Rhytidectomy
or
Facelift
The face-lift procedure is performed to tighten the skin of the face and
neck and give the patient a more youthful and rested appearance. Face and neck-lifting is pursued both by relatively young patients to preserve a more
youthful appearance and by older individuals to attain a younger and more rested look. Correspondingly, the results of a face-lift can range from
subtle to dramatic according to the extent of aging changes present in the individual.
As we age,
our skin begins to wrinkle and lose elasticity. One of the first signs is "cheek creases" that
appear without smiling. Further aging deepens the cheek creases and often creates "jowls" along the
lower jawline. In advanced facial aging, skin and fat dangle from under the chin forming a "turkey
gobbler" with vertically oriented bands and transversely running wrinkles.
Because it is unusual to find aging changes isolated in the face without accompanying changes in the
neck, the neck and face are usually treated simultaneously. The face- and neck-lift, which is
medically termed a rhytidectomy, is performed through incisions that are made in existing skin
creases and hair-bearing regions surrounding the ear. Minimal or no hair is trimmed from the scalp
along the incisions. Then, the surgeon retracts and advances the skin and its underlying tissues to
affect a smoother and more defined contour to the neck and jawline.
If necessary, the surgeon will trim or suction local deposits of fat along the jawline or under the chin. This occasionally requires an incision in the shaded area under the chin. Your surgeon tightens the tissue by moving both the skin and often the deeper subcutaneous tissues and muscles. The excess skin is excised and discarded as the incisions are closed with sutures and staples. The tightening is performed symmetrically on each side of the face.
Face- and neck-lifting surgery takes four to five hours and can be performed either with local or
general anesthesia. Patients usually are hospitalized for one night postoperatively for observation and
can wash their hair on the first postoperative day. Dressings are rarely worn beyond two days, but
swelling and bruising may be considerable for two to three weeks. The surgeon will remove the
sutures or staples in stages over the first five to ten postoperative days.
After the sutures are removed,
patients are free to begin using cosmetics and usually return to their "routine" within two and three
weeks.
Because the face-lift procedure restructures large areas of tissue, you should be aware of several
risks: blood collecting under the skin and compromised blood flow or healing of the skin. These
complications can lead to irregularities in the skin or scarring. Patients can minimize these risks by
avoiding tobacco products and aspirin-like medications that "thin" the blood.
Because the skin is separated from the nerves and muscles which animate the face, you may
experience numbness or weakness in moving the eyebrow or corner of the mouth postoperatively.
Fortunately, this usually is resolved within two to three weeks, but it occasionally can take several
months to subside.
Scars can require nearly a year to complete a cycle of fading and softening. Those in the scalp can
occasionally be more visible due to thinning of the adjacent hair. You may be able to notice scars
extending in front of the ear and around the earlobe if you look closely. However, all of these
limitations can usually be minimized by using properly selected cosmetics, earrings and hairstyles.
Rarely, poorly healed scars require additional measures to improve their appearance.
There are some limitations to a face-lift. First, a face- and neck-lift procedure alone will not affect aging changes in the eye or forehead region, which may require eyelid surgery or a forehead lift. Second, the redraping of the skin addresses skin laxity to a greater degree than wrinkling. Fine wrinkles, like those surrounding the lips and eyes, are due to alterations inherent to aging skin and usually must be addressed by a skin resurfacing procedure such as dermabrasion ,chemical peel or laser treatment. Depending on the area of the face in question, resurfacing can be performed in the same setting as face-lifting. The additional benefits of these skin resurfacing procedures to the skin quality and tone greatly enhances the rejuvenating effect of the face and neck lift procedure.
Finally, while the procedure renders a more youthful appearance, the extent of the enhancement will gradually diminish over time. The longevity of a face-lift is impossible to predict for a given patient since it is influenced by environmental factors like continued exposure to tobacco products and sun as well as factors genetically unique to the individual. It can be said that the face-lifted individual will never look as aged as if the operation had never been done. With sufficient continued aging, repeat face-lifting or "mini-lifting" operations may occasionally become necessary.