What is a Facelift?
A Facelift, also known as Rhytidectomy, is a surgical procedure to rejuvenate facial appearance in those suffering the natural aging process of a loss of bony support and fat pads responsible for volume in the face, as well as a descent of the skin ultimately leading to wrinkles. This procedure is commonly combined with a Necklift to improve descent of skin throughout neck as well.
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.
Patients with 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 age – related changes is a loss of strength in the fascial 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. 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’ (when combined with Necklift). 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.
This surgical procedure is performed on an outpatient basis, in our Joint Commission certified operating suite. Surgery lasts on average of 3 hours, and then patients are discharged home that same day. Patients who undergo Facelift and/or necklift will follow up in our office 1-3 days post operatively.
Things to know:
- Following surgery patients can expect to have a large head wrap dressing that is usually removed in 3-5 days.
- Although each patient responds differently to surgery, one can expect some degree of swelling and bruising following surgery that will improve over approximately 3 weeks.
- You may begin showering in 48 hours after surgery. When showering, wash all areas with soap and water, and pat dry with a towel. It is important that you do not submerge your surgical incision in water (i.e. no bath tubs, swimming pools, etc.).
- Sutures will be absorbable. Follow up appointments will typically be scheduled in weekly and then two-week intervals. You may begin scar massage and use of scar creams approximately 3 weeks after surgery.
- 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 necklift, blepharoplasty, fat grafting, laser resurfacing and brow lift.
Postoperative restrictions are as follows:
- No heavy lifting, pushing, or performing any activities.
- No submerging incision sites (i.e swimming) for a minimum of 3 weeks, no sweat producing activities for a minimum of 3 weeks, light activity for 3 weeks.