Facelift Surgery

The goal of facial aesthetic surgery is to reverse the signs of aging without leaving telltale signs. A facelift is not intended to make a person look fundamentally different, just fresher. It is an effective way to “turn back the clock” and the beneficial effects will last about ten years. When properly performed there is a natural appearance that never looks tight. Scars are usually inconspicuous, even with short hairstyles.

Most women become candidates for facial aesthetic surgery sometime after forty (men after fifty). The criteria to determine when one is ready are not rigid and the decision is always somewhat arbitrary. Early aging signs may be considered insignificant to some individuals but more disturbing to others. Facelifts are never performed on a purely preventive basis, however. The primary disadvantage to delaying corrective surgery is that progressive aging changes may require a more aggressive procedure. The result may not be as good due to the normal loss of skin elasticity that occurs with increasing age. The best candidates are generally between ages 45 to 55. You are probably a good candidate for facial aesthetic surgery if you have specificaging signs such as a loose neck or jowls that you find troublesome.

A complete facelift only addresses signs of aging in the lower half of the face and the neck. It does not treat the eyes or forehead. It is particularly effective in tightening loose neck skin and re-establishing a smooth jaw line devoid of jowls.

The normal facelift incision pattern starts within the scalp above the ear and courses downward following the curve of the ear. It courses within the earlobe crease to the bottom of the ear. The incision then travels in the crease behind the ear for a variable distance depending on the type of facelift being performed (regular or short-scar).

Facelifts almost always require more than just skin tightening. Using aggressive skin removal alone to restore facial shape can result in a distorted and unnatural appearance. Almost all patients benefit from tightening of the SMAS layer under the skin in order to remove jowls, restore cheek contour, and soften nasolabial folds. The SMAS layer is made of fibrous fat tissue that is strong. It overlies the facial muscles which themselves are never manipulated in any way during a facelift. Tightening of the SMAS layer is important to achieve a natural appearance. It minimizes the amount of skin removal necessary and thereby helps avoid a “pulled” look. Those who have had a facelift before have already had most of the excess skin removed. A repeat facelift in these individuals focuses more on SMAS tightening with little if any additional skin removal.There are several variations in facelifts:  a short- scar facelift,  a necklift and a complete facelift.

There are factors less subject to surgical controls that influence the outcome of facial surgery. These include the thickness and elasticity of the facial skin, the degree of wrinkling and sun damage, the amount and distribution of facial fat, the underlying bone structure, individual healing tendencies, hormonal influences, heredity, and previous injections of silicone and other substances into the face. The best surgical effort will likely achieve a more modest result in the presence of thin and inelastic skin, severe wrinkles, a paucity of facial fat, and unfavorable bone structure, for example.

The most common complication that can occur after a facelift is a hematoma. This happens in less than 2 percent. A hematoma results when blood collects as a lump underneath the skin. It may require a brief return to the operating room within twenty-four hours of surgery. Development of a hematoma does not have any adverse effect on either short-term recovery or the final aesthetic result. Other problems such as infection, eye irritation, delayed healing, or excessive scarring are uncommon. Facial nerve injury with weakness of a part of the face can occur on a transient or permanent basis. This is extremely rare. The vast majority of patients do not have any complications.

Smoking interferes with blood supply to the face and may result in other complications such as skin loss. It is essential to stop smoking completely for at least three weeks before surgery. This includes the use of nicotine containing gum. Simply cutting back on smoking is not enough. Failure to stop completely may result in skin loss behind the ear or on the cheek in front of the ear. Delayed healing and disfiguring scars can result and may require revisional surgery for correction.

Facelift surgery is usually performed in under general anesthesia or with deep intravenous sedation..Stitches are removed in one week. Swelling and discoloration usually subside in two weeks. Make-up to cover residual bruising may be applied to the face and lower eyelids as soon as one week after surgery. Hair may be washed several days after surgery and colored four weeks after surgery.

Mild cardiovascular exercise such as a stationery bike or walking outdoors can begin several weeks after surgery. It is best to wait as long as six weeks before resuming more intense exercise and activities such as jogging, weightlifting, ball sports, yoga, pilates, and skiing.

 
Facelift Surgery
 
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