Face Lift (Rhytidectomy)

Candidates for Surgery

Facelift candidates are those who feel the appearance of their aging face may interfere with self image and happiness.  Aging is unavoidable; unfortunately the outward signs usually appear while you still feel young and have productive years ahead.  The outward manifestations of aging need not be accepted as a matter of course.  Facial rejuvenating procedures are highly rewarding and satisfying procedures for appropriate patients. Skin prematurely ages from a number of factors such living in a hot dry climate, excessive sun exposure especially in your youth, smoking, or fair skin color.

Face lift or Rhytidectomy is an operative procedure designed to remove the major folds, wrinkles, and sagging areas from redundant skin on the face and neck, which naturally occur with aging.  It is frequently done in conjunction with a similar procedure for the eyelids called blepharoplasty, or cheeks (cheek lift or “midface lift”)  since the aging process is usually present in this region as well.  A forehead lift or brow lift may be recommended to elevate the eyebrows and remove deep creases.  If one part of your face is aging faster than another, a procedure can be customized to target that region, such as a “mini-face lift”, or neck lift.  In conjunction with surgery, hollowed areas can be filled in with fat injections (lipoinjection or fat transfer) or injecting fillers such as Sculptra, Radiesse, Jeuvederm or Restylane

It is impossible to remove every wrinkle regardless of the treatment and too much surgery would result in an un-natural, pulled or plastic look.  Fine wrinkles, particularly those about the mouth, may require additional treatment, such as chemical peeling, dermabrasion, laser or filler injections.  The procedure intends to rejuvenate the facial appearance and may subsequently restore a youthful feeling.

Contrary to some articles in popular newspapers and lay journals, a face lift is not as simple as having a hairdo. The procedure is accomplished by an operation and, as in all operations, there is risk involved.  Cosmetic surgery is an art and an inexact science; consequently no assurance or guarantee of results can be given. Your result is highly dependent on the skill and experience of your surgeon.  There have also been many advances in the field of facial rejuvenation such as short scar technique and endoscopic assisted surgery.  The surgeons at Pacific Center for Plastic Surgery each hold 25 years of experience in these techniques and utilize the latest advances.  They are considered experts in the field of facial rejuvenation and are board certified by the American Board of Plastic Surgery, and members of the American Society of Aesthetic Plastic Surgery.

The face lift can be done in combination with removal of fat from beneath the chin directly or by liposuction (submental lipectomy) and/or rearrangement of the platysma muscle of the neck to give a more youthful chin line.

Incisions: These vary to some degree depending upon whether the patient is male or female, the hairstyles, hairline, age, previous surgery, etc.  Generally the incision starts in the temple, in front or within the hairline.  It continues in front of the ear, sometimes partially hidden within the ear (tragus). It then goes under the earlobe, behind the ear fold and ends within the hairline or at the hairline behind the ear.  The newer, shorter scar techniques, which do not include scars in or by the hairline, can be used for most patients.  Frequently another small and hidden incision is made under the chin in a natural skin fold.  This allows fat removal and tightening of the platysma muscle in the neck if required.

Surgery Location: Face lifts and ancillary procedures are usually performed as outpatients in a surgicenter.  A one night stay in post-operative care facility may be advisable in some cases.  Local anesthetic combined with intravenous sedation is usually used.  This will allow the patient to sleep through most of the procedure. General anesthesia is available upon request but usually is not necessary.

Patients should expect swelling, discoloration, and bruising of the skin for several weeks following a face lift.  Individuals vary a great deal in their response, but commonly the patient will be presentable within 3 weeks. Our experts in camouflage make-up can teach you how to make temporary bruising less or not noticeable shortly after surgery.  The marks left by the incisions are often noticeable at first, but these gradually improve as the wounds mature. Specialized lasers such as the Diolite, and IPL lasers at the Pacific Center for Plastic Surgery can be utilized to make your scar pale and mature more quickly giving you a finer, less noticeable scar beginning a few weeks following surgery.

The scars mature during the 6-12 months following the procedure.  During the healing time, it will become apparent that the procedure reduced the sagging and loose skin creating a more youthful appearance.  The facial features themselves are generally not appreciably changed.  Additionally, the fine lines and wrinkles of the face are usually not significantly affected by a face lift; dermabrasion or chemical peel of the skin are sometimes used to reduced fine lines during or after a face lift.  Fat or other volume filler injections may also be recommended.

Results vary between individuals, thus it is difficult to determine how long the results will last.  On average, results hold for 5 to 10 years as the skin continues with the natural aging process.  You may repeat the face lift procedure at a later time if you wish. There is always an improvement compared to not having the procedure, even though the aging process continues in the future.  A good analogy is that you are “setting your clock back with surgery but it keeps on ticking” so that you will always look better in the future because of the procedure despite the fact that you continue to age.  On occasion, patients with very loose skin experience early sagging as soon as the first year and require a secondary procedure to tighten the loose skin.

General Risks of surgery include infection, pain, delayed wound healing, hematoma (a collection of blood at the surgical site,) bleeding, reactions to anesthetic.  All surgeries have a possibility of complications and poor results; cosmetic surgery is no exception. Fortunately, complications in this field of surgery are uncommon.