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Top New York plastic surgeon Dr. Darrick Antell is board certified in plastic surgery, emphasizing aesthetic / cosmetic surgery. One of the procedures he performs is facelifts, both full and regional.
A facelift, also known as a Rhytidectomy, can improve the most visible signs of aging by the removal of excess fat, the tightening of underlying muscles, and the redraping of the skin of your face and neck. If you are considering a facelift, this section will give you a basic understanding of the procedure.
Considering Facelift Plastic Surgery
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 form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck.
A facelift (technically known as rhytidectomy) can't stop this aging process. What it can do is "set back the clock," improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.
If you're considering a facelift, this 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 patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well.
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 Facelift 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 Facelift Plastic 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 Facelift Plastic 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 Facelift Surgery will be performed
A facelift may be performed in a surgeon's office-based facility, an outpatient surgery center, or a hospital. It's usually done on an outpatient basis, but some surgeons may hospitalize patients for a day when using general anesthesia. Certain conditions such as diabetes or high blood pressure should be monitored after surgery, and may also require a short inpatient stay.
Types of anesthesia for a Facelift
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.
The Facelift Surgery
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 depend on your facial structure and your surgeon's technique.
If the neck needs work, a small incision may also be made under the chin.
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 Facelift Surgery
There isn't usually significant discomfort after surgery; if there is, it can be lessened with the pain medication prescribed by your surgeon. (Severe or persistent pain or a sudden swelling of your face should be reported to your surgeon immediately.) Some numbness of the skin is quite normal; it will disappear in a few weeks or months.
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 one week. Your scalp may take longer to heal, and the stitches or metal clips in your hairline could be left in a few days longer.
Recovery after Facelift Surgery
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 after Facelift Surgery
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, your hair 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 repositioned.
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.
What types of a Facelift is available?
The "full face-lift" includes the brow, the entire face and the neck, traditionally.
Commonly when only the term "face-lift" is used, the face and neck are what is being referred to.
There are also neck-only lifts, face-only lifts and regional facelifts, depending on the patient’s particular concern.
What are the advantages and disadvantages of a full/regional/etc. Facelift?
The trade off is generally the length of the incision necessary to perform the facelift procedure.
Generally, the more areas of the face that need improvement, the more of an incision is necessary to carry it out. However, there are some cases in which the difference in the size of the incision does not warrant isolating the surgery to one specific region.
The incision is delicately placed within the hair (hair is not shaved) and hidden within natural crevices and folds so it is as inconspicuous as possible. Younger patients are usually better candidates for regional facelifts or Mini Facelifts.
How long does a Facelift last?
No one can say for sure how long a facelift lasts. The clock is turned back, but keeps on running.
What will be discussed during my consultation for a Facelift?
Dr. Antell will ask you what concerns you most about your appearance and address that region first and foremost. He will talk about your options, the facelift surgery, the risks and potential complications, your recovery period, how much down time you should allow yourself, the operating room and the anesthesia.
He will show you in a mirror how much improvement you can expect from facelift surgery by simulating the amount of tension with his hands. He believes that computer imaging gives false expectations as it does not take into account the texture, thickness and elasticity of your skin, or of your ability to heal.
Dr. Antell spends as much time as is necessary with you to make sure you fully understand all the aspects of the procedure. Dr. Antell has had cosmetic surgery himself and speaks from experience as a patient as well as a doctor.
Can Facelift Plastic Surgery be done without scars?
The scars from facelift plastic surgery usually fade and are barely perceptible.
In some patients, especially younger ones, endoscopic surgery can be used to lift the eyebrows, remove frown lines, elevate the cheek and jowls, and tighten the neck. This endoscopic surgery can be done with tiny scars. However, if there is excessive skin, it must be removed for the best results through standard facelift incisions.
Can I have other Plastic Surgery procedures of the face done at the same time as a Facelift?
Yes, very often patients have their eyes or their brow done at the same time.
If the surgery is warranted, the final result is uniform and balanced and there is only one recovery period.
Some patients ask that their nose be touched up, because as we age, the tip of the nose can start to sag as well.
Other patients find that they have lost volume in their lips as they've gotten older and request a fat transfer to bulk up their lips for a more youthful, pouty appearance.
What is the Submuscular Aponeurotic System?
The SMAS is a layer beneath the skin which invests the facial muscles. By tightening the SMAS, the jowls are lifted, the neck is tightened, the cheeks are elevated. This "deep" or "2-layer" facelift is an improvement over earlier skin-only techniques.
How can I hide things during the time until I return to normal?
After facelift surgery, your plastic surgeon will discuss post-operative camouflage techniques with you prior to your surgery, but be assured that while almost everyone has some sort of temporary side effect such as bruising and swelling, there are makeup techniques that both men and women can use almost immediately to disguise them.
Generally speaking, makeup techniques can be used soon after facelift plastic surgery to cover discolorations, and to hide incision lines after the stitches have been removed and the incision is completely closed. Camouflage cosmetics include three basic types of products: concealers to hide incision lines and discolorations; contour shadows to disguise swelling; and color correctors to neutralize color in reddened skin.
Color correctors disguise yellowish discolorations or the pinkness that follows chemical peel and dermabrasion. Lavender neutralizes or removes yellow, and green has a similar effect on red. It will take a little patience and practice to master camouflage techniques, but most post-op patients feel its well worth the effort.
How to get started?
Dr. Darrick E. Antell and his staff will be happy to discuss Facelift (Rhytidectomy) with you. Please call for a private consultation or schedule an appointment online at our office.