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Facelift

The facelift, also known, as a rhytidectomy is a type of cosmetic surgery proposed to give a more youthful appearance of the face. It usually involves the removal of excess facial skin, with or without the tightening of underlying tissues. According to the most recent 2008 statistics from the American Society for Aesthetic Plastic Surgery, facelifts were the sixth most popular aesthetic surgery performed after breast augmentation, liposuction, eyelid surgery, abdominoplasty or tummy tuck, breast reduction, and nasal surgery. Many patients are fearful of facelifts because of the lately well-publicized potential for unnatural appearance and the possibility of visible complications, which may explain why facelifts are not more frequently performed. If done correctly however, the results can provide a natural youthful appearance.

In the traditional facelift, an incision is made in front of the ear extending up into the hairline. The incision curves around the bottom of the ear and then behind it, usually ending past the hairline on the back of the neck. After the skin incision is made, the skin is separated from the deeper tissues. The extent of this elevation and the depth at which it is performed depends on the procedure proposed, the surgeon’s preference, his or her training and experience. At this point, the deeper tissues may be tightened with sutures, with or without removing some of the excess deeper tissues. The skin is then re-draped, and the amount of excess skin to be removed is determined by the surgeon's judgment and experience. The excess skin is then removed, and the skin incisions are closed with sutures and staples.

Facelifts are helpful for eliminating loose skin folds in the neck and laxity of tissues in the cheeks. The areas not well corrected by a facelift include the nasolabial folds, perioral mounds or marionette lines or lines around the lips. Although facelift requires skin incisions, which results in permanent scars, those scars in front of and behind the ears, if done correctly, usually become inconspicuous over a period of time. Hair loss in the portions of the incision within the hair-bearing scalp can rarely occur. In men, the sideburns can be pulled backwards and upwards, resulting in an unnatural appearance if appropriate techniques are not employed to address this issue. In both men and women, signs of having had a facelift can be a pulled-back, "windswept" appearance, widening of the corners of the mouth, visible lines of pull especially with movement of the face, and visible scars.

Facelifts are effectively combined with eyelid surgery (blepharoplasty) and other facial procedures and are typically performed under general anesthesia or deep twilight sleep.
Contraindications to facelift surgery include severe concomitant medical problems. While not absolute contraindications, the risk of postoperative complications is increased in cigarette smokers and patients with hypertension and diabetes. Patients are typically asked to abstain from taking aspirin or other blood thinners for at least one week prior to surgery.

Aging of the face

Regrettably, correction of facial aging is a difficult process. That maybe why there are so many proposed surgical procedures for the restoration of the youthful face. In fact the best way to unravel this confusion maybe in understanding the aging process.

Aging of the face is a combination of factors that affect multiple areas. Skin changes, internal weakening of support structures, and the gradual effects of gravity take a combined toll that results in the aging face.

In this series of photographs of the same person in different decades of her life, the aging process is graphically seen. There is a gradual thinning of the skin, slow descent of the cheeks, known medically as the mid-face, and a visible loss of definition of the neck. With the decent of the cheeks several secondary changes occur. This includes a visual lengthening of the lower eyelids, a deeper appearance of the nasolabial fold, the appearance of jowls, and a widening of the lower third of the face.

Other changes include excessive upper lid skin, and descent of the eyebrows. In those patients that have significant mid-face descent, the only way to correct all the effects of that mid-face descent to the anatomic repositioning of the mid-face back to it’s original youthful position. That repositioning requires the vertical repositioning of the soft tissue toward the lower eyelids lids. Any repositioning other than in a direct vertical direction takes the soft tissue out of its normal youthful position and distorts the facial soft tissue giving the face an abnormal appearance.

Types of Facelifts

The type of procedure that is best suited for each patient depends on the extent of aging, the individual’s anatomy and the patient’s desired results. It is important to realize that each surgeon may have preferences as to the type of procedures depending of his or her training, previous experience and comfort level in facial surgery. In those cases the surgeon may direct the patient to one type of procedure whether it is appropriate or not. It is very important that the type of procedures proposed address the specific facial aging, its extent and the patient’s desires. In all cases the patient should ask themselves: what has changed in my face and does the specific procedure propose take the structures back to their youthful position?

Commercial Lifts

Commercial lifts or Branded lifts have become a popular attempt to lessen recovery and have the same results as traditional lifts. They are usually advertised through infomercials. Unfortunately these lifts do not have a scientific basis behind them. There has been very little unbiased reviews written about their results and their long term effectiveness. The companies try to have a catchy name and use a hard sell to increase costs to the patients. The most notarized of these lifts include the Quick lift of Lifestyle lift. It is concerning that there have been no long term unbiased scientific review of these procedures while patients are tempted by the idea of short recovery for significant results. It is very important that patients investigate and evaluate any proposed procedure for its scientific basis and its potential to correct the issues they are seeking to improve.

Laser lifts

Recently lasers have been touted to reproduce facelift results without significant recovery. These lasers use longer wave lengths in an attempt to heat the underlying collagen which then contracts thus producing skin tightening. To an extent this may help some of the fine lines of the skin but there has been no laser that has been shown to truly produce directional lift of the aging face. Many patients spend thousands of dollars without achieving results. Lasers are best use to reduce the effects of sun damage on the skin and to potentially reduce the visible fine lines which a face lift may not completely resolve.

Natural Looking Designed To You.

Although each person's results will differ, before and after photos are good examples of potential changes. They should be used not only as a comparison of techniques and surgeons, but are good starting points for evaluation, comparison and discussion with your surgeon. Please note that these are post surgical photos that are not suitable for all audiences. Viewers should be 18 or older to view the gallery images.

See More Before and After Photos >

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Anesthesia and Surgery Facility

In most instances the procedure is done under general anesthesia but depending on the patient’s desires it may be done under local anesthesia with some type of sedation.

Side Effects

There is expected temporary discomfort, swelling, and bruising. A temporary feeling of tightness may also be possible.

Smoking

Smoking may be one of the most important factors that increase the risk to facial surgical complications. If you are a smoker, you will need stop smoking for least two weeks before the surgery and two weeks after. You must not smoke for this time period to ensure proper healing, because cutting down is not adequate. Nicotine gum and nicotine skin patches can lead to the same healing problems caused by smoking.

Other Medications:

Some medications that increase bleeding times may add to the risk of bleeding during any surgery but especially during facial surgery. It is important to discuss all medications that you are taking both prescription and over the counter.

Risks

These include infection, pooling of blood beneath the skin (hematoma), and loss of sensation.

Recovery

Bruising is usually minimal but may last 2-3 weeks. The patient is usually asked to limit motion of the neck over the same period of time. The neck may feel numb for several months.

Duration of Results

Results may be enjoyed for 7 to 10 years.

Aesthetic and Reconstructive Surgery Associates, S.C.
10554 N. Port Washington Rd., Mequon, Wisconsin 53092
ph. 414.352.2766 | info@drjohnyousif.com