Face Lift, or a Rhytidectomy, is designed to restore a more youthful appearance by removing major wrinkles and sagging skin of face by reattaching the skin & soft tissue to their normal position. It involves tightening of the facial and neck muscles as well as the removal of any excess skin. The skin begins to wrinkle and sag as a result of age, sun exposure, gravity and genetics. Children and young adults have smooth & round faces due to evenly distributed fatty tissues in facial contours. Over time, the skin sags and folds over the chin, jawline and neck. Not only does a facelift improve facial appearance but also has a dramatic effect on the neck, enhancing its contour and profile.

A face lift can make a patient look 5 to 10 years younger

Dramatic as the end results are, this is not a simple procedure. It requires a week to 10 days of recovery.

Before Facelift Surgery

We will evaluate your medical history in order to determine your overall health. We will discuss with you how your face can look and what you can expect from surgery. Our objective is to create a natural appearance that is pleasing to you.

Preoperative Instructions: Avoid cigarette smoking, any kind of tobacco and drugs that contain aspirin several weeks prior to surgery to minimize excess bleeding. You may be required to take antibiotics to prevent infection. You may be instructed to shampoo your hair the night before surgery. Shaving of head is not required.

Facelift Surgery Procedure

A facelift is frequently performed in conjunction with blepharoplasty (eyelid surgery), forehead lift, chin augmentation, and / or liposuction of neck, to create an overall rejuvenation of the face.
Facelifts are performed in inpatient surgical centers. General anesthesia is usually required. The surgeon will make incisions inside the hairline at the temple, in front of the ear, then around the earlobe and behind the ear, ending at the scalp area. Excess skin is removed and sagging muscles and connective tissues are tightened and fixed in a desired direction. In some cases, fatty deposits are removed from beneath the chin and neck. Incisions are closed with small sutures. The procedure may take up to 2-3 hours depending on whether any other procedures are performed at the same time.

Recovery:

Initially you will have a large dressing wrapped around your head. You may have surgical drains attached to bulbs hanging at your neck. These will be removed in approximately 24-48 hours. Stitches around the ears will be removed in a few days. The scalp sutures will be removed in 7-10 days.

To minimize scarring, the doctor may remove the sutures in stages. Scarring fades quickly. Swelling and discoloration decrease within two weeks. Tightness in your face will be present for several weeks, which will soften gradually.

We recommend that you avoid the sun for several weeks after surgery.

Complications following facelift are rare. These include bleeding, infection, facial nerve injury, discoloration of the skin, numbness, asymmetry and scarring. Infection is rare due to the large blood supply to the face. As mentioned, the risk of bleeding is greater if you take aspirin or blood thinners within 2 weeks of the surgery. The risk of wound complications increases in diabetics, persons with a history of radiation, autoimmune and collagen disease as well as in smokers. By following pre and post-operative instructions, you will minimize potential problems.

In the weeks following surgery, the facial skin and area around the ear may be numb. There may also be some temporary discoloration as healing begins, which may take a few months to disappear. Occasionally, the facial nerve is bruised during surgery, resulting in temporary loss of function or sensation. However, actual permanent damage to the facial nerve is rare.

The healing process is gradual, so you will not notice final results for few months. A single procedure often achieves the desired results. Most patients who have had facelifts are pleased with their new, more youthful appearance.

Is there some minimal procedure for the same result?

Modified face-lift (soft face lift), Thread lifts (suspending the drooped tissues using barbed threads) along with endoscopic surgery of the brows and minimal surgery in the chin / neck area can give a younger look which may not be as powerful as a full-face neck lift. The recovery time for such a procedure is just a week and is a day care procedure with people going back home in the evening. The downtime for such soft face lifts is usually not be as good as full face lifts and you may require re-lifting of face after 2-3 yrs.

Brow Lift

Also known as forehead lift, a brow lift minimizes the creases that develop across the forehead, or those that occur high on the bridge of the nose; improves what are commonly referred to as frown lines; and repositions a low or sagging brow.

There are approximately four fingerbreadths of forehead before the hairline. The forehead should be smooth without horizontal wrinkles. If there are wrinkles during contraction of the forehead then it is normal. There should be no frown lines or creases between the eyes at rest. Sometimes a high forehead is considered attractive in females adding an open exposed look to the face. You can measure the width of your forehead by four fingerbreadths. Relax completely your face for 30 seconds. Make no motion. See if lines are left.

The forehead can be restored to laying flat without wrinkles at rest. The hairline can be altered. With surgery it can be raised easily or lowered less easily. The contraction of muscles around the wrinkles can be eliminated.

The forehead lift is the most common technique performed to improve the forehead and the eyebrows. In this process the skin of the forehead is lifted up. After the entire forehead skin is elevated, the muscles between the eyebrows that make the frown lines are usually cut so that this area of forehead no longer creases. This alone will greatly reduce the depth of the lines. Next, there are several processes that can be performed to weaken the wrinkle creating muscles. Usually the muscle is cut into a checkerboard pattern, which greatly reduces its strength, or strips of the muscle may even be removed. At the end, the surgeon may remove a strip of excess skin near the incision and sew the skin closed.

Hairline versus in the hair incision:

The standard forehead lift may be done with the incision right at hairline or about an inch behind the hairline, which is known as coronal incision. If the incision is behind the hairline, it is hidden but some hair may be lost if the surgeon removes excess skin at the edge. Also the hairline will be moved higher depending on how much skin is removed, usually less than an inch. In some patients this is desirable, in others it may not be. If the incision is at the hairline, the hairline will stay the same. However the scar may show particularly if excess skin is removed and there is tension on the hairline. Lately we have focused more on reducing muscle function and less on skin removal since the muscles are the reasons for the problem. Moreover these procedures are performed endocopically now days.

Complications in Forehead lift:

Elevation of hairline: If the incision is made in the hair the hairline may be elevated. Scarring may be noticeable if the incision is at the hairline and the hair is worn up. It improves a lot with time. Incisions may be designed so that the hair grows through the scar.

Numbness or loss of sensation: The nerves, which give sensation to the forehead run vertically from the middle of eyebrows. Surgeons are careful to avoid them, but sometimes they may get damaged temporarily or permanently. Paralysis of forehead muscle: If this happens the forehead lays flat. Usually the other side is cut so that the two sides match. The goal is the reduced muscle function of forehead.

Persistent wrinkles: If the muscle function is reduced enough, the improvement is excellent. The muscle tends to heal back together and create more wrinkles.

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