Over time, the effects of gravity, sun exposure, and hereditary factors show in the form of signs of old age on our faces. Growing old has been one of the biggest worries for the human race since ages and a search for ‘Fountain of youth’ remained elusive in mankind’s history till now. Surgical Face-lift is one such procedure, which is quite popular among men and women over the age of 45 to get back a youthful look. With this surgical technique, excess fat and skin are removed as well as tightening of facial skin and muscles is done, resulting in the elimination of most wrinkling and sagging and improvement of the aged appearance of the face. Latest techniques now give safe, natural looking and longer lasting results with much less downtime than before.
Q: Who are the ideal candidates for Facelift surgery and how is it planned?
A: The ideal candidates for Rhytidectomy or Facelift surgery have signs of facial aging in the form of skin sagging with some skin elasticity still maintained. People in 50-70 years age group are candidates for this surgery. A person undergoing facelift surgery should be in good general health and have realistic expectations from this surgery. A facelift works best in patients with thin skin and good bone structure. It eliminates the loose skin folds in the neck and wrinkles in the cheeks. The nasolabial folds and marionette lines do not correct very well with a facelift. Contraindications to facelift surgery include severe medical problems. Relative contraindications are cigarette smoking and patients with hypertension and diabetes. Patients should stop taking aspirin or other blood thinners before surgery at least one week before surgery.
Q: How is Facelift surgery performed?
A: The Face Lift procedure, also known as Rhytidectomy, involves separating the facial skin from the underlying fat and muscle layer, tightening of facial muscle layer (SMAS) and removing the excess skin. The incisions are placed within the hairline starting at the temples, running just in front of the ear and continuing around the bottom of the earlobe & going behind the ear into the hairline. All incisions are placed in a manner so that they are nearly invisible on healing. The skin is pulled in backward & upward direction; excess skin removed, facial muscle layer tightened and the wound is closed with fine sutures. A small drain is placed under the skin to avoid collection of blood or serum. The final result is a lift of sagging components of the face with smoother, tighter skin.
Q: What other procedures can be combined with facelift surgery?
A: Excess skin and wrinkling of the neck also get corrected in the same sitting by an additional neck-lift procedure. A Face-lift will not remove forehead lines, bags under the eyes or crow’s feet. The eye bags can be treated at the same time with eyelid surgery or Blepharoplasty. Forehead lines, crow feet lines, and brow sagging can be corrected with anti-wrinkle injection treatment.
Q: What type of anesthesia is used in the surgery?
A: The procedure is usually performed under general anesthesia but can be performed using a local anesthetic with intravenous sedation.
Q: How much time does Rhytidectomy or Facelift surgery take?
A: Rhytidectomy or Facelift surgery takes about 2-3 hours and it may take longer if Blepharoplasty surgery is combined in the same sitting. The patient can be discharged in the evening or a one-day hospitalization is advised. Suction drain, if placed, is removed after 24 hrs.
Q: What are the precautions and postoperative care after Rhytidectomy or Facelift surgery?
A: After Rhytidectomy or Facelift surgery, bruising or swelling appears within 1-2 days and resting with the head elevated and applying cold compresses will help to minimize this. Antibiotics and analgesics are prescribed during the first 4 days for quick and pain-free healing. For the first week after surgery, rigorous activity should be avoided. A facial garment or chinstrap is advised for 2 weeks. Stitches are removed after 7 days. In 2-3 weeks, one can resume most of normal activities and results will continue to improve for 6 to 12 months.
Q: What are the risks or complications from this surgery?
A: Risks and complications with this surgery are minimal. Swelling and bruising are common with Facelift surgery and there is a minimum risk of infection. Facelift surgery in the hands of an experienced Plastic surgeon is a very safe procedure with minimal risks or side effects. A facelift gives long scars. However, the portion of the scars in front of the ear is not very prominent. The scar behind the ear is well hidden. In men, the sideburns can be pulled backward and upwards giving an unnatural appearance. Sometimes one or both earlobes may be pulled downwards and/or distorted. Too much tightening of skin can give a “windswept" appearance to face. The rare complications include bleeding and formation of hematoma under skin flap which needs early evacuation, damage to the facial nerve branches and necrosis of the skin flaps, especially in smokers.