FACE LIFT

Over time, laws of nature such as gravity, all those years of exposure to the sun (when we didn't know better!), and the stresses of daily life can make us appear older and more tired than we are. We may see deep creases begin to show between our nose and mouth, our jawline is not as tight and firm as we remember, and the skin around our neck can become loose and "crepy". Each face ages differently, and even different parts of the same face begin to show age at different rates. Due to heredity and how we've maintained our skin, we may notice that some people age more gracefully than others.

Rhytidectomy-commonly known as facelift surgery-can help rejuvenate a face by removing excess fat, tightening underlying muscles and lifting the skin to a more youthful position on your face and neck. Often men and women in their mid-forties to late sixties opt for a refreshed and vibrant appearance, so that they look more like they feel, rather than their actual age. This surgery is performed on people as early as the late thirties and as late as the mid-seventies.

Some important facts about rhytidectomy:

• A face-lift corrects sagging tissue of the jawline and neck, not fine wrinkles, crow's feet, or the lines around the lips.
• A face-lift only minimally affects the nasolabial folds (deep vertical creases that run between the nostrils and the corners of the mouth).
• Face-lifts do not affect the texture of the skin.
• Face-lifts are often performed in conjunction with blepharoplasty (eyelid surgery), rhinoplasty (nose surgery), brow/forehead lift, and collagen or fat injections.

ALTERNATIVES TO SURGERY
Only surgery will actually tighten/remove excess skin. However, soft tissue fillers, such as collagen, transferred fat, or other implant devices may be an option for those who wish to postpone face lift surgery. Also, there is no substitute for taking good care of your skin. A dermatologist or registered esthetician (skin care specialist) can be consulted to find out more about the variety of light peels, skin care products that have been proven to enhance the appearance of the skin and reduce fine lines and wrinkles. With or without an interest in surgery, good "skin sense" will always make a positive impact on your appearance.

PREPARING FOR SURGERY
Your physician will evaluate and assess the sagging skin of your face in conjunction with the laxity and position of the tissues. Your doctor may recommend a brow/forehead lift, eyelid surgery (blepharoplasty), chin or cheek implants, and/or laser resurfacing in combination with the face-lift to achieve the desired results. It is critical to have a thorough assessment. Be absolutely clear and in agreement with your doctor about your desired look.

Prior to surgery, you and your doctor will make several important decisions regarding the location of the incisions and your desired look. You will also be given more specific instructions, 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.

THE PROCEDURE
Facelift incisions are usually hidden in the natural folds and creases of the skin. They usually begin at the temples behind the hairline and extend into the ear canal and back out under the earlobes and around into the scalp area behind the ear. If the neck needs attention, a small incision may also be made under the chin.

The skin is separated from the underlying tissues below. Fat may be trimmed or suctioned from underneath the neck and chin to improve the neck and jawline. The surgeon then tightens the muscle and tissues and places the skin in its new position and trims the excess. The incisions are closed with stitches or staples. A drain, which is a thin tube, may be temporarily placed under the skin to allow any fluid to pass through without collecting. You will generally be wrapped in bandages all over your head like a helmet, which aids in minimizing bruising and swelling.

Anesthesia
The type of anesthesia used during a facelift is dependent on the extent of the procedure to be performed, the doctor's choice, and the patient's medical history or desires. In most cases, a facelift is performed under local anesthesia along with oral or intravenous sedatives.

Length of Procedure
Facelift surgery is usually performed on an outpatient basis and takes two and-a-half to five hours. If you are having more than one procedure done, the surgery may take longer.

Level of Pain/Discomfort
Generally, with a facelift there is minimal to moderate discomfort during the postoperative period. Some people experience absolutely no discomfort at all.

PRE- AND POSTOPERATIVE INSTRUCTIONS
The following suggestions are intended to make you feel more comfortable and help you heal:

• Stop smoking, discontinue the use of alcohol, and stop taking vitamin E and any medications containing aspirin or ibuprofen (two weeks pre- and postoperative is usually recommended). Check with your doctor regarding any other medications (including homeopathic/herbal products) that you are currently taking.
• If you want to color or have a permanent, do it done a minimum of ten days prior to surgery. It will probably be about four to six weeks until you can color or have a permanent again.
• If you wear your hair short, do not have it cut prior to the procedure. In that way, the longer hair will help cover the incisions until they heal.
• Have someone stay with you the first night after surgery (the first twenty-four hours, optimally).
• Follow directions regarding any ointments to be applied and/or cleansing of incisions.
• Sunbathing and tanning beds must be avoided for a minimum of two weeks prior to surgery (for optimal skin care and health, these should be avoided completely). After surgery, if you must be in the sun, protect your face.
• Keep the head elevated above the level of your heart at all times for at least the first week, optimally two weeks.
• For about a week, avoid excessive talking, laughing, and heavy chewing (stay on a soft diet).
• Expect some numbness in the areas treated for eight to twelve weeks. Be careful when using a hair dryer or curling iron, because you may not feel the heat.
• Cold compresses - your doctor may instruct you to apply cold compresses for twenty minutes every hour for a minimum of forty-eight hours.

RECOVERY
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. Most of your stitches will be removed after about five days, although the stitches or metal clips in your hairline could be left in a few days longer

The swelling may shift over your face and neck area for the first few weeks. It will usually lessen daily, with some minor swelling remaining after the first few weeks. The bruising can last, on the average, anywhere from five days to several weeks but should diminish daily. Some patients have reported that the bruising dropped as low as the chest area. You can apply makeup (regular and/or camouflage) after the sutures/staples are removed.

RISKS/COMPLICATIONS
All surgery carries some uncertainty and risk. Of course much depends on physician selection, where you have your surgery performed, how well you comply with pre-and postoperative instruction, and your body's ability to heal. Complications are rare and are usually easily addressed by your surgeon however, you must be aware of the risks associated with your particular procedure.

Complications that can occur include hematoma (a collection of blood or fluid under the skin) damage to the nerves that control movement of the face (usually temporary), infection, and reactions to the anesthesia. Poor healing of the skin is usually associated with smokers.

STILL YOU… ONLY BETTER
A facelift won't make you stop aging, but once the healing period is complete, you will present a fresher more youthful face to the world. You will always look younger than if you didn't have the face lift at all-but that doesn't mean the hands of time have stopped completely. The day you have your face lift, you still are continuing to age-but those around you might wonder how you are able to keep your young and vibrant look. Tell them if you wish or…. make them wonder!