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Some of the most
visible signs of aging first appear on the face. As people age, the effects of
gravity, exposure to the sun, and the stresses of daily life can be seen in
their faces. Deep creases form between the nose and mouth; the jawline grows
slack and jowly; folds and fat deposits appear around the neck. If you'd like to
look as good as you feel, a facelift can help.
A facelift (technically known as rhytidectomy) can't stop this aging process.
What it can do is "set back the clock," improving the most visible
signs of aging by smoothing the loose skin on your face, removing excess fat,
and tightening underlying muscles. A facelift can be done alone, or in
conjunction with other procedures such as a forehead lift, eyelid surgery, or
nose reshaping.
If you're considering a facelift, this page will give you a basic understanding
of the procedure. It can't answer all of your questions, since a lot depends on
the individual patient and the doctor's suggestions. Please ask Dr. Graham about
anything you don't understand.
Candidates
for a facelift
The best candidate for a
facelift is a man or woman whose face and neck have begun to sag, but whose skin
still has some elasticity and whose bone structure is strong and well-defined.
Facelifts are most commonly performed on patients in the 40-60 age range.
However the procedure can produce good results for people in the sixties,
seventies and eighties as well
A facelift can make you look younger and fresher, and it may enhance your
self-confidence in the process. But it can't give you a totally different look,
nor can it restore the health and vitality of your youth. Before you decide to
have surgery, think carefully about your expectations and discuss them with Dr.
Graham.
You may be a good
candidate for a facelift if you have any of the following types of conditions:
-
A
deep line that runs from the corner of your nose to the corner of your mouth
-
Loss
of a well-defined jawline
-
Deep
wrinkles in the cheeks and sagging skin near the cheekbones
-
Loose
skin, wrinkles or excess fatty tissue in the neck
When a facelift is
performed by a qualified plastic surgeon, complications are infrequent and
usually minor. Still, individuals vary greatly in their anatomy, their physical
reactions, and their healing abilities, and the outcome is never completely
predictable. Complications that can occur include hematoma, injury to the nerves
that control facial muscles (usually temporary), infection, and reactions to the
anesthesia. Poor healing of the skin is most likely to affect smokers. You can
reduce your risks by closely following Dr. Graham's advice both before and after
surgery.
Planning
your facelift surgery
Facelifts are very individualized procedures. In your initial consultation Dr.
Graham will evaluate your face, including the skin and underlying bone, and
discuss your goals for the surgery. He will check for medical conditions that
could cause problems during or after surgery, such as uncontrolled high blood
pressure, blood clotting problems, or the tendency to form excessive scars. Be
sure to tell him if you smoke or are taking any drugs or medications, especially
aspirin or other drugs that affect clotting.
If you decide to have a facelift, Dr. Graham will explain the techniques and
anesthesia he will use, the type of facility where the surgery will be
performed, and the risks and costs involved. Don't hesitate to ask if you have
any questions, especially those regarding your expectations and concerns about
the results.
Preparing
for surgery
Dr. Graham will give you specific instructions on how to prepare for surgery,
including guidelines on eating and drinking, smoking, and taking or avoiding
certain vitamins and medications. Carefully following these instructions will
help your surgery go more smoothly. If you smoke, it's especially important to
stop at least a week or two before and after surgery; smoking inhibits blood
flow to the skin, and can interfere with the healing of your incision areas. If
your hair is very short, you might want to let it grow out before surgery, so
that it's long enough to hide the scars while they heal.
A facelift may be performed in Dr. Graham's Boca Raton office-based facility, an
outpatient surgery center, or a hospital. It's usually done on an outpatient
basis, but some surgeons may hospitalize patients for a day when using general
anesthesia. Certain conditions such as diabetes or high blood pressure should be
monitored after surgery, and may also require a short inpatient stay.
Whether your facelift is being done on an outpatient or inpatient basis, you
should arrange for someone to drive you home after your surgery, and to help you
out for a day or two if needed.
TYPES OF ANESTHESIA
Most facelifts are performed under local anesthesia, combined with a sedative to
make you drowsy. You'll be awake but relaxed, and your face will be insensitive
to pain. You may ask for general anesthesia. In that case, you'll sleep through
the operation.
Facelift
Surgery
A facelift usually takes several hours-or somewhat longer if you're having more
than one procedure done. For extensive procedures, Dr. Graham may schedule two
separate sessions.
The exact placement of incisions and the sequence of events depends on your
facial structure and Dr. Graham's technique.
Incisions usually begin above the hairline at the temples, extend in a natural
line in front of the ear (or just inside the cartilage at the front of the ear),
and continue behind the earlobe to the lower scalp. If the neck needs work, a
small incision may also be made under the chin.
In general, the doctor separates the skin from the fat and muscle below. Fat may
be trimmed or suctioned from around the neck and chin to improve the contour.
The surgeon then tightens the underlying muscle and membrane, pulls the skin
back, and removes the excess. Stitches secure the layers of tissue and close the
incisions; metal clips may be used on the scalp.
Following surgery, a small, thin tube may be temporarily placed under the skin
behind your ear to drain any blood that might collect there. Dr. Graham may also
wrap your head loosely in bandages to minimize bruising and swelling.
After
your facelift
There isn't usually significant discomfort after surgery; if there is, it can be
lessened with the pain medication prescribed by Dr. Graham. (Severe or
persistent pain or a sudden swelling of your face should be reported to your
surgeon immediately.) Some numbness of the skin is quite normal; it will
disappear in a few weeks or months. Dr. Graham may also tell you to keep your
head elevated and as still as possible for a couple of days after surgery, to
keep the swelling down.
If you've had a drainage tube inserted, it will be removed one or two days after
surgery. Bandages, when used, are usually removed after one to five days. Don't
be surprised at the pale, bruised, and puffy face you see. Just keep in mind
that in a few weeks you'll be looking normal. Most of your stitches will be
removed after about five days. Your scalp may take longer to heal, and the
stitches or metal clips in your hairline could be left in a few days longer.
Getting
back to normal
You should be up and about in a day or two, but plan on taking it easy for the
first week after surgery. Be especially gentle with your face and hair. Dr.
Graham will give more specific guidelines for gradually resuming your normal
activities. They're likely to include these suggestions: Avoid strenuous
activity, including sex and heavy housework, for at least two weeks (walking and
mild stretching are fine); avoid alcohol, steam baths, and saunas for several
months. Above all, get plenty of rest and allow your body to spend its energy on
healing.
At the beginning, your face may look and feel rather strange. Your features may
be distorted from the swelling, your facial movements may be slightly stiff and
you'll probably be self-conscious about your scars. Some bruising may persist
for two or three weeks, and you may tire easily. By the third week, you'll
look and feel much better. Most patients are back at work about ten days to two
weeks after surgery.
Your
new look
The chances are excellent that you'll be happy with your facelift-especially if
you realize that the results may not be immediately apparent. Even after the
swelling and bruises are gone, the hair around your temples may be thin and your
skin may feel dry and rough for several months.
You'll have some scars from your facelift, but they're usually hidden by your
hair or in the natural creases of your face and ears. In any case, they'll fade
within time and should be scarcely visible.
Having a facelift doesn't stop the clock. Your face will continue to age with
time, and you may want to repeat the procedure one or more times-perhaps five or
ten years down the line. But in another sense, the effects of even one facelift
are lasting; years later, you'll continue to look better than if you'd never had
a facelift at all.
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