As people grow old, the effects of gravity, sun exposure and the stress of everyday life could show up on their faces. Deep wrinkles are formed between nose and cheeks, the face loses its shape and sags, creases and fat pockets appear around the neck.
A facelift (rhytidoplasty) cannot stop the ageing process. It can ”turn back time” though, enhancing the most visible signs of ageing by the removal of excess fat and skin tissue, the tightening of the face muscles and the reallocation of the face and neck skin tissue. A facelift could be combined with other procedures such as blepharoplasty or rhinoplasty
Best candidates for a facelift
Best candidates for a facelift are men and women whose face and neck is beginning to “sag”, but whose skin hasn’t lost its elasticity and whose face bone structure is strong and well defined. Most of the patients are between 40 and 60 years of age, but a facelift can be successfully performed in older patients.
A facelift can make a person look younger, more fresh and radiant and will boost his or her self-confidence. It can neither give you a whole new appearance, nor can it restore the health and vitality of youth.
Before you decide to undergo the operation think carefully what your expectations are and make sure to discuss them thoroughly with your surgeon.
Every surgical operation carries risks
When a facelift is performed by a certified plastic surgeon, complications are rare and usually minor.
Everyone’s anatomy, natural response and healing ability are different, therefore the results of a surgical procedure are never exactly predictable.
A smoker, will most probably go through a worse healing process than a non-smoker.
All risk is significantly reduced when the patient follows the surgeon’s orders both before and after the operation.
Arranging your operation
A facelift is a highly personalized procedure. Your surgeon will evaluate in the beginning your face and skin, your bone and muscle structure, and will discuss thoroughly your goals for the operation.
He will question you on your medical history, to avoid possible problems that can occur during and after the operation.
High blood pressure, problems with blood coagulation and a tendency for hypertrophic (raised) scars are an example of such conditions. Do not forget to tell your surgeon if you are a smoker or take any medication, especially aspirin or medications that contain aspirin which affects blood coagulation.
The surgeon will explain to you the procedure and the anesthesia you will receive, the hospital where the procedure will take place, the risks and the expected cost of the operation. Do not hesitate to ask anything concerning the procedure.
Preparation for surgery
Your surgeon shall provide you with specific instructions for your operation regarding what to eat & drink, smoking, taking or not certain vitamins and medication. If you follow those instructions, your operation should end in success. If you are a smoker it is imperative to stop smoking at least one or two weeks before and after the operation.
Smoking prevents blood flow to the skin and can impede proper healing of your face.
Before surgery it is advisable to let your hair grow a little to cover the scars during healing.
Make sure there is a friend or member of the family to drive you back home after the operation is over and the doctor discharges you from the hospital.
Where does the procedure take place
Facelifts are performed in a hospital. The procedure takes place in the morning and later that day you can return home. If there are other medical conditions not related to the procedure (e.g. diabetes, high blood pressure e.t.c.) you may need to stay at the hospital overnight.
Most facelifts are performed under general anesthesia. The surgeon may alternatively inject a local anesthetic in combination with a sedative, so that the patient is relaxed and the experience is painless.
Facelifts are delicate and highly complex operations. It takes time to achieve the desired results.
Every surgeon approaches the procedure in his own way, although they usually operate first on one side of the head and then on the other.
The incisions around the ears are concealed under the hair and follow the natural lines of the face
In general, skin tissue is separated from the face muscles. If necessary, liposuction is performed on the neck (especially on the “jowl”) at the same time. Then the face muscles are lifted internally, with sutures. Finally excess skin tissue is pulled and trimmed and the incision is closed with fine sutures.
Ending the operation, the surgeon places temporarily a tiny plastic tube under the skin behind your ear to drain all the possible post-surgery fluids. The head is usually bandaged like a turban for a few days to minimize post-surgery swelling and bruising.
After the operation
The procedure does not cause any significant discomfort. Common pain killers can take care of any slight pain. A little numbness of the face is common and expected. This can last a couple of weeks and then the usual feeling of your face returns. It is best to keep the head elevated as much as possible (e.g. sleeping with two or three pillows) for a few days after the operation.
One or two days after the operation, the plastic tube behind your ear is removed, while the bandages are usually removed after five days. In the beginning, your face will look a little strange: swollen and bruised. In a few weeks though you will look many years younger.
Most of the sutures are removed after a week.
After the operation
The day after surgery you will be able to stand up and move with ease. For about a week after surgery you should be very careful with your movements. In the beginning your face will feel rather numb and sensitive, not reacting in the usual way. Swelling might temporarily change your features and your face movements will seem a little stiff. Possible bruising will last approximately for ten days.
You will receive specific instructions from your surgeon about the gradual return to your everyday activities. Avoid physical strain, including sex and heavy house work for at least two weeks. Walking is allowed. Avoid alcohol and saunas for several weeks. Most of all, give your body the chance to spend all its energy to your healing.
The third day after the operation you will feel and look much better. Most patients return to work ten days to two weeks after surgery. You can use makeup from the second week on.
Your new look
You will be pleased with the operation, especially if you realize that the results take a few days to show. Your skin will feel numb and dry for a long time. Men could realize that from now on they should shave in new spots (on the neck behind the ear) where new skin tissue with hair is relocated. The incisions are easily concealed under your hair around the ears. In any case, the scars will thin gradually and within a year will barely be visible.
Facelifts don’t stop our biological clock. Your face will continue to age, and you might want to repeat the procedure five or ten years later. From another perspective though, the results of a facelift are permanent, because years later you will continue to look better than if you had never had the facelift.