|
If you're considering a facelift...
As people age, the effects of gravity, exposure to the sun,
and the stresses of daily life can be seen in their faces.
Deep creases form between the nose and mouth; the jawline
grows slack and jowly; folds and fat deposits appear around
the neck.
A facelift (technically known as rhytidectomy)
can't stop this aging process. What it can do is "set
back the clock," improving the most visible signs of
aging by removing excess fat, tightening underlying muscles,
and redraping the skin of your face and neck. A facelift can
be done alone, or in conjunction with other procedures such
as a forehead lift, eyelid surgery, or nose reshaping.
If you're considering a facelift, this brochure
will give you a basic understanding of the procedure when
it can help, how it's performed, and what results you can
expect. It can't answer all of your questions, since a lot
depends on the individual patient and the surgeon. Please
ask your surgeon about anything you don't understand.
THE BEST CANDIDATES FOR A FACELIFT
The best candidate for a facelift is a man or woman whose
face and neck have begun to sag, but whose skin still has
some elasticity and whose bone structure is strong and well-defined.
Most patients are in their forties to sixties, but facelifts
can be done successfully on people in their seventies or eighties
as well.
A facelift can make you look younger and fresher,
and it may enhance your self- confidence in the process. But
it can't give you a totally different look, nor can it restore
the health and vitality of your youth. Before you decide to
have surgery, think carefully about your expectations and
discuss them with your surgeon.
ALL SURGERY CARRIES SOME UNCERTAINTY
AND RISK
When a facelift is performed by a qualified plastic surgeon,
complications are infrequent and usually minor. Still, individuals
vary greatly in their anatomy, their physical reactions, and
their healing abilities, and the outcome is never completely
predictable.
Complications that can occur include hematoma
(a collection of blood under the skin that must be removed
by the surgeon), injury to the nerves that control facial
muscles (usually temporary), infection, and reactions to the
anesthesia. Poor healing of the skin is most likely to affect
smokers.
You can reduce your risks by closely following
your surgeon's advice both before and after surgery.
PLANNING YOUR SURGERY
Facelifts are very individualized procedures. In your initial
consultation the surgeon will evaluate your face, including
the skin and underlying bone, and discuss your goals for the
surgery.
Your surgeon should check for medical conditions
that could cause problems during or after surgery, such as
uncontrolled high blood pressure, blood clotting problems,
or the tendency to form excessive scars. Be sure to tell your
surgeon if you smoke or are taking any drugs or medications,
especially aspirin or other drugs that affect clotting.
If you decide to have a facelift, your surgeon
will explain the techniques and anesthesia he or she will
use, the type of facility where the surgery will be performed,
and the risks and costs involved. Don't hesitate to ask your
doctor any questions you may have, especially those regarding
your expectations and concerns about the results.
PREPARING FOR YOUR SURGERY
Your surgeon will give you specific instructions on how to
prepare for surgery, including guidelines on eating and drinking,
smoking, and taking or avoiding certain vitamins and medications.
Carefully following these instructions will help your surgery
go more smoothly. If you smoke, it's especially important
to stop at least a week or two before and after surgery; smoking
inhibits blood flow to the skin, and can interfere with the
healing of your incision areas.
If your hair is very short, you might want
to let it grow out before surgery, so that it's long enough
to hide the scars while they heal.
Whether your facelift is being done on an outpatient
or inpatient basis, you should arrange for someone to drive
you home after your surgery, and to help you out for a day
or two if needed.
WHERE YOUR SURGERY WILL BE PERFORMED
A facelift may be performed in a surgeon's office-based facility,
an outpatient surgery center, or a hospital. It's usually
done on an outpatient basis, but some surgeons may hospitalize
patients for a day when using general anesthesia. Certain
conditions such as diabetes or high blood pressure should
be monitored after surgery, and may also require a short inpatient
stay.
TYPES OF ANESTHESIA
Most facelifts are performed under local anesthesia, combined
with a sedative to make you drowsy. You'll be awake but relaxed,
and your face will be insensitive to pain. (However, you may
feel some tugging or occasional discomfort.)
Some surgeons prefer a general anesthesia.
In that case, you'll sleep through the operation.
THE SURGERY
A facelift usually takes several hours-or somewhat longer
if you're having more than one procedure done. For extensive
procedures, some surgeons may schedule two separate sessions.
Every surgeon approaches the procedure in his
or her own way. Some complete one side of the face at a time,
and others move back and forth between the sides. The exact
placement of incisions and the sequence of events depends
on your facial structure and your surgeon's technique.
Incisions usually begin above the hairline
at the temples, extend in a natural line in front of the ear
(or just inside the cartilage at the front of the ear), and
continue behind the earlobe to the lower scalp. If the neck
needs work, a small incision may also be made under the chin.
In general, the surgeon separates the skin
from the fat and muscle below. Fat may be trimmed or suctioned
from around the neck and chin to improve the contour. The
surgeon then tightens the underlying muscle and membrane,
pulls the skin back, and removes the excess. Stitches secure
the layers of tissue and close the incisions; metal clips
may be used on the scalp.
Following surgery, a small, thin tube may be
temporarily placed under the skin behind your ear to drain
any blood that might collect there. The surgeon may also wrap
your head loosely in bandages to minimize bruising and swelling.
AFTER YOUR SURGERY
There isn't usually significant discomfort after surgery;
if there is, it can be lessened with the pain medication prescribed
by your surgeon. (Severe or persistent pain or a sudden swelling
of your face should be reported to your surgeon immediately.)
Some numbness of the skin is quite normal; it will disappear
in a few weeks or months.
Your doctor may tell you to keep your head
elevated and as still as possible for a couple of days after
surgery, to keep the swelling down.
If you've had a drainage tube inserted, it
will be removed one or two days after surgery. Bandages, when
used, are usually removed after one to five days. Don't be
surprised at the pale, bruised, and puffy face you see. Just
keep in mind that in a few weeks you'll be looking normal.
Most of your stitches will be removed after
about five days. Your scalp may take longer to heal, and the
stitches or metal clips in your hairline could be left in
a few days longer.
GETTING BACK TO NORMAL
You should be up and about in a day or two, but plan on taking
it easy for the first week after surgery. Be especially gentle
with your face and hair, since your skin will be both tender
and numb, and may not respond normally at first.
Your surgeon will give more specific guidelines
for gradually resuming your normal activities. They're likely
to include these suggestions: Avoid strenuous activity, including
sex and heavy housework, for at least two weeks (walking and
mild stretching are fine); avoid alcohol, steam baths, and
saunas for several months. Above all, get plenty of rest and
allow your body to spend its energy on healing.
At the beginning, your face may look and feel
rather strange. Your features may be distorted from the swelling,
your facial movements may be slightly stiff and you'll probably
be self-conscious about your scars. Some bruising may persist
for two or three weeks, and you may tire easily. It's not
surprising that some patients are disappointed and depressed
at first.
By the third week, you'll look and feel much
better. Most patients are back at work about ten days to two
weeks after surgery. If you need it, special camouflage makeup
can mask most bruising that remains.
YOUR NEW LOOK
The chances are excellent that you'll be happy with your facelift-especially
if you realize that the results may not be immediately apparent.
Even after the swelling and bruises are gone, the hair around
your temples may be thin and your skin may feel dry and rough
for several months. Men may find they have to shave in new
places-behind the neck and ears-where areas of beard- growing
skin have been repositioned.
You'll have some scars from your facelift,
but they're usually hidden by your hair or in the natural
creases of your face and ears. In any case, they'll fade within
time and should be scarcely visible.
Having a facelift doesn't stop the clock. Your
face will continue to age with time, and you may want to repeat
the procedure one or more times-perhaps five or ten years
down the line. But in another sense, the effects of even one
facelift are lasting; years later, you'll continue to look
better than if you'd never had a facelift at all.
Back to Procedures
Information provided by American
Society of Plastic Surgeons. |
