A facelift, or rhytidectomy, is a procedure in cosmetic surgery that aims to give a more youthful appearance to the face.
It reshapes the lower half of the face by removing excess facial skin.
Rhytidectomy can tighten loose, hanging skin around the jaw line, also known as "jowls." It can also remove deep creases around the mouth and nose, and excess, hanging skin and fat under the chin and in the neck.
The procedure can also tighten the underlying tissues, and it may be combined with surgery to enhance the forehead, cheeks, brows, and eyelids.
A facelift removes excess facial skin.
Facelift surgery is usually done as an outpatient procedure. It may involve a local anesthetics and sedatives or general anesthesia.
The procedure can take from 2 to 5 hours, and the person can normally go home on the same day after surgery.
In a traditional facelift, the surgeon makes an incision in front of the ear, extending up into the hair or hairline as well as behind the ear into the hair-bearing scalp.
The surgeon lifts the skin off the deeper facial muscles and fat, gently pulls the skin in an upward and posterior direction, and removes the excess skin. They may tighten the deeper tissues of the face.
A small incision, or cut, may be made under the chin to tighten the skin and deeper tissue of the neck. This is known as a neck lift.
The incisions are then closed with sutures and possibly staples. A drain may be placed under the skin behind the ear for one or two days, to remove any excess blood and fluids. Bandages are applied.
Facelift surgery is individualized to a patient’s needs, and a cosmetic surgeon will tailor his or her techniques accordingly.
Patients who exhibit a mild degree of jowling and sagging skin are often good candidates for a mini-facelift. This is a less invasive technique that allows a cosmetic surgeon to tighten deep facial tissues through shorter incisions, typically located along the hairline above each ear and/or in the natural creases surrounding the ear. Through these incisions, structural tissues around the cheeks are lifted and tightened to correct jowling, refine the jawline, and rejuvenate a “tired” appearance.
Depending on the case, a mini-facelift may be performed using local anesthesia with sedation or general anesthesia; your cosmetic surgeon will recommend the best option for your individual needs. A mini-facelift can help you address unwelcome signs of aging before they become too pronounced, postponing the need for more extensive surgery for many years.
A standard or “traditional” facelift will more fully address moderate to advanced aging around the mid-face and neck. While the surgery is more extensive than those for a mini-facelift, and thus more recovery time is required, the results are more dramatic. Through incisions located just behind the hairline, starting near the temples, and around the front of the ear, hidden in the natural folds, a cosmetic surgeon can reposition the deeper tissues beneath the skin and remove excess skin to smooth creases, eliminate jowling and sagging skin under the chin, and restore a naturally youthful contour to the face and neck.
A facelift procedure includes the following steps:
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
A variety of other procedures can further enhance the outcome of a facelift. They include:
Facial implants or fat transfer to improve contour
Resurfacing techniques to improve the tone and texture of facial skin
Wrinkle reduction by injection of fat or fillers
Step 2 – The incision
Depending on the degree of change you'd like to see, your facelift choices include a traditional facelift, limited incision facelift or a neck lift.
A traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp. Fat may be sculpted or redistributed from the face, jowls and neck and underlying tissue is repositioned, commonly the deeper layers of the face and the muscles are also lifted. Skin is redraped over the uplifted contours and excess skin is trimmed away.
A second incision under the chin may be necessary to further improve an aging neck. Sutures or skin adhesives close the incisions.
facelift traditional incision
An alternative to a traditional facelift uses shorter incisions at the temples, continuing around the ear. "Mini-lifts" are usually reserved for patients with less skin relaxation, as the results are less rejuvenating than a full facelift.
Facelift limited incision
A necklift addresses the sagging jowls, loose neck skin and fat accumulation under the chin. The neck lift incision often begins in front of the ear lobe and wraps around behind the ear, and ends in the posterior hair behind the ear.
Facelift neck lift incision
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Step 3 – Closing the incisions
The incisions will be closed with sutures that may dissolve or may need to be removed after a few days. Some surgeons use skin glues to seal the incisions. Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear.
Step 4 – See the results
The visible improvements of a facelift appear once swelling and bruising subside. Your final result should not only restore a more youthful and rested appearance, but also help you feel more confident about yourself. Get more information about facelift results.
A face-lift surgery can cause complications. Some can be managed with appropriate care, medication or surgical correction. Long-term or permanent complications, while rare, can cause significant changes in appearance. The risks include:
Hematoma. A collection of blood (hematoma) under the skin that causes swelling and pressure is the most common complication of face-lift surgery. Hematoma formation, which usually occurs with 24 hours of surgery, is treated promptly with surgery to prevent damage to skin and other tissues.
Scarring. Incision scars from a face-lift are permanent but typically concealed by the hairline and natural contours of the face and ear. Rarely, incisions can result in raised, red scars. Injections of a corticosteroid medication or other treatments might be used to improve the appearance of scars.
Nerve injury. Injury to nerves, while rare, can temporarily or permanently affect nerves that control sensation or muscles. Temporary paralysis of a select muscle, resulting in an uneven facial appearance or expression, or temporary loss of sensation can last a few months to a year. Surgical interventions may offer some improvement.
Hair loss. You might experience temporary or permanent hair loss near the incision sites. Permanent hair loss can be addressed with surgery to transplant skin with hair follicles.
Skin loss. Rarely, a face-lift can interrupt the blood supply to your facial tissues. This can result in skin loss (sloughing). Sloughing is treated with medications, appropriate wound care and, if necessary, a procedure to minimize scarring.
Like any other type of major surgery, a face-lift poses a risk of bleeding, infection and an adverse reaction to anesthesia. Certain medical conditions or lifestyle habits also can increase your risk of complications. The following factors may present a significant risk or result in unfavorable results, and your doctor may advise against a face-lift.
Blood-thinning medications or supplements. Medications or supplements that thin the blood can affect your blood's ability to clot and increase the risk of hematomas after surgery. These medications include blood thinners (Coumadin, Plavix, others), aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), ginseng, Ginkgo biloba, fish oil and others.
Medical conditions. If you have a medical condition that prevents blood clotting, you won't be able to have a face-lift. Other conditions, such as poorly controlled diabetes or high blood pressure, increase the risk of poor wound healing, hematomas and heart complications.
Smoking. Smoking significantly increases the risk of poor wound healing, hematomas and skin loss after a face-lift.
Weight fluctuation. If you have a history of repeated weight gain and loss — factors that affect the shape of your face and condition of your skin — the outcome of the surgery may not be satisfactory or may be satisfactory for only a short time.
However, the following points should be discussed and considered before going ahead:
Facelift surgery is not recommended for anyone with serious medical problems, and the candidate should be in good mental and physical health.
Patients with high blood pressure and diabetes have a higher risk of complications.
Cigarette smoking and tobacco use increase the risk of complications after surgery. It can interfere with wound healing. A person who is considering a facelift should completely stop smoking or using nicotine products.
It is important to have reasonable expectations and to remember that a facelift will not stop the overall aging process.
Good skin elasticity and bone structure will give the best results.
Patients should not use taking aspirin or other blood thinners for at least a week before surgery.
It is important to have realistic expectations when undergoing cosmetic surgery. The results are often permanent.
Most patients experience some discomfort, but medication can relieve tenderness.
Bruising and swelling will be at their worst after 2 days, and they can persist for a few days.
Recovery normally takes around 2 weeks, and vigorous activity can resume after 4 weeks.
Sutures are removed about 5 to 10 days after surgery.
Incisions and bandages must be kept dry, and the patient should follow the specific instructions about bathing and washing.
It is important to follow the doctor's instructions, as this will speed the healing process and allow for the best possible result.
Numbness and muscle stiffness is normal for some time. Scars can take nearly a year to fade and tone down.
It is worth remembering that while genetics play a role, a healthy lifestyle with a balanced diet and sufficient exercise can also help to maintain the appearance of the skin.
Avoiding smoking and limiting alcohol intake, stress, sun exposure, and contact with pollutants can all help extend the youthful appearance of skin.
The same habits can help maintain the effects of facelift surgery.