Facelift ( Rhytidectomy )

Indications

With increasing age, the face undergoes characteristic changes which are secondary to loss of elasticity in the skin and loosening of the underlying muscles. The effects of sun-exposure, gravity and smoking are reflected in the aging face. Loss of skin elasticity, combined with the effects of gravity causes the skin to sag and tissues underneath the skin to bulge.

In the face, the first signs of aging are fine wrinkles around the mouth and at the corners of the eyes; the upper eyelids develop redundant skin, crow’s feet lines deepen; deep wrinkle lines appear between the eyebrows, across the forehead and run down from the side of the nose to the chin; with increasing age, the neck becomes more wrinkled and the jaw line less distinct.

A facelift operation corrects some of these aging changes. It is usually a cosmetic operation; however, it is occasionally used in patients who have rare disorders which cause premature skin aging and sometimes for treating patients with facial weakness.

This approach allows flexibility so the surgeon can tailor the procedure to each patient and avoid the “windswept” look that was common some years ago. The procedure is modified for each patient individually to provide the best results.

During your consultation your plastic surgeon will examine you and discuss recommendations for the specific type of facelift to yield the best results. The procedure is often done as an outpatient with recovery either at a specialized overnight care center or at home. It is performed under general anesthesia administered by a physician anesthesiologist to minimize discomfort during the procedure.

Anesthetic

General anesthetic; may be done under local anesthetic with intravenous sedation.

Length of operation

Varied; may take several hours, particularly if other procedures are performed.

Time in hospital

2 – 3 days

Postoperative discomfort/limitations

There will be some discomfort; significant pain is unusual. Swelling and bruising are common. Bruising may take 2 – 3 weeks to settle. Stitches/staples are removed between 5 and 10 days postoperative. Numbness of cheek, skin and ears is common and settles over a few weeks or months. The face looks puffy and feels stiff initially. Scars are mostly good and can be hidden by the hair.

In men the sideburns are moved closer to the ears; men may have to shave behind their ears where skin has been lifted. A facelift produces most improvement in the lower half of the face, jaw-line and neck. Sagging eyebrows, forehead wrinkles, fine wrinkles and deep lines around the mouth are not usually improved.

With time, the effects of age and gravity will become apparent again. A facelift procedure puts the aging clock back – but the clock keeps ticking; even so a facelift will always have some noticeable benefit.

Stop aspirin, non-steroidal anti-inflammatory drugs and smoking two weeks before surgery.

Time off work

3 – 4 weeks

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