As life spans lengthen, most people feel energetic long after their appearance begins to show premature signs of aging.

One of the most common requests we hear is “for the outward appearance to reflect the more youthful energy a person feels inside.” Many patients want a smoother contour and tightening of the jowl area. Some want to elevate sagging cheeks; others want to elevate facial expression “laugh lines” from their drooping position. Many want to reduce jowling in the areas of the chin and neck. Patients who request one or any combination of these improvements are seeking information about a facelift.

Rhytidectomy (rye-tidd-ec-toe-me – the technical term for facelift) can affect one’s appearance as dramatically as any facial cosmetic surgery.

Rhytidectomy is a safe, effective procedure performed to restore a more youthful appearance and less fatigued look while maintaining or improving function. Once thought a beauty procedure sought by only wealthy women, men in today’s competitive corporate workplace are increasingly seeking facelift procedures to restore a younger look that more typifies their energy level.

When patients come to our office seeking facial plastic surgery, it’s not uncommon for them to focus on a single aspect of their appearance rather than the overall picture. One of the most common concerns we hear from patients seeking facelifts is the “turkey wattle,” the loose skin dangling under the chin. Many times patients will request just a “neck lift.” It is important to know that patients are rarely satisfied with “just a neck lift.” Why? When excess neck skin is removed, the lax skin of the face bunches up in front of the ears and the look is unnatural. If a surgeon tells you he can do a neck lift alone, we strongly encourage obtaining a second opinion before proceeding. Furthermore, the benefit of doing the neck and face together is the opportunity to combine neck liposuction to obtain fat for placement elsewhere in the face. Fat injections make use of fat that would otherwise be discarded. Fat injections can be used in many areas of the face including the smile lines and for lip augmentation.

A good surgeon, knows that his responsibility is to evaluate not only the areas of concern but also the motivation behind the requests. It goes without saying, a facelift won’t save a failing marriage. Similarly some patients not ready for cosmetic surgery are better served with conservative measures, such as Botox for fine lines and wrinkles or Collagen for crows feet. Patients who educate themselves about facial rejuvenation know when and if the time is right to proceed.
When discussing rejuvenation procedures the best place to start is by looking at before and after photos to see just what can be accomplished. As you will see in the photos, patients often ask to combine a face lift with a brow lift for correction of frown lines between the eyes or blepharoplasty for improvements in bags under the eyes. Chin implants, cheek implants, rhinoplasty(nasal surgery), otoplasty (ear surgery) and lip surgery can also be performed in conjunction with a facelift.

Many patients seek information about improving superficial skin wrinkles with a chemical peel, laser surgery or similar skin resurfacing procedure. Although some improvement in facial wrinkles can be obtained from a facelift, it will not address all the superficial lines that come from premature aging, overexposure to weather and genetics. Facelifts address “saggy” skin; skin resurfacing addresses textural wrinkles and imperfections.

At your initial consultation, we will evaluate the soft tissue and bony architecture as well as the form and function of the head and neck. An overall assessment of the face provides the basis for what one may expect from a facelift. Skin type, ethnic background and age, along with the degree of deformity and function are important factors influencing the outcome of surgery.

As with all facial plastic surgery, a thorough health assessment and realistic expectations are prerequisites. Your understanding of procedures and routines is essential to a successful final result.

 

BEFORE FACELIFT SURGERY

At your preoperative appointment our nurse will provide all the instructions for you to follow before and after surgery. On the business day prior to the operation we ask you to call to confirm your arrival time for surgery. Upon arrival for your surgery, you will talk with a nurse (who will start an IV), discuss anesthesia (local anesthesia with IV sedation keeps you asleep and comfortable) and meet with your doctor before going to the operating room. A facelift takes about three hours depending on the structure and amount of excess tissue prior to surgery. If you are having a combination of procedures your surgery will take longer. Recovery time from the anesthetic takes about an hour and you will be discharged about five to six hours from the time of admission.

 

PREOPERATIVE FACELIFT INSTRUCTIONS

  1.     Please avoid any aspirin, aspirin-containing products, or ibuprofen (Advil, Aleve, etc.) for one week prior to and two weeks following your surgery. See our “Medication List” for products to avoid prior to surgery. If you are on any medications that affects bleeding (such as coumadin or warfarin) please notify the office immediately.
  2.     Please refrain from tobacco products and alcohol for one week prior and three weeks following surgery. Along with delayed wound healing, persistent skin redness and other complications may persist when tobacco and alcohol are not discontinued.
  3.     Please notify us of all routine medications and significant health history. We ask that you remain on your daily medications unless instructed otherwise. At the preoperative appointment, our nurse will tell you which daily medications to take with just a sip of water on the morning of surgery.
  4.     At your preoperative appointment you will be given prescriptions for use following surgery including an oral antibiotic and pain medications. Please obtain these prescription medications before your surgery so you will have them ready for use when you return home after surgery.
  5.     We will ask you to start Vitamin C (ascorbic acid), which helps promote healing, for one week before and two weeks following surgery.
  6.     You may not eat or drink after midnight the evening before the procedure unless instructed otherwise. You may brush your teeth. Your procedure will be cancelled if you do not follow these instructions.
  7.     Remove all make-up and nail polish before arriving for your procedure.
  8.     Someone must be available at all times while you are here at the clinic for surgery. Someone will need to drive you home after your surgery and stay with you that evening. Transportation to the office for packing removal the day following surgery is also required.

 

AFTER FACELIFT SURGERY

When you wake up from surgery you will notice a soft, bulky head wrap dressing. Attached to your head dressing are “balls” or drains. These drains collect excess drainage and help prevent infection. Following your facelift, the nurses will ask assist you to meet the discharge criteria: to drink liquids, walk with a steady gait, void, manage your discomfort, and monitor and empty the drains. For patients who have a combination of procedures such as an eye tuck, your vision may be cloudy from the ointment we place in your eyes at the time of surgery. The nurses will review all instructions you will need for care following your facelift.

You will be asked to come to our office (not the Surgery Center) the following day after surgery for a dressing change and drain removal. Although most patients describe drain removal as discomfort rather than pain, you are encouraged to take your pain medication about an hour prior to drain removal. You will be asked to return in four to five days for suture removal.

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