Enhancing your appearance with a facelift

If you are bothered by the signs of aging in your face, a facelift may be right for you.
Technically known as rhytidectomy, a facelift is a surgical procedure to improve visible
signs of aging in the face and neck, such as:

• Sagging in the midface
• Deep creases below the lower eyelids
• Deep creases along the nose extending to the corner of the mouth
• Fat that has fallen or is displaced
• Loss of muscle tone in the lower face may create jowls
• Loose skin and excess fatty deposits under the chin and jaw can make even a
  person of normal weight appear to have a double chin

Rejuvenation procedures typically performed in conjunction with a facelift are brow lift,
to correct a sagging or deeply furrowed brow, and eyelid surgery to rejuvenate aging
eyes.What it won’t do: As a restorative surgery, a facelift does not change your
fundamental appearance and cannot stop the aging process.

A facelift can only be performed surgically; non-surgical rejuvenation treatments cannot
achieve the same results, but may help delay the time at which a facelift becomes
appropriate and complement the results of surgery.

Is it right for me?

A facelift is a highly individualized procedure and you should do it for yourself, not to
fulfill someone else’s desires or to try to fit any sort of ideal image.

Facelift surgery is a good option for you if:

• You are physically healthy
• You don’t smoke
• You have a positive outlook and specific, but realistic goals in mind for the
  improvement of your appearance

What to expect during your consultation

The success and safety of your facelift depends very much on your complete candidness
during your consultation. You’ll be asked a number of questions about your health,
desires and lifestyle.

Be prepared to discuss:

• Why you want the surgery, your expectations and desired outcome
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco
  and drugs
• Previous surgeries

Your surgeon may also:

• Evaluate your general health status and any pre-existing health conditions or
  risk factors
• Discuss the options available to you for facelift and facial rejuvenation
• Examine and measure your face
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of a facelift and any risks or potential complications
• Discuss the type of anesthesia that will be used

Preparing for surgery

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they
  can increase bleeding

Special instructions you receive will cover:

• What to do on the night before and morning of surgery
• The use of anesthesia during your face lift
• Post-operative care and follow-up
  

Your plastic surgeon will also discuss where your procedure will be performed. A facelift
may be performed in an accredited office-based surgical center, outpatient or ambulatory
surgical center, or a hospital.

You’ll need help

If your facelift is performed on an outpatient basis, be sure to arrange for someone to
drive you to and from surgery and to stay with you for at least the first night following
surgery.

What happens during facelift surgery?

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The
choices include intravenous sedation and general anesthesia. Your doctor will
recommend the best choice for you.

A variety of other procedures can further enhance the outcome of a facelift. They
include:

• Facial implants
• Soft tissue augmentation to recontour the facial structure
• Resurfacing techniques to improve the tone and texture of facial skin
• Wrinkle reduction by injection

Step 2 – The incision

Depending on the degree of change you’d like to see, your facelift choices include a
traditional facelift, limited incision facelift or a neck lift.

A traditional facelift incision often begins in the hairline at the temples, continues
around the ear and ends in the lower scalp. Fat may be sculpted or redistributed from
the face, jowls and neck, and underlying tissue is repositioned, commonly the deeper
layers of the face and the muscles are also lifted.

Skin is redraped over the uplifted contours and excess skin is trimmed away. A second
incision under the chin may be necessary to further improve an aging neck. Sutures or
skin adhesives close the incisions.

Traditional Facelift

An alternative to a traditional facelift uses shorter incisions at the temples, continuing
around the ear and possibly within the lower eyelids or under the upper lip.

Limited Incision

Sagging jowls, loose neck skin and fat accumulation under the chin may be corrected
with a neck lift. The neck lift incision often begins in front of the ear lobe and wraps
around behind the ear ending in the lower scalp.

Neck Lift

Step 3 – Closing the incisions

Once healed, the incision lines from a facelift are well concealed within the hairline
and in the natural contours of the face and ear.

Step 4 – See the results

The visible improvements of a facelift appear as swelling and bruising subside. Your
final result should not only restore a more youthful and rested appearance, but also
help you feel more confident about yourself.

The decision to have a facelift is extremely personal and you’ll have to decide if the
benefits will achieve your goals and if the risks and potential complications are
acceptable.
Your plastic surgeon and/or staff will explain in detail the risks associated with surgery.
You will be asked to sign consent forms to ensure that you fully understand the procedure
you will undergo and any risks and potential complications.

The risks include:

• Unfavorable scarring
• Bleeding (hematoma)
• Infection
• Poor wound healing
• Anesthesia risks
• Correctable hair loss at the incisions
• Facial nerve injury with weakness
• Facial asymmetry
• Skin loss
• Numbness or other changes in skin sensation
• Fatty tissue found deep in the skin might die (fat necrosis)
• Fluid accumulation
• Pain, which may persist
• Skin contour irregularities
• Skin discoloration, sensitivity or swelling
• Sutures may spontaneously surface through the skin, become visible or produce
  irritation that require removal
• Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location,
  unacceptable visible deformities at the ends of the incisions (It may be necessary
  to perform additional surgery to improve your results)
• Deep vein thrombosis, cardiac and pulmonary complications
• Possibility of revisional surgery

A special note about the use of fibrin sealants (tissue glue)

Fibrin sealants (made from heat-treated human blood components to inactivate virus
transmission) are used to hold tissue layers together at surgery and to diminish
post-operative bruising following surgery.

This product has been carefully produced from screened donor blood plasma for
hepatitis, syphilis, and human immunodeficiency virus (HIV). These products have
been used safely for many years as sealants in cardiovascular and general surgery.
This product is thought to be of help in diminishing surgical bleeding and by adhering
layers of tissue together.

When you go home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical
attention immediately. Should any of these complications occur, you may require
hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results
are expected, there is no guarantee. In some situations, it may not be possible to
achieve optimal results with a single surgical procedure. Another surgery may be
necessary.

Be careful

Following your physician’s instructions is key to the success of your surgery. It is
important that the surgical incisions are not subjected to excessive force, abrasion,
or motion during the time of healing. Avoid wearing any clothing that must go over
your head. Your doctor will give you specific instructions on how to care for yourself.

When your procedure is completed, a bandage could gently be placed around your
face to minimize swelling and bruising. A thin tube may be present to drain any excess
blood or fluid that may collect under the skin.

Be sure to ask your plastic surgeon specific questions about what you can expect
during your individual recovery period.

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery? When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

The results will be long-lasting

It may take several months for swelling to fully dissipate and up to 6 months for incision
lines to mature.

Life-long sun protection will help to maintain your rejuvenated appearance by
minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help
extend the results of your rejuvenated, more youthful appearance.

How much will facelift surgery cost?

Cost is always a consideration in elective surgery. Prices for facelifts can vary widely.
A surgeon’s cost for facelift surgery may vary based on his or her experience as well
as geographic office location.

Many plastic surgeons offer patient financing plans, so be sure to ask. Cost may include:

• Surgeon’s fee
• Hospital or surgical facility costs
• Anesthesia fees
• Prescriptions for medication
• Post-surgery garments, and
• Medical tests

Your satisfaction involves more than a fee

When choosing a plastic surgeon for facelift surgery, remember that the surgeon’s
experience and your comfort with him or her are just as important as the final cost
of the surgery.

• General anesthesia: Drugs and/or gases used during an operation to relieve pain
  and alter consciousness.
• Hematoma: Blood pooling beneath the skin.
• Intravenous sedation: Sedatives administered by injection into a vein to help
  you relax.
• Tear trough: Deep creases below the lower eyelids.
• Nasolabial fold: Deep creases between the nose and cheek
• Jowls: A jaw line that sags into the neck, usually caused by loss of muscle tone
  in the lower face.
• Local anesthesia: A drug injected directly to the site of an incision during an
  operation to relieve pain.
• Rhytidectomy: A surgical procedure also known as facelift, to reduce sagging
  of the mid-face, jowls and neck.