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| Services : Plastic Surgery : Face Lift |
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Am I a good candidate?
Wrinkles, sagging skin, laxity in the jowls and neck begin to appear after years of exposure to the elements, facial expressions and the natural aging process. Not long ago, a facelift was considered by many to be reserved for movie stars and celebrities. Today, a facelift, or rhytidectomy, is not just for the rich and famous. It is one of the most well-accepted and most frequently performed cosmetic procedures in the world. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well. Facelifts are very individualized procedures. In your initial consultation the surgeon will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery. Your surgeon should check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. Be sure to tell your surgeon if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.
Although the incisions made for a facelift are hidden back in your hairline, it does nothing to correct the visible signs of aging in the upper face. A facelift provides an overall lift to the lower third of your face by tightening loose skin in the jowls, neck, and jaw line. A facelift alone will not remove forehead wrinkles, crow's feet or bags under your eyes. These areas can, however, be treated at the same time as your facelift. During your initial consultation, your surgeon will discuss your particular condition, your expectations, and the probable outcome of your various treatment options. You will be shown several before and after photographs of patients having similar conditions, and we will explain the details of your procedure. The procedure Most facelifts are performed under local The incision is placed in the natural crease behind the ear. Excess skin and fat may be removed. The incision is then closed with fine sutures and/or metal clips. If metal clips are used, shaving hair from the incision site may be avoided. A facelift can take between two to four hours depending on the extent of the procedure
Most surgeons throughout our centers use Dr. Fanous technique which create minimal swelling. Pain is normally minimal and can be controlled with oral medications. We will take off your bandages in our office in a day or two after surgery. You may then go home, take a shower and wash your hair. Sutures may be removed in one week. Using Dr. Fanous technique, healing is a quick process. After about one week you will feel comfortable (with make-up) among strangers. After ten days you will look and feel confident enough to go out with friends again. Direct sun should be avoided for several weeks. Most patients are delighted with their new, more youthful and relaxed appearance. Your surgeon will give you more specific guidelines for gradually resuming your normal activities. They're likely to include these suggestions: Avoid strenuous activity, including sex and heavy housework, for at least two weeks (walking and mild stretching are fine); avoid alcohol, steam baths, and saunas for several months. At the beginning, your face may look and feel rather strange. Your facial movements may be slightly stiff and you'll probably be self-conscious about your scars. It's not surprising that some patients are disappointed and depressed at first. By the second week, you'll look and feel much better. Most patients are back at work about seven to ten days after surgery.
When a facelift is performed by a qualified surgeon operating in a good center, complications are infrequent and usually minor. Still, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable. Complications that can occur include hematoma (a collection of blood under the skin that can be easily removed with a fine needle), injury to the nerves that control facial muscles (usually temporary) and infection. Poor healing of the skin is most likely to affect smokers. You can reduce your risks by closely following your surgeon's advice both before and after surgery and refrain from smoking for several days before and after your surgery. Your new look The chances are excellent that you'll be happy with your facelift. The hair around your temples may be thin and your skin may feel dry and rough for a few weeks. Men may find they have to shave in new places-behind the neck and ears-where areas of beard- growing skin have been repositioned. You'll have some scars from your facelift, but they're usually hidden by your hair or in the natural creases of your face and ears. In any case, they'll fade within time and should be scarcely visible. Gravity and longevity are a formidable combination, leaving their mark on the skin and on all that lies beneath it. The skin shrinks here and sags there, thins out, and becomes increasingly susceptible to the damage caused by exposure to the sun. Sad to say, our faces begin to rearrange much earlier than most of us would like to admit. “Crow's feet,” those short straight lines radiating from the outer edge of the eyes, can appear any time after the age of 30. Skin in the upper eyelids loosens as well. Creases in the forehead, between the eyebrows, and around the nose and mouth suddenly seem more noticeable when a woman reaches her 40s. By the age of 50, the neck starts to wrinkle, the jawline seems to blur, and the tip of the nose may look a bit droopy. Although signs of age appear at different times in different women, facial wrinkling and sagging become hard to ignore by the sixth decade of life. A facelift (facialplasty) can turn the clock back a few years. Such procedures have been done since the early 1900s, but the modern era of facelifting dates from the 1970s when plastic surgeons began using techniques that correct the agerelated changes that occur deep beneath the skin. While a properly performed facelift will make a woman look younger, the procedure won't work miracles. Surgery can't transform you into a “different” woman, or save a marriage. One of the toughest jobs facing a plastic surgeon is deciding who will truly benefit from the surgery and who is likely to be disappointed.
Careful questioning during the first appointment helps doctors identify women who expect the impossible. If you have trouble describing exactly what you want to change or seem distraught about a relatively minor “deformity,” you are not a good candidate for a facelift, and probably won't receive one. If the doctor thinks plastic surgery would be good for you, he or she will ask about your medical history, any allergies, previous surgery, reactions to medication, and personal habits such as smoking. Anything that may interfere with natural blood clotting mechanisms such as high blood pressure and medicines containing aspirin, poses the danger of excess bleeding and must be avoided. Smoking causes skin sloughing, in which areas of skin literally slide off the face, leading to additional scars. Surgery may therefore be delayed for several weeks until your blood pressure has dropped to normal levels, for example. Aspirin and smoking are banned for at least two weeks before surgery. Preparations for surgery include a comprehensive physical examination. The doctor also checks every part of the face for creases, wrinkles, lines, puffiness, and sagging. The doctor will assess your skin's thickness, elasticity, and mobility; check the jaw and neck for fatty deposits; examine the thickness of the hair and note the location of the hairline; and document any previous surgical incisions and scars. An assistant will then take a series of photographs which the surgeon will use to plan the operation and explain the procedure to you. The photographs will also remind you later of how you looked before surgery. Such photo sessions are standard before just about any kind of plastic surgery. The doctor will explain the surgical plan feature by feature. Some trouble spots can be improved but not eliminated. Forehead lines, crow's feet, and creases around the nose and mouth can be softened, for example, but not removed altogether. Fine wrinkles can, however, be treated with a chemical face peel after the area has healed. Facelifts involve close work around the mouth and hairline, where bacteria hide in large numbers. To minimize contamination, you will be asked to remove all makeup the night before surgery and to scrub your face and wash your hair and scalp with a medicated soap.
Your hair will be combed away from your face. Antibiotic ointment may be combed into your hair to flatten it and prevent infection. You'll take antibiotic medication and perhaps a sedative as well. The surgeon will place marks on your face as a surgical “blueprint” just before you receive general anesthesia. The relatively small facialplasty incisions, next to each ear, give the surgeon full access to the face, from cheeks to chin. The forehead, eyes, and nose are done with separate incisions. Electrocautery is used to singe the blood vessels and minimize bleeding. The skin is pulled tight, redraped, and tacked down in two spots above and behind the ear. The surgeon trims the extra skin and closes the incision. The procedure is then repeated on the other side of the face. After the Operation THE SURGICAL REMEDY FOR SAGGING SKIN
 A facelift can't produce perfection, but it can reduce the bags, wrinkles, and creases that come with advancing age. Tucked under the hairline and behind the ears, the basic incisions are almost unnoticeable. Separate invisible incisions alleviate baggy eyes. Be prepared, though, for a long convalescence: it can take up to 3 months for swelling and bruising to totally disappear. After the procedure, an elastic net dressing that leaves only a small part of the face and eyes exposed will cushion the skin flaps and absorb drainage from the wounds. This dramatic mummylike dressing helps remind you to let your face rest. Dietary restrictions are necessary after facial surgery to limit the nausea and vomiting induced by anesthesia. Furthermore, chewing can cause bleeding. You'll start out on clear liquids and quickly progress to a full liquid diet. Soft foods are added the day after surgery. If all goes well, you can return to your usual menu the day after that. Movement is discouraged for 24 hours. Don't talk on the phone and walk as little as possible. Keep your head still and slightly elevated at a 30degree angle. After 24 hours, you can resume light activity. Most surgeons keep their facialplasty patients in the hospital for at least one night. You'll wash your hair on the third day after surgery and at least every other day after that, to keep the incisions clean. The stitches will be removed on days 5 through 10 after surgery. You can expect swelling, blackandblue marks, and numbness for many weeks after a facelift. Most women are confident enough to venture out of the house after a few weeks although all swelling and bruising may not disappear for 3 months. Sun block is strongly recommended for the first 6 months.
Several complications can follow facialplasty: Hematomas. The most common problem you may encounter is the formation of a hematoma, the pooling of blood under the skin. If too much blood collects—a situation that occurs only 10 percent of the time—the surgeon pierces the skin and drains it. Most “major” hematomas appear within the first 10 to 12 hours after surgery. Another 10 to 15 percent of patients develop smaller hematomas, many of which aren't noticed until the swelling goes down. Skin sloughing. This happens most often in the skin around the ear, where the skin is especially thin and is also geographically farthest from the circulation system that supplies blood to facial structures. Superficial skin sloughs (in the top layer of the skin) may leave little or no scarring. In the 1 to 3 percent of facialplasty patients who develop deeper, fullthickness skin sloughs, however, some amount of scarring is inevitable. The risk of skin sloughing is up to 12 times greater in cigarette smokers than in nonsmokers. Numbness. Your face may feel numb for 2 to 6 weeks after surgery. The reason is that lifting the skin disrupts the sensory nerves that provide feeling to it. Disturbing a facial nerve branch can interfere with your ability to move parts of your face. Full movement usually returns within a few weeks to a year after the injury, but can sometimes take even longer. Scars. Facelift scars tend to fade away, becoming virtually invisible. The scars can become more evident if the blood supply to the skin flaps was compromised during surgery or the skin was pulled too tight, causing tension on the incision. Hair loss. About 1 to 3 percent of people who have had facialplasty lose some hair, usually around the temples, where the incision interrupted the blood supply. Dark Spots. Patches of darker skin may appear when facial swelling prevents the diagnosis of small hematomas. In most cases, the skin gradually lightens back to normal, although the process can take 6 to 8 months. In rare cases, the darker spots become permanent. |
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