Rhy tidectomy is the technical name for facelift surgery. A facelift surgery removes extra facial skin with or without tightening of underlying facial tissues and makes a person look younger. With age a person’s face loses elasticity and becomes loose with simultaneous loss of fat and muscle tone.
Facelifts are suitable for correcting loose skin & folds in the face, neck and cheeks. The areas like nasolabial folds and perioral mounds marionette lines are not adequately treated by facelifts and are usually treated with Botox or fillers. Crepe wrinkles about the eyes are treated with the CO2 laser or radiofrequency tightening (ThermiSmooth). Sagging of the forehead skin is a forehead lift and excess hanging skin of the upper lid is called a blepharoplasty. Large fatty bulges below the eys are treated with lower blepharoplasty.
The Procedure- A facelift procedure is normally executed by making an incision at the hairline in front of, around the lower border and in the crease behind the ear. The incision is made around and up behind the ear till reaching the hairline behind the ear so the ending scar is minimally visible. The facial and neck skin with the fatty tissue are then lifted up from the underlying muscle and fascia over the cheeks and neck as far as required in order to correct the looseness of the skin. The exposed muscle and fascia are tightened with sutures with what is called a SMAS plication suturing technique with or without removing the extra muscle and fascia. . The skin is then pulled back to drape it gently over the now suspended deeper tissues. The excess skin is cut off and the skin incisions are closed by sutures. Sometimes a drain in the wound is necessary to allow excess blood-tinged fluids to flow out. The bandages are then put on. There are also surgical techniques which allow surgeons to go under deeper tissues instead of merely going under skin and fat.
A facelift is usually performed under general anesthesia or “deep twilight sleep” which is also known as awake surgery with deep sedation.
Considerations- The extent of skin that is to be removed is a crucial factor that decides greatly the success and naturalness of the facial lift procedure. Much also depends on the surgeon’s experience and judgement. If the skin is removed a little too much and pulled excessively, problems can happen. The sideburns in men and the corners of the mouth in men and women may be pulled backwards and upward; the incorrect pull may result in an earlobe being pulled forward or distorted. All of these may result in an unnatural appearance which is known as “pulled back” or “windswept” appearance, all of which are avoided as much as possible. This appearance may also be caused due to bone structure changes that occur with age.
To achieve the best results, some additional procedures may be required and these are- Neck lift, eyelid surgery (blepharoplasty), forehead lift, brow lift, cheek (malar) and Chin (submalar) implants, liposuction, autologus fat injection, removal of buccal(cheek) fat pad, chemical or laser peel. The results of facelift surgery normally last for about five to ten years. Most of the time, the results of a facelift surgery are very satisfying and the surgery helps the patients to attain very youthful appearance.
Recovery- The surgery is performed at our outpatient surgical center which is well equipped and AAAHC accredited. Pain and discomfort after the surgery are normally not severe and treated with pain medications as needed. The dressings are usually removed after 3 to 5 days and the recovery time is about one week or so, even though some activities may be resumed after one day of the surgery.
Contraindications- Like in any other surgery, facelift surgery has some risks and infrequent but possible complications. Some of the complications that may arise, although infrequently, are: reaction to anesthesia or sedatives; bleeding, hematoma, bruising; infection; skin necrosis; asymmetry; neurological dysfunction; thickened scar.
The risks of post operative complications are increased for smokers and those with hypertension and diabetes. The patients are advised not to take aspirins and any other blood thinning medications much before or after the surgery. The patients are also advised to consult with their surgeons on the contraindications and how to minimize the risks of their occurrences.
Deficiencies – There are certain enhancements of the face that a facelift cannot adequately treat. One is volume to the face. As we age, we lose volume in the midface area. This can only be treated using facial fillers or fat, which can be done at the time of a facelift, or as an outpatient in a single procedure. Second, a facelift cannot adequately treat certain wrinkles of the face, such as under the eyes or around the lips. These must be lasered for adequate treatment.
Other Options – Many people are wanting “facelift” benefits without undergoing surgery. There are multiple noninvasive options for people. Restoring volume and reducing wrinkles are parts of a new type of procedure called the liquid facelift. Combining Botox plus Facial Fillers or fat grafting can provide remarkable results without the downtime of a surgical facelift. Laser resurfacing can smooth wrinkles, decrease pigmentations and provide overall smoother skin while stimulating the formation of collagen to take years off the face for a much younger look. See our Facial Rejuvenation page for options for you.