Understanding Rhytidectomy: Aging of the face is inevitable, over time the skin begins to loosen on the face and neck. Crow’s feet appear at the corners of the eyes. Fine forehead lines become creases and then, gradually, deeper folds. The jawline softens into jowls, and beneath the chin, another chin or vertical folds appear at the front of the neck. Heredity, personal habits, the pull of gravity, and sun exposure contribute to the aging of the face. As the aging population grows, it is obvious why rhytidectomy has become the third most desired facial plastic surgical procedure.
“I always told myself that when the muscles of my face started going south, I would have something done – right away. I didn’t want to wait so long that the surgery would cause a remarkable difference. So, 12 months ago, I had a facelift, and I haven’t regretted it for a moment. It didn’t give me a new face – it gave me back my old face, the way it was 10 years ago. The changes were so subtle that no one has any idea I did it, and that’s what I wanted – to look like me, only better.” – Jackie B , a g e 5 8
Understanding the Surgery
Your surgeon begins the incision in the area of the temple hair, just above and in front of the ear. Next it continues under the earlobe and follows the back of the ear and blends into the hairline. The skin is gently lifted as the surgeon repositions and tightens the underlying muscle and connective tissue. Some fat may be removed, as well as excess skin. For men, the incision is aligned to accommodate the natural beard lines. In all cases, the incisions are placed where they will fall in a natural crease of the skin for camouflage. After trimming the excess skin, the surgeon closes the incisions with fine sutures and/or metal clips. This will permit precise surgery and avoid shaving hair in the incision sites. Depending on the extent of the surgery, the process can take from two to four hours. When the procedure is performed with a combination of mild sedatives, local anesthesia, and a mild intravenous anesthesia (“twilight sleep”), the patient will experience little discomfort. Some surgeons will prefer general anesthesia for their facelifts. Following the surgery, the surgeon will apply a dressing to protect the entire area where the incisions have been made.
Actual placement of incisions varies from patient to patient and is dependent on the surgeon’s judgment for that patient.
The trend in facelifts is to have surgery at a younger age. The typical patient is likely to be in her 40s or 50s and she may be just beginning to see some signs of aging.
Some swelling and bruising are expected after a facelift, but much of it will diminish within the first week or two.
What to Expect After the Surgery
Even though most patients experience minimal pain after surgery, the surgeon will still prescribe medication. Some degree of swelling and bruising is unavoidable, and your surgeon may instruct you to use cold compresses to keep swelling to a minimum. If a dressing has been applied, it will be removed within one to two days. The surgeon will also instruct you to keep your head elevated when lying down, to avoid as much activity as possible, and to report any undue discomfort. Although there are few complications in facelift surgery (thousands are performed each year), some risk exists in any surgery. In some cases, a drainage tube may have been inserted during surgery. This will be removed on the first or second day after surgery. All sutures and staples are usually removed within five to 10 days following surgery.
Surgeons generally recommend that patients avoid vigorous activity. Recovery usually takes two to three weeks, though many patients go back to work in two weeks. Scars are usually not noticeable after enough time has passed for them to mature. In any case, they are easily disguised in natural skin creases, by the hair, or, in persistent cases, by makeup until total healing has occurred. Since surgery does not stop the aging process some relaxation of tissues can occur over the first few weeks. The goal of an artistic facelift is natural beauty without the tell tale signs of being “overdone”.