Facelift

Gravity and longevity are a formidable combination, leaving their mark on the face. The skin shrinks here and sags there, thins out, and becomes increasingly susceptible to the damage caused by exposure to the sun. With aging we lose the fat, muscle and bone of our face giving us the inward (concave) curves of the cheeks instead of the outward (convex) curves seen in the full face of children. 

Sad to say, our faces begin to rearrange much earlier than most of us would like to admit. "Crow's feet," those short straight lines radiating from the outer edge of the eyes, can appear any time after the age of 30. Skin in the upper eyelids loosens as well. Creases in the forehead, between the eyebrows, and around the nose and mouth suddenly seem more noticeable when a woman reaches her 40s. By the age of 50, the neck starts to wrinkle, the jaw-line seems to blur, and the tip of the nose may look a bit droopy. The nose grows by 20% of its origin due to skin sagging.

The ears also migrate downward and grow longer. The white of the upper lip becomes longer and the red of the lips narrower due to bone and fat loss. 

Although signs of age appear at different times in different people, facial wrinkling and sagging become hard to ignore by the fifth decade of life.

Facelifts became very popular ten years ago as they were the only game in town. Today they have to compete with neck liposuction, Acculift non invasive lasers, fat transfer and chemical peels. Today, a facelift is reserved for cases of severe skin sagging especially of the neck or the development of a deep nasolabial fold. According to US statistics, more than 150,000 facelifts were performed in 2010. 

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. Careful questioning during the first appointment helps doctors identify people who expect the impossible. If you have trouble describing exactly what you want to change or seem distraught about a relatively minor "deformity," you are not a good candidate for a facelift, and probably won't receive one. 

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 such as garlic supplements or vitamin E.

Too many surgeons claim to be experts at 62 different cosmetic procedures. At CosmeSurge^®, we have a facelift plastic surgeon who has done hundreds of facelift surgeries and does one every week. The average cosmetic surgeon is lucky to perform one per month. Remember: Practice Makes Perfect.

While we do not guarantee perfect results, we sure try to give you the best advice, best surgeon and the best surgical and anesthesia team. 

You fees cover not only the lab work and hospital stay, but any procedure you may need to fix any problem resulting from the facelift surgery in he next three months after surgery. In our hands, problems are rare enough we can offer such a service. 

What does a face lift accomplish?

Although the incisions made for a facelift are hidden back in your hairline, it does nothing to correct the visible signs of aging in the upper face. A facelift provides an overall lift to the lower third of your face by tightening loose skin in the jowls, neck, and jaw line. 

A facelift alone will not remove forehead wrinkles, crow's feet, bags under your eyes or a deep wrinkle at the fold between your cheek and your lips. These areas can, however, be treated at the same time as your facelift with eyelid surgery, brow lift or fat transfer. During your initial consultation, your surgeon will discuss your particular condition, your expectations, and the probable outcome of your various treatment options.

Preparing yourself for surgery Preparations for surgery include a comprehensive physical examination. The doctor also checks every part of the face for creases, wrinkles, lines, puffiness, and sagging. The doctor will assess your skin's thickness, elasticity, and mobility; check the jaw and neck for fatty deposits; examine the thickness of the hair and note the location of the hairline; and document any previous surgical incisions and scars. An assistant will then take a series of photographs which the surgeon will use to plan the operation and explain the procedure to you. The photographs will also remind you later of how you looked before surgery. Such photo sessions are standard before just about any kind of plastic surgery. 

The doctor will explain the surgical plan feature by feature. Some trouble spots can be improved but not eliminated. Forehead lines, crow's feet, and creases around the nose and mouth can be softened, for example, but not removed altogether. Fine wrinkles can, however, be treated with a chemical face peel after the area has healed. 

Facelifts involve close work around the mouth and hairline, where bacteria hide in large numbers. To minimize contamination, you will be asked to remove all makeup the night before surgery and to scrub your face and wash your hair and scalp with a medicated soap. 

How the surgery is done?

Facelifts are performed under local anesthesia with heavy sedation or under general anesthesia. The choice can be made after an informed consent and a discussion with our experienced anesthesiologist taking your personal preferences into account. The incision is placed in the natural crease behind the ear. 

Excess skin and fat may be removed. The incision is then closed with fine sutures and/or metal clips. If metal clips are used, shaving hair from the incision site may be avoided. A facelift can take between two to four hours depending on the extent of the procedure. 

What happens after my surgery?

Pain is normally minimal and can be controlled with oral medications. After the procedure, an elastic net dressing that leaves only a small part of the face and eyes exposed will cushion the skin flaps and absorb drainage from the wounds. This dramatic mummy-like dressing helps remind you to let your face rest. 

Dietary restrictions are necessary after facial surgery to limit the nausea and vomiting induced by anesthesia. Furthermore, chewing can cause bleeding. You'll start out on clear liquids and quickly progress to a full liquid diet. Soft foods are added the day after surgery. If all goes well, you can return to your usual menu the day after that. 

Movement is discouraged for 24 hours. Don't talk on the phone and walk as little as possible. Keep your head still and slightly elevated at a 30 degree angle. After 24 hours, you can resume light activity. We keep our facelift patients in the hospital for one night. 

You'll wash your hair on the third day after surgery and at least every other day after that, to keep the incisions clean. The stitches will be removed on days 5 through 10 after surgery. 

Unless you are a smoker or a diabetic, healing is a quick process. After about one week you will feel comfortable (with make-up) among strangers. After ten days you will look and feel confident enough to go out with friends again although all swelling and numbness may not disappear for many weeks. Direct sun should be avoided for several weeks. 

Your surgeon will give you 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. 

At the beginning, your face may look and feel rather strange. Your facial movements may be slightly stiff and you'll probably be self-conscious about your scars. It's not surprising that some patients are disappointed and depressed at first. 

By the second week, you'll look and feel much better. Most patients are back at work about seven to ten days after surgery. Most patients are delighted with their new, more youthful and relaxed appearance.

When a facelift is performed by a qualified surgeon operating in a good center, 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. 

Here are some of the infrequent complications that may occur: 

Hematomas. The most common problem you may encounter is the formation of a hematoma, the pooling of blood under the skin. If too much blood collects—a situation that occurs only 10 percent of the time—the surgeon pierces the skin and drains it. Most "major" hematomas appear within the first 10 to 12 hours after surgery. Another 10 to 15 percent of patients develop smaller hematomas, many of which aren't noticed until the swelling goes down. 

Skin sloughing. This happens most often in the skin around the ear, where the skin is especially thin and is also geographically farthest from the circulation system that supplies blood to facial structures. Superficial skin sloughs (in the top layer of the skin) may leave little or no scarring. In the one to three percent of facelift patients who develop deeper, full thickness skin sloughs, however, some amount of scarring is inevitable. The risk of skin sloughing is up to 12 times greater in cigarette smokers than in nonsmokers.

Numbness. Your face may feel numb for two to six weeks after surgery. The reason is that lifting the skin disrupts the sensory nerves that provide feeling to it. Disturbing a facial nerve branch can interfere with your ability to move parts of your face. Full movement usually returns within a few weeks to a year after the injury, but can sometimes take even longer. 

Scars. Facelift scars tend to fade away, becoming virtually invisible. The scars can become more evident if the blood supply to the skin flaps was compromised during surgery or the skin was pulled too tight, causing tension on the incision. 

Hair loss. About one to three percent of people who have had facelifts lose some hair, usually around the temples, where the incision interrupted the blood supply. 

Dark Spots. Patches of darker skin may appear when facial swelling prevents the diagnosis of small hematomas. In most cases, the skin gradually lightens back to normal, although the process can take 6 to 8 months. In rare cases, the darker spots become permanent. 

Unless your surgeon is extremely fast, we do not recommend performing concurrently major surgery of the body as marathon 7- 9 hour surgeries are associated with higher infection rates, anesthesia related complications, and fatal blood clots traveling from the leg to the lungs. 

You can reduce your risks by closely following your surgeon's advice both before and after surgery and refrain from smoking for several days before and after your surgery.