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A facelift is a surgical procedure to reverse the agingsigns in the face and the neck in which sagging facial skin is elevated, pulledupwards, and sutured back. By removing excess skin and fat from the face and/orneck, the procedure reduces or eliminates many wrinkles, giving patients ayounger, rejuvenated appearance.   The word “rhytidectomy” derives from the Greek “rhytis,”meaning wrinkle, and “ektome,” which means excision: excision of skin to removewrinkles. While the operation originally entailed tightening just the skin, itsoon became clear that significant, lasting results required that deeper layersof tissue also be restructured or excised. Today the operation incorporatesplastic surgery techniques addressing the layers under the skin, and issometimes called rhytidoplasty. The term facelift applies to thearea from the cheeks down to the neck; the eyes and the forehead are treated inseparate procedures (although they may be performed concurrently).  How is a facelift performed? Facelifts usually begin with an incision at the temples justabove the hairline.

This incision is extended downwards in front of the ear,below the earlobe, and behind the ear. Placement varies slightly between menand women.  The surgeon then separates the skin of the face and themuscle from deeper tissues.  Depending onthe person’s needs, tissues are reshaped and/or excised.

In some cases the surgeon may perform liposuction to removeexcess fat from the cheeks, nasolabial fold, or chin, for example.  The underlying muscle may be tightenedseparately, or in conjunction with the skin. The skin is then redraped in itsnew position and sutured, either with stitches or staples.  Some patients opt to undergo concurrent procedures such aseyelid tightening (blepharoplasty),chin implants, or forehead lifts (in which the skin of the forehead istightened in the same fashion as during a facelift).

Surgeons in thisdepartment perform endoscopic brow lifts, a minimally invasive technique thatminimizes scarring and side effects.  Drainage tubes may be placed beneath the neck skin or behindthe ears to minimize swelling during the initial recovery period. The surgeryusually takes several hours to perform.  Anesthetics during Facelifts In our department, we often perform facelifts using generalanesthesia.  Recovering from a Facelift After surgery, patients will experience swelling of the faceand eyelids, and marked discoloration.  Alarge fluffy dressing is applied after surgery, and this is replaced by a thinelastic wrap after the first day. Pain is usually surprisingly moderate andeasily controlled with medications.

Pain in and around the ears is also commonduring the first two weeks.   Patients should rest with their head elevated for thefirst 2 days. By the 2nd or 3rd day, patients may showerand shampoo (carefully).  Strenuousactivity must be avoided until swelling and bruising have subsided, which maybe approximately 4 to 6 weeks.  Patients look and feel much better after two weeks. The skinmay be dry and rough for several months, and hair near the temples may be thin.

Men whose beard-growing skin has been moved may need to shave in new placessuch as behind the neck or ears.   How effective are facelifts? Most patients are very happy with their results. Patientscan expect many wrinkles to be reduced or eliminated, and to appear youngerthan before surgery.

Every single wrinkle will not be eliminated, however,especially more superficial ones. Final results will depend on factorsincluding prior sun damage, smoking status, age, aging rate, and type of skin.Patients may wish to consider subsequent treatment of superficial wrinkles withtechniques such as chemical peels, dermabrasion, or laser resurfacing.  It is not possible to say how long the effects of a faceliftwill last, but some degree of rejuvenation will be permanent. It is importantto understand that while facelifts bring the skin back to an earlier stage inthe aging process, it can not stop the aging process from occurring.

Skin agingand stretching will take place, and some looseness of the neck may becomeapparent within three months. Those with very loose skin in the neck mayrequire a second operation to achieve optimal results.  What are the risks associated withfacelift? As with any surgery, facelift involves some risks.

Theprimary risks are swelling, bruising, bleeding, scarring, or injury to the 7thcranial nerve (controlling movement of the face). Such injury may causenumbness or pain.    Facelifts and Smoking Smokers are at risk for skin loss during facelifts.

Becausenicotine and carbon monoxide reduce skin oxygen levels and the flow of skininto skin flaps, approximately one in ten smokers will experience death of skincells at the incision site. Avoiding smoking for two to four weeks prior tosurgery and a month after surgery can improve, but will not eliminate, thisrisk. About our Physicians All surgeons in this division arecertified otolaryngologists who have done additional fellowship training infacial plastic and reconstructive surgery, and are board certified by the American Academy of Facial Plastic andReconstructive Surgery.

Having limited the scope of their practice solely tothe face, they offer the highest level of knowledge and experience availableanywhere.  

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