Houston Facelift (rhytidectomy)

A facelift, or rhytidectomy, is one the most popular and satisfying cosmetic surgery procedures. This procedure smoothes loose skin on your face and neck by removing excess fat, tightening underlying muscles and re-draping the skin. Although it cannot stop the aging process, a facelift can minimize the appearance of deep cheek folds and loose sagging skin on the face and neck. As a result your face will appear younger and fresher. A facelift can be performed by itself or in conjunction with other procedures such as a forehead lift, eyelid lift, or nose surgery.

• How is a facelift performed?
• How long does a facelift take?
• What type of anesthesia is used?
• Where is the procedure performed?
• When can I return home and resume normal activities?
• How do I prepare for a facelift?
• What precautions are necessary during recovery?
• What are the possible complications after a facelift?
• What results can I expect after a facelift?
• Choosing the right surgeon

How is a facelift performed?

There are many variations to the facelift procedure. The incision typically begins in the hair near the temple and continues in front of the ear, around the ear lobe into the crease behind the ear, then into or along the lower scalp. Muscles and sagging tissue are tightened, excess skin or underlying fat is removed, or suctioned and the remaining skin is repositioned or tightened to create a more youthful look. Your surgeon will then apply sutures (stitches) or metal clips on the scalp to secure the layers of underlying tissue and close the incision. If the neck needs lifting, a small incision may be made under the chin as well. Your surgeon may apply small drainage tubes behind the ear to drain away fluids that might accumulate. In addition your head may also be wrapped in bandages to reduce any swelling.

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How long does a facelift take?

Facelift surgery generally requires two hours to perform, depending upon the complexity of the procedure and your particular goals.

What type of anesthesia is used?

A facelift may be performed under local anesthesia with either light or deep sedation, or general anesthesia. The longer the procedure is expected to take, the more likely that general anesthesia will be recommended. You can discuss and determine your particular needs for anesthesia with your surgeon.

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Where is the procedure performed?

A facelift may be performed in a surgeon's office-based surgical suite, an outpatient surgery center, or a hospital.

When can I return home and resume normal activities?

Patients usually return home the same day, although, may hospitalize patients for a day when using general anesthesia. Most people return to work and their usual activity within ten days.

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How do I prepare for a facelift?

During your initial consultation, your surgeon will discuss the changes that you would like to make to your appearance. Since the appearance of your face and neck is a matter of personal perception and preference, you will need to discuss your concerns in detail so your surgeon can determine the appropriate alternatives. You also should make arrangements ahead of time for someone to drive you to and from your procedure and to assist you with your daily activities during your recovery period.

Prior to your surgical procedure, the surgeon will perform a complete health history and physical. Knowledge of your allergies, medications and previous surgeries should be brought to your surgeon's attention at this time. Smoking cessation is advised for at least one week prior to your surgery. Smoking inhibits blood flow to your skin and may delay the healing process of your incision areas. Specific instructions to assist you in preparing for this procedure will be given to you after the health history and physical is complete. Depending on your individual health status, the instructions may include guidelines regarding your diet, alcohol intake, smoking and which medications to take or avoid. Your experience will be much smoother if you remain compliant with your surgeon's instructions.

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What precautions are necessary during recovery?

You will have a bandage for the first night. The tiny surgical drains placed in the hair behind your ears will be painlessly removed along with your bandages on the following morning. After an eyelid procedure, ice compresses are applied for 24 hours, but the eyes are not bandaged and lubricating ointment/drops used may cause blurred vision for one to two hours. Immediately after the facelift, you may notice a tight sensation in the neck and under the chin. This feeling may last several weeks and is a normal part of recovery.

You are encouraged to shampoo your hair daily after your procedure with a mild shampoo. A light cover-up may be applied to the eyelids starting four days after your procedure. Eyelid makeup including mascara, eye shadow, eyeliner and artificial eyelashes may also be applied four days after your procedure. However, it is important to remove all makeup thoroughly at the end of the day using an upward motion. You may use oiled eye pads for removal of eye makeup. All stitches (sutures) will be removed within seven to ten days; eyelid stitches (sutures) are to be removed in four days.

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What are the possible complications after a facelift?

Facelifts rarely produce serious complications. The most common complication after a facelift is a collection of blood under the skin (hematoma). In less than two percent of facelift operations, this collection of blood must be removed in the operating room immediately post-procedure. Occasionally, small hematomas are removed several days after the procedure. Complications such as infection, eye irritation, delayed healing or excessive scarring are rare.

Small sensory nerves near the surface of the skin are interrupted during a facelift and portions of your scalp, cheeks, and neck may feel numb. Sensation usually returns over several months, but some numbness may last indefinitely. Facial nerve damage could occur, but is extremely rare.
With a facelift, the scars are placed either within the hair or in natural creases and lines of the face so that they are inconspicuous or easily hidden by makeup or hair styling. Your scars fade with time and are usually not noticeable. It is always important to be informed about the possible complications before any surgery. Be sure to discuss any concerns you may have with your surgeon.

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What results can I expect after a facelift?

Some swelling and discoloration is expected following your facelift, but usually subsides within 10-14 days. Your surgeon will want to examine you several times during the week or two following your facelift. Your stitches will be removed in stages, usually between the third and tenth postoperative days. Your hair around your temples may be thin at first and your skin may feel dry for several months. You will feel happier with your facelift if you realize that the final results may not be immediately apparent.

Remember that a facelift cannot stop the aging process. Although excess skin is removed and wrinkles are diminished, your skin continues to age. In time you may feel the need to have a second procedure. As you grow older the skin of the upper lids becomes looser and may create additional folds in which case an upper lid "touch-up" can be done. While additional procedures are done for some, most have only one facelift and remain pleased with their appearance.

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