A Facelift (Rhytidectomy) is a surgical procedure designed to smooth and firm the skin, providing a fresh, youthful appearance.  Throughout one’s life, the sun’s radiation, stress, gravity, and other factors cause the skin to sag and fit more loosely.  Areas of the face and neck, in particular around the jaw line, are especially prone to the aging process.  Though these changes are gradual, wrinkles and other signs of aging can make individuals “feel older” than they really are.

Surgery for a facelift involves the contraction and realignment of facial and neck skin, and in some instances the removal of excess fat deposits.  A facelift is often performed in combination with other facial cosmetic procedures and can be performed any time signs of aging begin to appear.  However, patients are generally in their forties or older when they elect to undergo this procedure.

Reasons for Considering a Facelift:

• Sagging skin, muscles, and fat in the face and neck.
• Excess skin and fat on the neck.
• Sagging jaw line.
• Crease lines along the nose, mouth, and chin.

The most important point to understand about facelifts and facial aging is that we all age differently and in different ways. The causes vary and include sagging of excess skin, deflation of the face due to fat loss, changes to the bony structures around the mouth and eyes, and bulging of fat around the lower eyelids. Other causes are still in the process of being fully understood. There is wide variation in the type and magnitude of these changes between individuals.This means that no single operation or procedure should be applied to all people. Instead, your plastic surgeon should be comfortable with a variety of facelift techniques and “customize” their use for each individual patient.

Q & A

What is a facelift?
In its simplest terms a facelift removes excess or sagging skin belonging to the face and neck. The classic (subcutaneous) facelift involves incisions placed in front of and behind the ears. The skin and fat of the face and neck is then lifted off of the underlying structures such as facial muscles, nerves, and other soft tissue structures. Excess skin is pulled up and back and trimmed off. The edges of the incisions are brought together and closed with sutures. The resulting scars are well hidden in natural skin borders and creases around the ears and adjacent to the hairline

Are there different types of facelifts?
Facelifts originated near the turn of the century still serve as the basis for treating excess or drooping skin of the face and neck. Better understanding of the anatomy of the face and causes of facial aging has resulted in several innovations and additions to the classic facelift. Besides removing excess skin most facelifts include repositioning of the deeper tissues by tightening of a support layer to the face known as the “SMAS”. SMAS stands for the Superficial Musculo Aponeurotic System. The acronym SMAS is often used to describe facelifts that tighten this layer in addition to removing excess skin to help achieve rejuvenation of the face.

What is a midface lift?
The area of the cheeks and lower eyelids is known as the midface. Recently much attention has been focused on this area since the classic facelift frequently does not satisfactorily correct this area. Also the midface will typically sag and droop sooner than the lower face and neck. In response, facelifts have been developed termed “midface lifts” to help pull up sagging cheeks and older or tired-looking lower eyelid. There are actually about as many ways to lift the midface as there are plastic surgeons. However, almost all operations involve separating the cheek tissues from the underlying cheek bones and placing them in a higher position. Removal of excess lower eyelid skin is done after the cheek tissue is secured in its new position. Midface elevation can be done by incisions placed in the hairline of the temple, lower eyelid, inside of the mouth, or a combination of these approaches. In addition, some surgeons use a small scope or TV camera to aid in lifting the midface through smaller access incisions. Sometimes fat in the lower eyelid is removed, repositioned, or even added to achieve a more youthful look.

At what age should one have a facelift?
In general the traditional facelift (for the neck and jowls) is usually performed for individuals in their 40’s to 60’s. Since the midface seems to show signs of aging sooner, the midface lift is recommended for individuals as early as 30-40 years of age. These procedures can be, and often are, combined in one operation. Timing also depends on when each individual feels they are in need. This can differ widely depending on a patient’s geographic or cultural background. The correct answer to the question of timing is whenever the changes of aging become disturbing.

Will a facelift help with the line that runs from the corner of the nose to corner of my mouth?
The nasolabial fold is a crease or fold that runs from the ala of the nose, or “corner” of the nose, down to the corner of the mouth and sometimes the jaw line. Many different procedures ranging from the traditional facelift, SMAS facelift, midface lift, or even to cutting out the crease have been attempted. None have been able to correct this aging feature with any long-term success. Injecting substances such as fat or collagen to “fill out” the fold seems to help, but only temporarily as these materials will absorb with time.

What recovery time is involved with a facelift?
Recovery time for a facelift is generally from 1-2 weeks for most swelling and bruising as well as suture removal. If any drains have been placed they are usually removed in the first 2-3 days. However, it takes at least one month for the more obvious changes accompanying a facelift to disappear. This is a good time-frame to keep in mind if you plan on attending an important social occasion, travel or just “show off” your new look.

How long does a facelift last?
The general rule of thumb is that a facelift will last about 5-10 years. Facelifts can be repeated after several years if necessary. The longevity of the result can be adversely affected by bad behavior such as smoking or chronic sun exposure. The same forces that prematurely age skin are not reversed by having a facelift. Aging is an individual characteristic that is independent of having had surgery.

What other operations can be done at the same time?
Usually other facial procedures will accompany a facelift. These procedures include chin liposuction, brow lifting, eyelid surgery, chin implants, cheek implants, or rhinoplasty (nose surgery). Occasionally, operations such as a tummy tuck, liposuction or breast augmentation can be performed at the same time as a facelift. Combined procedures are commonly done, and the decision to do so depends chiefly on the anesthetic risks involved.

Additional information can be found on the following web sites:
plasticsurgery.org
surgery.org

To arrange a consultation, please call Aesthetic Surgery Associates at (254) 526-5106 or toll-free 1-866-232-0469