Facelift (Rhytidectomy)


Do you find yourself looking tired and older than you feel? Have your laugh lines around your mouth become a permanent fixture or your fine lines on your forehead become creases or deep folds?As the years go by, the skin begins loosen on the face and neck. You buy the potions and lotions you exercise, eat right and get lots of sleep (you do, don’t you?) but your crow’s feet and bags under your eyes still appear.. The jaw line softens into jowls, and beneath the chin, another chin appears. Perhaps you have lost a lot of weight and kept the skin (it happens!) Everyone has their own reasons for wanting a facelift and the great thing is you have a lot of options and techniques available to you to get the results you want.

Not every facelift is the same. Some people want to look 15 years younger while others only want to look “fresher and less tired” Please read through this information to find out more about facelifts and what they can and cannot do.

The most common misconception about facelifts / rhytidectomy is that they deal with the entire face. They do not! A facelift only addresses the bottom 2/3’s of your face including your neck. A facelift does not remove bags or excess skin around your eyes. That procedure is called Blepharoplasty (for your comfort and ours we call it eyelid surgery) A facelift also does not address your forehead. So if you have brows that hang down around your eyes or if you have deep wrinkles or creases on your forehead you would be a good candidate for a brow lift.

Many people only need a facelift while other need what we call “the works” which is facelift, brow lift and blepharoplasty. There are so many options out there the combination of procedures and treatments are endless and should always be customized for your particular needs and wants.

Here is some information about facelifts. Please read through it and if you have any questions you can always click on the chat button at the top of the page and a real person can help you!

Remember the best plastic surgery is sun block!!

A good candidate for a facelift:

  • has sagging skin in the face and neck
  • has skin that still has some elasticity
  • is in good health
  • is a non-smoker
  • maintains a stable weight (at least 6 months)
  • has a strong bone structure
  • has realistic expectations

An ideal candidate for any type of cosmetic surgery will understand that cosmetic surgery is intended as a means of enhancement. A facelift can have very dramatic results depending on the patient, but individuals should be realistic about the results they can achieve through surgery. If you do not meet all of these criteria, but meet some of them, you may still be a good candidate for a facelift. If you smoke you must quit at least 2 months before the surgery. Smokers have a 1500% higher risk of complications. If you have good skin tone, it is more likely that your skin will respond well to the surgery. Many people start a extensive skin treatment program months before their surgery to increase elasticity and improve skin texture.

You are also at increased risk for complications if you have diabetes, poor circulation, heart, lung or liver disease, smoke, have a family history of blood clots, take certain medications, etc. You’ll want to discuss your medical history thoroughly with your physician before you choose to undergo surgery.

A facelift can:

  1. Turn back the clock 7 to 10 years
  2. smooth the appearance of wrinkles
  3. reduce the amount of loose skin or excess fatty tissue especially along the jaw line
  4. tighten the muscles beneath the skin of the face and neck
  5. remove jowls and sagging skin.

A facelift cannot:

  1. Change the texture of the skin or get rid of age spots, acne scars and fine lines.
  2. Reduce bags, wrinkles, and excess skin underneath or above the eyes.
  3. Address issues in the upper 1/3 rd of your face including your eyes and forehead.
  4. Stop the aging process

To get an idea of the results you might have, place your fingers on the center of your cheeks and press the skin up and back. Skin folds can be tightened and reduced, but not eliminated. If you softly pinch the skin in front of your ear, you’ll see how much skin can be excised during the procedure.

Your initial consultation

At the initial online consultation you will be asked to send a digital photo including a side and frontal view. Your doctor will ask you to describe in detail what you would like improved. Be specific about what you would like done. Bring up all of your concerns no matter how small. This is your time to discuss your wants and desires so your surgeon fully understands your expectations. Now that your surgeon knows what you expect he’ll be able to determine whether your goals are realistic. Your physician will then examine your skin, hairline, and structure of your face to determine which techniques will be employed, where incisions will be made and what results can be achieved. Your skin type, thickness and texture, your age, and pre-existing sun damage will all effect the final result.

Face Lift Pre-Op Instructions

  • Do not take aspirin or anti-inflammatory medications, Vitamin A or any blood thinning medications for 2 weeks prior to surgery.
  • If you smoke, quit smoking for at least 2 weeks pre-op (and anticipate no smoking for the recovery, smoking greatly increases your risk of complications)
  • We can help you fill prescriptions such as pain medication and antibiotics before surgery
  • Purchase any homeopathic medicines (i.e. Bromelain and Arnica Gel, for swelling and bruising) Be sure to discuss this with your doctor
  • You’ll want soft foods that do not require much chewing for the first day or two. Consider: Protein shakes, soup, pudding, applesauce, yogurt, oatmeal, cottage cheese, juice (purchase flexible straws for easier drinking) Talk to your doctor about low-sodium foods to reduce swelling
  • Set up a hotel recovery area: lots of pillows, books, magazines, journal, stationery, lotion, baby wipes, tv, videos, remote control, etc.
  • Black out windows so you can rest during the day
  • Prepare ice packs to reduce post-op swelling
  • Mouthwash (you won’t be able to brush your teeth for the first day or two)
  • Moisturizers, scar reducing/minimizing creams (such as Mederma) and petroleum jelly for incisions
  • Laxatives (pain medications are often binding
  • Eye Drops (after any surgery, eyes can be dry)
  • Night before surgery, thoroughly remove all makeup
  • Morning of surgery, wash face thoroughly and do not apply any products
  • Bring sunglasses to wear on the way home from surgery
  • On the day of surgery, wear loose clothing which will be easy to get off and on after operation (consider a shirt that buttons in front)
  • Follow your physician’s directions carefully regarding medications, eating & drinking, etc.

The Surgery

SSI provides an overnight stay in the hospital for all facelifts to ensure your comfort and monitor your recovery. SSI and the Plastic Surgeons we work with do not categorize a facelift, under any circumstance, as an out patient procedure.

Anesthesia: General or Sedation Location: SSI performs every surgery in a Hospital Surgery time: 2-4 hours.

Depending on your face and problem areas, your surgeon may choose a two-layer face-lift, a skin-only face lift, a deep (subperiosteal) face lift, neck lift, laser or endoscopic lift. In a two-layer face-lift (the most common procedure and generally the most effective), incisions are usually made in the contour of the ears, beginning in front of and extending around the earlobe and back into the hairline. After the incisions are made, the skin is separated from the facial muscles and skin fat (the doctor may remove excess fat) and the skin is pulled up and back to tighten the muscles of the face and neck.

The surgeon may tighten the underlying tissue, the sub muscular aponeurotic system (SMAS), that tightens the neck and lifts the cheeks. The skin is then pulled back and any excess trimmed off. The incisions are then closed with stitches and metal staples may be placed in the scalp. If you have elected to smooth your chin and neck, there may also be a small incision hidden underneath your chin. A small drain tube may be placed under the skin to collect excess blood and prevent swelling. The incision is then sutured closed. The head is then bandaged to prevents fluid collection.

Recovery After a Face Lift Surgery

Pain Level: Moderate discomfort. 1-3 days of pain medication.

Swelling and bruising:2 weeks or more

Numbness: lasts several weeks

Bandages: Changed in 1-2 days (drains and sutures removed first 2-5 days)

Work: Return after 1-3 weeks

Exercise: Wait 2-3 weeks

Sun protection: Six months with SPF 15 or higher

Final result: Seen 1-4 months following most facelifts

When surgery is completed, you will be taken into a recovery area where you will be closely monitored. A bandage will have been wrapped around your face to minimize swelling. The bandage may make it difficult to hear. Your private assistant will be with you at the hospital and be there to help you in anything you may need. Your surgeon will follow up the next morning to check on you and change your dressing before you are released.

Your face and eyelids will be swollen and bruised after surgery. This will be most pronounced the first few days and lasts anywhere from one to six weeks after surgery. Most bruising will disappear within two weeks. It may take months to fully heal. The speed of recovery depends upon the type of skin, age and healing ability of the patient. Most patients can resume everyday activities about two weeks after surgery. Your face may feel numb for a few weeks or even months. This is normal and usually subsides. Scars take longer to fade, but because they are hidden in hairlines, behind the ears and in natural folds, they shouldn’t be very noticeable.

Your appearance improves dramatically each day following your surgery. Typically, you will need assistance for the first couple of days, but then you can care for yourself. You can shower by the second or third day, but be careful not to rub the incisions. All lifting, straining, bending and any vigorous activity is to be avoided until all bruises have faded and such activities do not cause any discomfort. To minimize bleeding and swelling, refrain from vigorous exercise for first 2 to 3 weeks. Pain can usually be controlled with pain medication. To prevent complications it is important to:

  • Keep your head elevated as much as possible to reduce swelling
  • Apply ice packs to minimize swelling
  • Do not take aspirin or anti-inflammatory medications
  • Do not smoke or be exposed to secondary smoke during recovery
  • Avoid exposure to direct sunlight
  • Use a sunblock (minimum 15 SPF) to protect your skin

Expect that your facelift will turn back the clock approximately 7-10 years. You will continue to age on your new face. The results of your facelift may be dramatic or subtle, depending on how you looked before surgery. Since the healing process is gradual, you should expect to wait at least several weeks to fully realize your results. Additional minor changes, or settling, may occur over several months.



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