Facelift (Rhytidectomy)
Aging of the face is
inevitable. As the years go by, the skin begins to
loosen on the face and neck. Crow's feet appear at the
corners of the eyes. Fine forehead lines become creases
and then, gradually, deeper folds. The jawline softens
into jowls, and beneath the chin, another chin or
vertical folds appear at the front of the neck.
Heredity, personal habits, the pull of gravity, and sun
exposure contribute to the aging of the face. As the
aging population grows, it is obvious why rhytidectomy
has become the third most desired facial plastic
surgical procedure.
If you ever wondered how
a rhytidectomy, or facelift, as it is commonly called,
could improve your looks or self-confidence, you need to
know how a facelift is performed and what you can expect
from this procedure. This pamphlet can address many of
your concerns and provide you the information you need
to begin considering facelift surgery.
Successful facial plastic
surgery is a result of good rapport between patient and
surgeon. Trust, based on realistic expectations and
exacting medical expertise, develops in the consulting
stages before surgery is performed. Your surgeon can
answer specific questions about your specific needs.
As with all facial
plastic surgery, good health and realistic expectations
are prerequisites. Understanding the limitations of
rhytidectomy is crucial and psychological stability is
vital. There is no ideal in a facelift. Rather, the goal
is to improve the overall facial appearance. Skin type,
ethnic background, degree of skin elasticity, individual
healing, basic bone structure, as well as a realistic
attitude are factors that should be discussed prior to
surgery. This procedure is sometimes performed on
patients in their thirties, and successful surgery has
been performed on patients in their eighties. A facelift
cannot stop aging, nor can it turn back the clock. What
it can do is help your face look its best and give you a
look of health and a more youthful appearance. A side
benefit is that many patients experience increased
self-confidence.
Before deciding on a
facelift, you should discuss with your facial plastic
surgeon whether the overall effect will be more
successful if additional changes are made in the chin
and neck areas through other facial surgery. Many
patients decide to have facial liposuction to remove
excess fatty deposits in conjunction with a facelift. If
several flaws need correction, more than one procedure
may be necessary for the best overall result.
Your choice of a
qualified facial plastic surgeon is of paramount
importance. During the preliminary consultation, the
surgeon will examine the structure of your face, skin
texture, color, and elasticity. Photographs will be
taken so the surgeon can study your face. Individual
risks will also be examined, especially those related to
medical situations such as high blood pressure, a
tendency to scar, smoking, and any deficiency in blood
clotting. The surgeon will take a thorough medical
history, as well as assess the patient's mental and
emotional attitudes toward the surgery. Because a
realistic attitude is crucial to the success of the
surgery, the surgical procedure and realistic
expectations will be discussed.
After the decision to
proceed with a rhytidectomy is made jointly by you and
your surgeon, the surgeon will describe the technique
indicated, the type of anesthesia, the surgical
facility, any additional surgery, the pros and cons to
include possible complications, and costs of the
procedure.
The surgeon begins the
incision in the area of the temple hair, just above and
in front of the ear, and then continues around the lobe,
circling the ear before returning to the point of origin
in the scalp. The skin is raised outward before the
surgeon repositions and tightens the underlying muscle
and connective tissue. Some fat may be removed, as well
as excess skin. For men, the incision is aligned to
accommodate the natural beard lines. In all cases, the
incision is placed where it will fall in a natural
crease of the skin for camouflage.
After trimming the excess
skin, the surgeon closes the incisions with fine sutures
and/or metal clips, which permit surgery without shaving
hair from the incision site. Depending on the extent of
the surgery, the process can take from two to four
hours. When the procedure is performed with a
combination of mild sedatives, local anesthesia, and a
mild intravenous anesthesia, the patient will experience
little discomfort. Some surgeons prefer to use general
anesthesia for facelifts. Following the surgery, the
surgeon will apply a dressing to protect the entire area
where the incisions have been made.
Even though most patients
experience very little pain after surgery, the surgeon
will still prescribe medication. Some degree of swelling
and bruising is unavoidable, and your surgeon may
instruct you to use cold compresses to keep swelling to
a minimum. If a dressing has been applied, it will be
removed within one to two days. The surgeon will also
instruct you to keep your head elevated when lying down,
to avoid as much activity as possible, and to report any
undue discomfort. Though there are few risks in facelift
surgery and thousands are performed every year, some
risk exists in any surgery.
In some cases, a drainage
tube may have been inserted during surgery. This will be
removed on the first or second day after surgery. All
sutures and staples are usually removed within five to
10 days following surgery. Surgeons generally recommend
that patients avoid vigorous activity. Patients should
prearrange for post-surgery support from family and
friends.
Recovery usually takes
two to three weeks, though many patients go back to work
in two weeks. Scars are usually not noticeable after
enough time has passed for them to mature. In any case,
they are easily disguised in natural skin creases, by
the hair, or, in persistent cases, by makeup until total
healing has occurred. Bear in mind that the aging
process continues after surgery and that some relaxation
of tissues will occur over the first few weeks.
Facial plastic surgery
makes it possible to correct many facial flaws and signs
of premature aging that can undermine self-confidence.
By changing how you look, cosmetic surgery can help
change how you feel about yourself.
Insurance does not
generally cover surgery that is done purely for cosmetic
reasons. Surgery to correct or improve genetic deformity
or traumatic injury may be reimbursable in whole or in
part. It is the patient's responsibility to check with
the insurance carrier for information on the degree of
coverage.
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