Facelift


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Member - American Society of Plastic Surgeons

Facelift

Facelift
Are You A Good Candidate
Meeting With The Doctor
How The Procedure Is Performed
What To Expect After Surgery
Possible Side Effects And Risks
How Long Will The Results Last
Questions You May Have

Facelift
A facelift, also known as a rhytidectomy, is a surgical procedure designed to improve the most visible signs of aging on your face and neck. The procedure removes skin on the face and neck that is loose and sagging, tightens the underlying muscles and support structures, and redrapes the skin to provide a more youthful and rejuvenated appearance. A facelift can be done alone or in conjunction with other procedures such as eyelid surgery or a forehead lift.

There are several techniques used to perform a facelift, each done in its own way and each with its own benefits:
� In the traditional facelift, an incision is made at the hairline, excess skin is removed, the remaining skin is pulled and tightened, and stitches are used to close the incision. The traditional facelift is used when there are large amounts of sagging and drooping skin to be removed.
� With the mini-lift, a small incision is made in front of each ear and a small area of skin is lifted. This technique is particularly suited for patients in their late thirties or early forties since it targets the early signs of aging.
� The "weekend facelift" uses liposuction to remove excess fat from the chin and uses lasers to constrict the fat cells and tighten the surrounding tissues of the neck area. This procedure works well for people who primarily wish to tighten the jowls to reduce the heavy look under the chin.

Working with the experienced doctors and staff at The Metropolitan Institute for Plastic Surgery, you can determine which type of facelift is right for you and be assured of a safe and pleasing outcome.

Are You A Good Candidate 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 successfully performed on people well into their seventies and eighties. If you are generally healthy, have a realistic view about the results that can be achieved with a facelift, and have any of the following conditions, you may be a good candidate for the procedure:

� Loss of skin elasticity and/or muscle tone on your face and/or neck
� Wrinkles or furrows on your face and/or neck
� Deep creases forming between the bottom of your nose and the corner of your mouth
� A diminished jaw line
� A sagging or heavy chin

Meeting With The Doctor
Prior to scheduling your facelift, you will have an extensive consultation with the doctors and staff at The Metropolitan Institute for Plastic Surgery. The goals of the consultation are to evaluate your facial and neck structure, your skin elasticity, and your underlying muscle tone to determine if a facelift is right for you and, if so, which of the many techniques suits you best. The doctor will thoroughly explain each procedure, along with its risks, benefits, and recovery times. You will be asked to describe in detail how you want your face and neck to look after your facelift. Working together, you and the doctor will decide which technique will give you the results you desire.

The Metropolitan Institute for Plastic Surgery doctors and staff will:
� Review the various facelift options with you
� Clearly discuss the potential risks of each procedure
� Outline in detail how the surgery is performed and what you can expect before, during, and after the procedure
� Provide detailed cost and payment information
� Answer all your questions

You will be asked to provide:
� Details about your medical history
� A list of all medication you currently take including over the counter medications such as aspirin, vitamins, and herbal supplements
� Information regarding your tobacco and alcohol use

How The Procedure Is Performed Your facelift will be performed at one of region's premiere accredited outpatient-based surgical facilities: the Center for Ambulatory Surgery, Inc. (CASI) or the Washington Hospital Center, or at Sibley Memorial Hospital. If your facelift is extensive or is combined with other procedures, a hospital stay of one to two nights may be required. Your facelift will take between two to six hours to complete and can be performed either under general anesthesia or local anesthesia with sedation depending on what you and the doctor prefer. With general anesthesia, you will be completely asleep throughout the procedure. With local anesthesia, you will be lightly sedated and your face and neck area will be numbed. You will be awake, but will be relaxed and will feel no discomfort. The type of anesthesia used and whether or not a hospital stay is required will be discussed with you at your initial consultation.

The doctor makes an incision beginning at your hairline above the temple, extending in a natural line in front of the ear, and continuing behind the earlobe to the lower scalp. If your neck is being worked on, the doctor makes a small incision under your chin. The incisions are usually made well behind the hairline so that they are not visible.

Once the incisions are made, the doctor carefully separates the skin from the fat and muscle below. If necessary, fat is trimmed or suctioned from around the neck to improve the contour of your neck and chin. The doctor then tightens the underlying muscle and support structures, redrapes the skin, and removes any excess skin.

Once the procedure is complete, the doctor uses stitches to secure the layers of tissue and to close the incisions. Surgical clips may be used to secure the scalp. A small thin tube called a drain may be temporarily placed under the skin behind your ear to help drain any blood that might collect there. Your head is wrapped with gauze dressings to help reduce the swelling.

What To Expect After Your Surgery
Activity When

Drainage Tubes Removed One to Two Days After Surgery

Bandages Removed One to Five Days After Surgery

Shower and Shampoo Hair Three Days After Surgery

Stitches Removed Five to Seven Days After Surgery

Back to Work Two to Four Weeks After Surgery

Driving As Soon as You Feel Comfortable

Strenuous Activity Six Weeks After Surgery

Fading of Scars Several Months to One Year

Immediately After Your Surgery
In most cases, facelift surgery is performed on an outpatient basis and you go home shortly after the surgery. You may be sleepy from the anesthesia and the surgical area will be sore so you will need to have someone drive you home. If your facelift is performed at the hospital, you can expect to stay in the hospital for one to two nights. Once you go home, you may want to have someone stay with you for the first few days. There will be some bruising, swelling, and numbness. You will need to keep your head elevated and remain as still as possible for a few days after surgery to help reduce the swelling. Pain medication will be prescribed to alleviate as much post-surgery pain as possible.

The First 24 to 48 Hours After Your Surgery
You may experience some numbness and temporary discomfort around the incisions. Any pain or discomfort you experience can be controlled with prescribed medication. You will also experience swelling and some bruising. You will need to keep your head elevated for the first few days after surgery to reduce the swelling of your face and neck. Your discomfort level will improve rapidly after the first two days.

Your doctor will remove your bandages at your first post-operative visit. There may be a small amount of bleeding around your incisions. This is normal and can usually be controlled by applying light pressure to the area. If the bleeding does not respond to light pressure or becomes heavy, call The Metropolitan Institute for Plastic Surgery for further instructions.

You can wash your hair 48 hours after surgery (or 24 hours after the drains are removed). However, if you dry your hair, keep the dryer on the lowest setting since your scalp may be numb and there is a risk that you might burn yourself.

The First Two Weeks After Surgery
Although you will be up and around in the first few days after your surgery, you should take it easy for the first week after surgery. Your stitches and any surgical clips used will be removed within two weeks of the surgery, usually in two steps. You can begin using makeup two days after your stitches are removed. Most patients are back to work within two weeks of surgery.

You will notice that you will become increasingly more comfortable during the first few weeks after your surgery. You may also notice:

� Mild to moderate swelling, tenderness, and bruising in the area of the incisions. This will gradually disappear within the first two weeks after surgery, with most of the swelling and bruising disappearing within a month. The swelling may cause it to feel funny when you make certain facial expressions.

� Numbness in the area of your incisions; this is normal and may take several weeks to disappear completely.

� Itching as a result of the healing of the nerves near your incisions. This feeling is more pronounced with the traditional facelift and may take up to six months to disappear completely.

Resuming Your Normal Routine
Everyone heals at different rates and you are the best judge of when you are ready for certain activities, but the following are general guidelines:

� You can most likely return to work within two weeks of your surgery.

� You can resume driving as soon as you feel comfortable doing so.

� You can most likely return to your physical exercise program within six weeks of your facelift. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.

� Most of the visible signs of your surgery should fade within about three weeks.

� Prolonged exposure to heat and sun should be limited for several months.

� The scars caused by the incision should be protected from sunlight for at least a year after surgery.

Things To Be Aware Of After Your Surgery

� Bruising and swelling usually decrease enough so that you can comfortably go out in public about ten to twenty days after your surgery.

� You may experience a loss of sensation or numbness in the area of your surgery. This is entirely normal and may take several weeks to disappear.

� Generally, the scalp heals at a slower rate than the face or neck. For this reason, any surgical clips used in your scalp will be left in longer than the stitches in your face and neck.

� Some of your hair around the incision may fall out and may temporarily be a bit thinner than normal. Normal hair growth usually resumes within a few weeks or a month. Permanent hair loss is rare.

� Your face and neck will feel dry. Apply a good fragrance-free moisturizer frequently.

� Avoid saunas and steam baths the first few months after your surgery.

� Protect your scars with sunscreen for at least six months after surgery. Use an SPF 15 (or greater) sunscreen every time you are outside. Apply the sunscreen before applying makeup

� Hair texture and manageability can change temporarily as a reaction to surgery. Wait at least six weeks before coloring, highlighting, or perming your hair once it returns to its normal texture.

What Are Possible Side Effects or Risks?
All surgical procedures have some degree of risk; however, major complications from facelift surgery are unusual. During your initial consultation with the doctors and staff of The Metropolitan Institute for Plastic Surgery, your individual risks will be assessed and discussed. As with any surgery, you can help reduce the risks by closely following the pre and post-surgery instructions provided to you. And the doctors and staff of the Institute will be with you every step of the way to ensure a safe and pleasing outcome. Most likely risks include the following.

� Infection
� Nerve damage
� Hair loss
� Asymmetry
� Blood or fluid collect
� Skin sloughing, delayed healing at the incisions points
� Wide or thickened scars

How Long Will the Results of Your Facelift Last? A facelift removes excess skin and repositions fat and muscle to reduce jowls and smooth the jaw line for a more youthful appearance. These results generally last between five to ten years, longer in many cases. It is important to keep in mind that the effects of aging, gravity, and environmental factors will continue to affect the smoothness, sagging, and wrinkling of your face and neck. Meticulous skin care is critical to maximize the effectiveness and longevity of your surgical results.

Questions You May Have
� Are there other procedures that could be done along with facelift surgery to enhance the overall appearance of my face?
A facelift is often performed in conjunction with a neck lift, brow lift, or eyelid surgery to enhance the overall youthful appearance. Botox injections are a non-surgical alternative that may temporarily reduce the amount of lines and wrinkles in your face and neck.

� Will my insurance coverage pay for my facelift?
A facelift is considered cosmetic surgery and, therefore, is not covered by insurance. You are responsible for the full payment of the procedure. Cost and payment information will be fully discussed with you during your initial consultation.

� Are there alternatives to facelift surgery?
Botox injections are a non-surgical alternative to a facelift. These injections can reduce or eliminate lines and furrows by blocking the nerve impulses to temporarily paralyze the muscles that cause wrinkles. Meticulous skin care may also help improve the tone, texture, and occasionally the contour of your facial skin. Laser resurfacing and chemical peels may also provide a less invasive option to surgery.