Cy-Fair Lifestyles and Homes magazine Dec 2009: Health1 - Rhytidectomy: Real answers to real questions about facelifts

By Cheryl Alexander

Aging is an inevitable process. As the years pass, our skin loses elasticity and begins to loosen on our faces and necks. Crow ’s feet make their appearance in the corners of our eyes; facial lines become first creases, then folds; our jawline becomes more jowl-like; our chin multiplies two or three times; our neck sags. Worse even, nothing we try in the way of prevention works the way we imagine it should. We look in the mirror and wonder, “Is it time yet for me to consider a facelift?”

Whether you’ve actually had this conversation with yourself or not, educating yourself in regard to your options for maintaining your appearance as you grow older is a good idea. According to The American Society for Aesthetic Plastic Surgery, more than 150,000 Americans each year opt to undergo facelift surgery, or rhytidectomy, so it is obviously on the minds of more than a few people. In this article, you ’ll find real answers to real questions about rhytidecotmy.

Who can I trust to perform this kind of surgery?

Great question! This is the first and most important question you can ask. Be sure that you select a surgeon whose credentials include the following:

•Has completed at least five years of surgical training with a minimum of two years in plastic surgery;

•Is trained and experienced in all plastic surgery procedures, including breast, body, face and reconstruction;

•Operates only in accredited medical facilities;

•Adheres to a strict code of ethics;

•Fulfills continuing medical education requirements, including standards and innovations in patient safety;

•Is board certified by The American Board of Plastic Surgery.

Who is a good candidate for a facelift?

The best candidates for facelifts are people who are experiencing some wrinkling and sagging in the skin of their face and neck, but whose skin still has some elasticity. The procedure works best on people in their 40s, 50s and 60s, but it still can be effective on patients into their 80s.

Facelifts are recommended only for people of normal weight who are in good health. Those with certain conditions, such as blood clotting problems, uncontrolled high blood pressure and the tendency to form large scars, should check with their primary care doctor before considering a facelift.

What is a basic facelift procedure like?

Just as each face is unique, each patient can expect a unique experience. Prior to surgery, the doctor will assess the patient ’s skin condition and consistency and explain the procedure. Smokers will be asked to stop smoking permanently or, at the least, for several weeks before and after surgery. As with any surgery, smoking interferes with both circulation of blood and the healing process. Additionally, patients will be expected to avoid aspirin and any other medications that may increase bleeding. On the day of surgery, a

facelift procedure will involve the following basic steps:

Step 1 – Anesthesia

Medications to aid in your comfort during surgery will be administered. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision

During a traditional facelift, the doctor makes an incision that begins around the hairline near the temple and curves around the earlobe, ending at the bottom of the hairline. The surgeon may also make a small incision under the chin to specifically tighten the skin of the neck.

The doctor separates the skin from the fat and muscle underneath, then suctions out (via liposuction) or trims excess fat to give the face a sleeker look. The doctor next tightens the SMAS layer of skin to lift the cheeks, give the jawline more definition and firm the neck.

Step 3 – Closing the incisions

Finally, the doctor restores the outer layer of skin and removes any excess with a knife or laser. The incision is closed with stitches, sutures or tissue glue. The surgery can take between two to four hours, depending on the extent of the tissue and muscle work and the number of different procedures being performed.

Step 4 – The results

The visible improvements of a facelift appear as any swelling and bruising subside. Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear. Your final, long-lasting results should not only restore a more youthful and rested appearance, but also help you feel much more confident.

Are there other types of facelifts?

Yes, there are a few other choices. The mini-lift is a less-invasive procedure where a smaller incision is made and a smaller area of the face is targeted than in a traditional facelift. A type of mini-lift called the “weekend facelift” derives its name because many patients opt to have the procedure performed on a Friday and return to work on a Monday. A mini-lift will improve the appearance of jowls and loose skin in the neck, but with less dramatic results than a true facelift.

Another option is the S-lift, which targets only on the lower third of the face, smoothing out the neck and jowls. After the doctor injects a local anesthetic into an area near the ear, an S-shaped incision is made to separate the skin from the tissue underneath. When the skin is lifted, the underlying muscles and tissues are

tightened. Because of the smaller area being worked on (and therefore the smaller incision), this technique takes less time than a traditional facelift, and the recovery time is shorter.

To perform the mid-facelift, the surgeon makes tiny incisions in the hairline above the patient ’s ear, as well as inside the mouth, pulling the fat pads in the cheeks up and over the cheekbones to tighten sagging skin in the cheekbone area. This procedure is commonly performed with an endoscope —a tiny camera that allows the doctor to visualize the surgical area.

What should I NOT expect from a facelift?

A facelift will not change your fundamental appearance and cannot stop the aging process.

A facelift can only be performed surgically; non-surgical rejuvenation treatments will not achieve the same results, though they may help delay the time at which a facelift becomes appropriate. Rejuvenation treatments will complement and sustain the results of the surgery.

Are there other procedures that I should possibly consider to be performed at the same time?

A variety of other procedures can further enhance the outcome of a facelift. They include:

•Facial implants

•Soft tissue augmentation to recontour the facial structure

•Resurfacing techniques to improve the tone and texture of facial skin

•Wrinkle reduction by injection

•Brow lift

•Eyelid surgery (blepharoplasty)

How much does a traditional facelift cost?

The surgeon’s fee is typically about $5,000, and the entire procedure can range anywhere from $6,000 to $12,000. It can be pricey, and because the facelift is a cosmetic procedure, most insurance companies won ’t cover the cost. But the results are longlasting—generally 10-15 years. Non-surgical techniques are about a third of the price, but the results don ’t tend to last as long.

Is a facelift right for me?

A facelift is a highly individualized procedure and you should do it for yourself, not to fulfill someone else ’s desires or to try to fit any sort of ideal image. Only consider facelift surgery if you are healthy and don ’t smoke or are willing to stop smoking; if you have a positive outlook and specific, yet realistic goals for your outcome in mind. And always ask your doctor to fully explain the risks of any procedure, factoring in your individual medical history. l