

Surgeons call this operation a "Rhytidectomy". This operation attempts to use surgical means to correct the changes which occur in the natural process of aging. As the skin ages, deep creases form around the mouth, folds appear in the neck and the jawline loses its definition. Traditionally, face lifts are designed to restore a more youthful and vigorous appearance.

The right time may be any time from age thirty-five to age seventy-five. You should consider having a facelift when the changes of age bother you.

A face lift markedly improves the contours of the neck and jowls. It immensely rejuvenates the middle face and affects very positively the corners of a drooping mouth, flat cheek areas, and crows feet on the lateral aspects of the eyes. It will tighten loose skin and muscle and remove bulges of fat in your neck, and it will tighten the loose tissues in your face.

A well done face lift will not change a person even when large amounts of fat have to be removed from an unsightly, heavy neck. One should simply look years younger than before. While the face continues to change with age, the benefits uniformly make the face appear younger than the patient's chronological age.

For many people, the results may be permanent to the extent that the fat does not return and the muscles do not loosen. The skin will loosen again with time, though, and the muscle may loosen to some degree. A reasonable best estimate of "how long it will last" for the techniques I use is eight to ten years.

Operation:

The incisions will usually begin at the temples, in the hair, and extends down to the ear, behind the earlobe and around the back into the scalp. The type of incision varies according to the problem presented by the individual case. Then the skin of the face and neck is undercut, forward into the cheeks, downward and backward into the neck, thereby freeing it, so it can be drawn up, tightened and smoothed. The excess is cut away. The skin edges are carefully tailored to fit smoothly into the scalp and around the ear. I now tighten the facial tissues in two layers, first elevating and tightening the platysma muscles and a layer of tissue called the SMASS, then tighten the skin separately. I remove the fat from beneath the jaw and in the neck to improve their contours. The scars are so placed as not to be readily visible.

Anaesthesia

This procedure takes around four to five hours and is done with either I.V sedation or general anaesthesia, most rhytidectomies are carried out under local anaesthesia with sedatives providing a "twilight sleep". Insurance will not cover the procedure as it is considered completely cosmetic in nature.

All surgeries are performed in a private hospital. Patients are required to check into the hospital on the morning of the surgery and normally remain in the hospital for one night following this surgery. There should be little or no pain after a face-lift. Medication will control the minimal pain and discomfort that patients usually experience. Drains may be used, but they are usually removed the next day as are the dressings. Sutures are removed four days after surgery and supporting dressings may be worn for several days after the sutures are removed. It is extremely important that the newly rejuvenated skin be protected from sun damage after surgery. A broad brimmed hat and SPF 15 or stronger sunscreen is essential. You should not sunbathe for six weeks. Recovery or after care accommodation provide continued recuperation for the patient. We suggest twelve days for major surgeries. Plan on not being able to drive for two weeks and on being out of work for a full two to three weeks. Exercise also needs to be curtailed for a full two to three weeks. The majority of patients go back to work after two weeks or a little longer.

Conditions that increase your risk:

1. Tendency to bleed or if you are taking medicine that thins your blood considerably increases your risk of bleeding during facelift surgery.
2. High blood pressure also increases your risk of excessive bleeding especially if it is about 150/100.
3. Smoking increases your risk of poor healing after any surgery, but especially after a face lift.

Side effects and complications:

Major complications are rare. When a face lift is performed by a qualified plastic surgeon, complications are infrequent and usually minor. However, any surgical procedure can result in complications. Infection, bleeding, and damage to important structures such as nerves in the operating area may occur. Each patient assumes a different degree of risk with every surgical procedure and these should be explained by your surgeon and understood by you before you proceed with any procedure. No surgeon can guarantee a complication-free outcome for any procedure.

The following points have to be clear:

1. That at times fluid or blood may accumulate in the operated areas, requiring, aspiration or drainage.
2. There may be swelling in the face, which could last several weeks.
3. There may be black and blueness for several weeks as well.
4. There may be certain areas of numbness over the face and neck, which could last an indefinite period of time.

You can reduce your risks by closely following your surgeon's advice both before and after surgery.

The Plastic Surgeon should discuss the expectations with regard to possible outcome in some detail. Patients with unrealistic expectations are not good candidates for cosmetic surgery, including the face lift procedure. Although successful face lifts can temporarily set the clock back, no cosmetic procedure can permanently forestall all the effects of aging. Some patients will require other procedures such as chemical peel to achieve the results they want.

Before	After

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