Facial aging has five major components:
1. Laxity with descent or drooping of skin and soft tissues and
2. Facial atrophy with the deflation of the facial cosmetic units.
3. Muscles of the neck relax and hang downward causing the overlying skin to stretch. This gives a banding effect causing the loss of a nice neck angle. If there is associated fat, significant fullness will result in a “turkey waddle” deformity.
4. Deep creases between the nose and the mouth form on the leading edge of the cheeks from atrophy of the fat and descent of the skin and soft tissues of the cheek.
5. Increased sun damage and smoking cause wrinkling around the mouth and possibly over the entire face. The modem face lift incorporates tightening and elevation of the underlying facial structures. Fat (usually borrowed from the abdomen) is injected to all the areas of the face restoring, contour, fullness, and improved skin texture. Neck muscles are tightened with sutures after the underlying fat is removed; restoring a nice contour.
Often a chemical peel or laser resurfacing is performed simultaneously to erase wrinkling. Platelet gel or platelet rich plasma made from your own blood is sprayed underneath the skin flaps of the facelift. This has been shown to decrease bleeding, bruising, and swelling and it hastens the healing of the face. The harmonic scalpel is used in the face and the skin structures. The harmonic tip vibrates 51 ,000 times a second; thus cutting through tissue with friction and not heat or cold steel. Small blood vessels are actually coagulated as they are divided by the harmonic scalpel. This leads to less bruising, swelling, and bleeding and less heat damage from cautery devices. The face is divided into three parts: 1. The forehead and brow 2.The cheeks and jowls 3. The neck fat and muscles. Depending upon your needs and desires, your surgery can include only one, two, or all three of these areas.
If You’re Considering a Facelift
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 may form between the nose and mouth, the jawline can grow slack, and folds and fat deposits might appear around the neck.
A facelift (technically known as rhytidectomy) doesn’t stop this aging process, but it can turn back the clock, significantly moderating the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin on your face and neck. A facelift can be done separately or in conjunction with other plastic surgery procedures such as a forehead lifts, eyelid surgery, or nose reshaping.
If you’re considering a facelift, this web page will give you a basic understanding of the procedure when it can help, how it’s performed, and what results you can expect. It can’t answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don’t understand.
The Best 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. Most facelift patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well, depending on their individual conditions.
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 your surgeon.
All Surgery Carries Some Uncertainty and Risk
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 (a collection of blood under the skin that must be removed by the surgeon), 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 your surgeon’s advice both before and after surgery.
Planning Your Surgery
Facelifts are very individualized procedures. In your initial consultation the surgeon will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery.
Your surgeon should 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 your surgeon 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, your surgeon will explain the techniques and anesthesia he or she will use, the type of facility where the surgery will be performed, and the risks and costs involved. Don’t hesitate to ask your doctor any questions you may have, especially those regarding your expectations and concerns about the results.
Preparing For Your Surgery
Your surgeon 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.
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.
Where Your Surgery Will Be Performed
A facelift may be performed under local anesthesia in a surgeon’s office, an outpatient surgery center, or a hospital. The procedure is usually done on an outpatient basis, but some surgeons may hospitalize patients for a day when using general anesthesia. A facelift usually takes several hours, sometimes longer if more than one plastic surgery procedure is being performed. For extensive procedures, some surgeons may schedule two separate sessions.
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. (However, you may feel some tugging or occasional discomfort.)
Some surgeons prefer a general anesthesia. In that case, you’ll sleep through the operation.
A facelift usually takes several hours-or somewhat longer if you’re having more than one procedure done. For extensive procedures, some surgeons may schedule two separate sessions.
Every surgeon approaches the procedure in his or her own way. Some complete one side of the face at a time, and others move back and forth between the sides. The exact placement of incisions and the sequence of events depends on your facial structure and your surgeon’s technique.
In most facelifts, incisions are made which 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 treatment, a small incision may also be made under the chin. In general, the facelift procedure 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. Following that, the underlying muscle and membranes are tightened, the skin is pulled back, and the excess is removed. Stitches secure the layers of tissue and close the incisions, and metal clips may be used on the scalp.
In general, the surgeon 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. The surgeon may also wrap your head loosely in bandages to minimize bruising and swelling.
After Your Surgery
There is usually no significant discomfort after surgery, but any resulting pain can be reduced with medication, and you should be up and around within a day or two. At first, your face may look and feel a bit strange¸ and your features may be distorted from the swelling. You may feel tired, but this is normal; just get plenty of rest and allow your body to spend its energy on healing. Most patients are back at work about ten days to two weeks after surgery. By the third week following surgery, you will look and feel much better.
Your doctor may 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, since your skin will be both tender and numb, and may not respond normally at first.
Your surgeon 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. It’s not surprising that some patients are disappointed and depressed at first.
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. If you need it, special camouflage makeup can mask most bruising that remains.
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. Men may find they have to shave in new places-behind the neck and ears-where areas of beard- growing skin have been re positioned.
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.
Please contact Dr. Peterson today at (281) 836-4576 for more information regarding facelifts, or any of the other plastic surgery procedures offered at his office in Houston, TX. A new and better you is only a phone call away!