Facelift (Rhytidectomy)

The natural aging process of the face involves a loss of the bony support structures and fat pads responsible for volume as well as a descent of the skin ultimately leading to wrinkles. 

To address these problems a variety of surgical procedures are currently available aimed at restoring what was lost and rejuvenating facial appearance, the most powerful of which is the face lift.  Not all age related changes can be addressed with this procedure and thus it can be combined with additional facial rejuvenation techniques to achieve patients’ desired goals.  A clear understanding of what the areas of concern are is therefore critical for the patient and should be clearly discussed with their surgeon. 

The age related changes in the face that can be improved with a face lift are jowls, excess neck skin and fat, hollowing out of the cheeks, deep wrinkles and loss of jawline definition.  The common thread amongst these changes is a loss of strength in the fasical support structure of the face known as the Superficial MusculoAponeuritc System (SMAS) leading to a downward descent of the skin, fat and muscles.  An effective facelift therefore combines an excision of excess skin with tightening of this support system for reliable long lasting results.

A variety of facelift approaches are currently available today all of which combine some aspect of skin removal with alteration of the SMAS.  To accomplish these goals the procedures involves elevation of the skin off of the underlying SMAS of the face as well as the neck.  Tightening of the SMAS is then performed by either excision and advancement or imbrication (sowing it onto itself).  If necessary imbrication of neck muscle can also be performed to address age related loss of neck contour commonly referred to as a ‘turkey neck.’  Once the fascial support structures are tightened attention is turned to removal of the excess skin that has developed as a result of the fascial laxity and is responsible for the appearance of wrinkles.  To properly excise the skin an incision extending from the temporal hairline, to around the ear and into the hairline in the back of the head is necessary.  This incision is generally very well hidden in natural anatomic folds and therefore difficult to see following the surgery.

Following surgery patients can expect to have a large head wrap dressing that is usually removed the next day.  Drains are sometimes used as well to decrease the risk of fluid accumulation in the tissue spaces and are also removed the following day.  Although each patient responds differently to surgery, one can expect some degree of swelling and bruising following surgery that will improve over the following weeks.

Since not all age related changes of the face can be corrected with a facelift alone, additional procedures are frequently performed at the same time as a face lift and can include blepharoplasty, fat grafting, laser resurfacing and brow lift.

Our surgeons take their time in consultation to ensure that all patients’ concerns are clearly defined and to match the necessary procedures with their desired results.  If you are interested in scheduling a consultation today please click here.

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