Face Lift

FACE LIFT (Rhytidectomy)

As people grow old, the effects of gravity, the exposure to sun rays and daily stress may be reflected in the face.

Deep wrinkles appear between the nose and the mouth, cheeks become loose and fat deposits in the chin and around the neck.

The face lift (technically known as rhytidectomy) cannot stop the aging process, but it can put the clock back and improve the most visible imperfections by removing the excess of fat, tensing underlying muscles and redesigning face and neck skin. It may be performed alone or together with other procedures, such as frontal lifting, eyelid surgery or nose reconstruction.

 

The best patients for lifting

It is recommended for men or women with faces and eyelids that have started to hang, but who have elastic skin with strong and well-defined bone structures. Most patients are 40-60 years old, although the surgery is also successful for those in their seventies or eighties.

Face lifting may enhance your appearance and improve your self-esteem but it cannot make a dramatic change or restore your health or youth vigor. Before deciding to choose this procedure, think about your expectations carefully and analyze them with your surgeon.

When this procedure is carried out by competent surgeons, complications are rare and the number of such complications is usually low. However, there are risks inherent to any surgery, such as hematomas (blood under the skin that must be extracted by the surgeon), damage to facial nerves controlling face muscles (which are temporary in almost all cases), infections and reactions to anesthesia. In the case of smokers, the recovery may be poor. Reduce risks by strictly following all surgeon’s indications.

Getting ready for surgery

Face liftings are very personal. In the initial consultation, the surgeon will examine your skin and underlying bones, and will speak about post-surgery goals.

Your medical history will be examined to see if there are any medical conditions that may affect surgery or post-surgery, such as incontrollable high blood pressure, problems with blood cots or a tendency to form excessive scars. Tell your physician whether you smoke or take any drug or medication, especially aspirins or other drugs that may affect blood coagulation.

Should you choose this procedure, the surgeon will explain to you the techniques and anesthesia to be used. Do not hesitate to express all your doubts during this first interview, including all your concerns regarding recommended treatment or costs.

Your surgeon will give you specific instructions, including guidelines as to food, smoking and taking or avoiding certain medicines or vitamins. Following these instructions strictly will lead to a successful surgery.

If you smoke, it is fundamental that you quit it at least two weeks previous to and after surgery because it prevents blood from flowing towards skin and it could interfere with incisions recovery.

If you have short hair, let it grow to conceal post-surgery scars.

Either in the case of an ambulatory or in-hospital surgery, you should count on someone to take you home and help you during the first or second day, if necessary.

Facelift should be made in a specialized clinic, being hospitalized during one night, especially to monitor patients with diabetes or high blood pressure.

Most of these procedures are carried out with local anesthesia, combined with a sedative to be relaxed and feel no pain. You could experience occasional discomfort that may be avoided with medication. Should general anesthesia be used, you will be able to sleep during the whole procedure.

Surgery

Face lift surgery takes a few hours, and some surgeons schedule it in two sessions.

Each plastic surgeon uses its own system, completing one side of the face first and then following with the other, while others go from one side to the other as surgery progresses. The exact location of incisions will depend on the specific conditions of the face of each patient and the surgical technique used.

In general, incisions begin in the temple behind the hair line, following a natural line in front of the ear (or inside the cartilage in front of the ear) to continue behind the lobe towards the scalp. Should the neck be corrected as well, a small incision could be made under the chin.
The surgeon separates skin from the fat or muscle under it. Fat may be cut up or sucked through ultrasound-assisted liposuction, making simultaneous extractions around the neck and chin to improve the profile.

Underlying muscles are tensed, the skin is drawn backwards and any excess of skin is removed.

A few stitches tighten the different layers of tissue and close incisions, and metal clips may be used in the scalp.

After surgery, a small drainage is placed under the skin behind the ear to extract any blood deposits. The head is bandaged to minimize swelling.

After the procedure

No significant discomfort appears after surgery and, if any, it may be relieved with medication prescribed by the surgeon.

In case of a serious and persistent pain or a sudden face swelling, call your surgeon immediately.

Slight face numbness is quite normal and it will disappear after a few weeks.

The patient must keep its head up for two or three days after the procedure to reduce swelling.

The drainage will be removed after one or two days, and bandages and stitches, from two to five days after the procedure. Do not be surprised if your face looks pale and swollen; it will all disappear after a few weeks. The scalp will take longer to cicatrize and, later on, stitches and clips will be removed.

Back to normal

You will be able to walk from one place to the other in one or two days, but take into account that you will be able to resume your normal activities in a week. Take special care of your face and hair because your skin will be very sensitive and a little numb.

Your surgeon will give you more specific instructions to resume your normal activities gradually, although strenuous activities should be avoided, such as heavy household chores or sexual activities for at least two weeks, although walks and light elongations are permitted. Avoid alcohol, Turkish baths or sauna for a few weeks, and exposure to sun rays for a few months. Above all, rest and allow your body to spend its energies in healing.

At the beginning, your face will look and feel strange. Your swollen features, stiff facial movements and scars will be noticeable. Some bruises may remain for two or three weeks, and maybe you will get tired quickly. Most patients usually feel disappointed and depressed at the beginning.

But after three weeks, you will begin to feel and look better. You can go back to work in two or three weeks after surgery, and makeup will improve your appearance considerably.

Your new appearance

If you understand that the results of face lifting are not visible immediately, you will be delighted with them. Even after swelling and bruises disappear, the hair around your temples will be a little scarce and you will feel your skin dry and rough for a few months. Men will discover that they have to shave themselves in places other than the traditional ones (behind the ear and the neck) due to the new location of these areas.

As a result of lifting, you will have some scars hidden by hair or in the natural lines of your face and ears. Anyway, they will disappear with the lapse of time.

The lifting does not stop time. Your face will continue to grow old and, maybe, you may want to repeat surgery once or more times after five or ten years.

Face lifting effects are lasting. Years after surgery, you will continue to look better than if you had never done it.