A facelift or rhytidectomy is a surgical procedure to improve visible signs of aging in the lower face and neck by removing excess skin and fat, and tightening and repositioning lax muscles. The procedure can improve the contour of the lower jaw and jowls, and soften deep lines from the nose to the corners of mouth.
Facelift surgery is individualized for each patient, depending on the desired outcome. It can be performed on its own, or in conjunction with other procedures such as a brow lift, eyelid surgery, nasal surgery, chin liposuction or chin implants.
Is Facelift surgery right for you?
Facelift surgery is an option for those who would like to address visible signs of aging, such as:
– Sagging in the mid-face
– Deep creases below the lower eyelids
– Deep lines from the nose to the corner of the mouth
– Jowls due to loss of muscle tone in the lower face
– Loose skin and excess fatty deposits under the chin and jaw
The best candidates for a facelift are those who exhibit these signs of aging, but still have some skin elasticity and well defined bone structure. This generally includes patients in their 40’s to 70’s, who are in reasonably good physical and emotional health.
How is the surgery performed?
The procedure begins with an incision along the hairline, from the temple and down around the ear lobe and to the back of the ear.
The skin is first separated from the superficial musculoaponeurotic system (SMAS), fat, and muscle underneath. Sagging tissues are then tightened and repositioned. The skin is pulled up and back, and any excess is removed to produce a firmer, more youthful appearance.
As part of the procedure, a technique known as lipofilling, which involves harvesting and injecting fat from other areas of your body, is used to dramatically improve the appearance of nasolabial folds and marionette lines. A special dressing and small drains are placed to reduce haematoma formation, and intravenous antibiotics are administered to reduce the occurrence of infection.
What to expect after surgery
After surgery, you will need to stay overnight at our facility under the direct observation of a private nurse. Local cryotherapy will be applied to reduce edema and bruising. The morning after surgery, Dr. Lanfranchi will see you to change the dressings and, if possible, remove the drains. He will then determine whether you can be discharged to the recovery facility.
Stitches are normally removed five days after the surgery. You are advised to rest as much as possible for one week after the surgery, and to avoid vigorous physical activity for at least 15 days. There may be some numbness and a feeling of skin tightness for around 6 weeks after surgery, but normally by the third to fourth week you should look and feel great.
The results achieved by a facelift can only be done surgically. However, patients who prefer to treat the signs of aging without surgery may opt for alternative forms of management to treat skin laxity and remove superficial wrinkles. Alternative treatments include microdermabrasion, chemical peels or laser skin tightening.
Other patients may prefer to have smaller, less invasive procedures such as facial liposuction or a neck lift to address problem areas in the lower face or neck.
Risks of Facelift Surgery
Every surgical procedure involves a certain amount of risk. Although most patients do not experience complications, it is important to understand the risks, potential complications, and consequences of facelift surgery.
Bleeding – Although this is highly unusual, some patients may experience problems with bleeding during or after surgery. Should post-operative bleeding occur, it may require emergency treatment to drain accumulated blood or blood transfusion. Less than 2% of patients present this complication.
Medical conditions such as hypertension may cause bleeding during or after surgery, so a physical checkup is required before surgery can be scheduled. Patients are also advised not to take any aspirin or anti-inflammatory medications for ten days before surgery, as this contributes to a greater risk of bleeding.
Infection – Infection is unusual after this surgery, and prophylactic antibiotics are used to avoid this complication. Should an infection occur, additional treatment including antibiotics or surgery may be necessary.
Scarring – Different people scar in different ways. While the majority of patients heal quite nicely, abnormal scars may occur in individuals who have a genetic predisposition for this. Scars may be unattractive and of a different color than the surrounding skin. Additional treatments are available to treat scarring, if necessary.
Delayed healing – Some areas of the face may not heal normally, or may take a longer time to heal. In rare cases some areas of skin may die. Frequent dressing changes or further surgery may be required to remove the unhealed tissue.
Smokers have a greater risk of skin loss and wound healing complications. It is our absolute policy not to operate on smokers, in order to guarantee patient safety and avoid complications. Patients who smoke are strongly advised to stop smoking for at least one month before and after the surgery.
Asymmetry – The human face is normally asymmetrical. There may be a variation from one side to the other in the results obtained from a facelift procedure.
Nerve injury – Motor and sensory nerves can be injured during a facelift operation, causing weakness or loss of facial movements. Such injuries may improve over time. Injury to sensory nerves of the face, neck and ear regions may also cause temporary or, in rare cases, permanent numbness. Painful nerve scarring is very rare.
Unsatisfactory results – You may be disappointed with the results of surgery. Although this is infrequent, it may be necessary to perform additional surgery to improve your results.
Hair loss – Hair loss may occur in areas of the face where the skin was elevated during surgery. The occurrence of this is not predictable.
Long-term results- Facelift surgery does not arrest the aging process or produce permanent tightening of the face and neck. Weight loss or gain, sun exposure, or other circumstances may influence the results of this surgery. Future surgery or other treatments may be necessary to maintain the results of a facelift operation.
For more information about facelift surgery, or to schedule a consultation, please contact Dr. Lanfranchi.