December 5, 2020

Facelift (Rhytidectomy)

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As we age, and it happens to all of us, our muscles become slack and the elasticity in our skin progressively lessens. The exposure to the sun and the stresses of daily life together with gravity is seen upon our faces. The folds and smile lines deepen, the corners of the mouth droop, the jaw line sags and the skin of the neck becomes slack. The there are our eyes. Eyebrows droop; the skin of the eyelids gathers in loose folds, fine wrinkles develop around the lips and at the corners of the eye including lines of expression. Substantial weight loss can also produce changes in facial appearances too.

Depressing isn’t it? What can you do about it? Have you considered a facelift?

There are many short-lived lifts, most of which are not even lifts, but are just filler injections hyped by catchy names like Y lift or Liquid lift (merely filler injections in the face). Yes, most filler injections will make patients look better, but most fillers only last if they are used in conjunction with a real lift.

There are several facelift procedures, but simple facelifts do not result in the ‘wind-tunnel’ effect or ‘surprised look’ that is sometimes caused by more extreme facelifts. Recovery from a simple facelift is easier and has fewer complications than the more extreme variety of facelifts. Further, there is less chance of bruising and stretching and they are considerably less expensive.

The best candidate for a facelift is one whose face and neck has begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well defined. Most patients are in their 40’s to 60’s, but facelifts can be done successfully on people in their 70’s or 80’s.

When considering a facelift, consultation is done with the surgeon to determine your qualifications and type of procedure appropriate for you. You will be asked about your history, be given a physical exam and administered a blood test. Be forewarned, many doctors will not do a facelift on people who smoke or have smoked, as this may have serious complications.

Sometimes the best results of the facelift procedure are attained by combining several surgical procedures, such as liposuction, brow lift, fat transfer, blepharoplasty, laser, or chin and cheek implants – all depending on the patient’s needs.

During a simple facelift procedure, the surgeon will make incisions that follow the contours of the ear, but hidden in your hair. This will produce modest, permanent scarring in most cases. The best improvement with a facelift is seen in the jowl area and under the neck, while the folds around the mouth, commonly known as nasal-labial folds, are not usually improved much with a simple facelift.

During surgery, after the ear contour incision is made, the skin is undermined – pulled upwards and back toward the scalp line. The excess skin is removed and is stitched or stapled into place. This is a typical, simple facelift.

A newer technique is the ‘deep plane facelift’, which involves going under the muscle of the face and pulling it along with the skin to essentially make the facelift last longer. Some doctors choose a laser or chemical peel before the surgery is performed, however it should be a light treatment only – anything too deep adds serious risks. Recovery and risk for deep plane facelifts are more extensive than for a classic facelift.

Because the muscles and skin are being manipulated, it is common for there to be some bruising, and the deeper the procedure, the more bruising will occur. For deeper and more complex surgeries, the pain, swelling and risks can also rise. However, it has been shown that some of the deeper procedures produce a longer-lasting result, which may be favorable to some patients.

Facelifts can provide excellent and dramatic results. It should not be obvious that you have had a facelift, but instead you look younger, more vital and cheerful. It is a procedure that technically works well but also increases morale and is well appreciated by the patient.

Women tend to have better results than men do in a facelift; men find it more difficult to disguise the scars and will need to shave their beard closer to the ear in front and also behind the ear where the skin has been lifted. Sometimes after surgery, men may have to shave in new places, as beard-growing skin may be slightly repositioned.

A facelift does not stop the clock, but it does put the clock back. The effect of the facelift is likely to always be there, in that you will not look as old as you would have done if it had not been carried out.

Information is consistent on facelifts across the board. As with all surgical procedures, there are risks involved that you must discuss with your doctor before surgery. Your own health record and practices can and will affect your candidacy for surgery. Be sure to be truthful with your physician to avoid as many side effects and risks as possible.

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