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Candidates:
Usually men and women over 40, although some patients in their thirties
may benefit from this procedure.
Objectives:
To improve the deep fold from the nose to the corner mouth, the jowls,
jaw line and cheekbones. It can also help the loose skin, and “turkey
gobbler” aspect of the neck by removing excess fat, tightening muscles,
redraping skin. It can be done in conjunction with the forehead lift and
blepharoplasty to correct the eyebrows and eyelids.
Incisions and technique:
There are different variations of facelift procedure. The incision is
usually placed in front and behind the ear, and is hidden in the natural
folds. From the back of the ear the incision goes into the scalp and is
hidden by the hair. The ear lobe has to be free and natural, avoiding
a stretched appearance. Sometimes a small incision underneath the chin
can be used to help with the tightening of the neck muscles. If necessary
the deeper tissues of the face and neck may also need to be repositioned.
The skin is pulled up and back and the excess is removed. The aspect should
look normal and not stretched. The fixing of the neck might involve liposuction
or liposculpture to improve contour. One of the most important aspects
of the facelift is the reposition of the lost volume. This can be achieved
either by folding and suturing the deeper structures or by injection of
fat, which is aspirated from another area.
Operating Time:
Two to four hours.
Anesthesia:
Local with sedation, or general.
In/Outpatient:
Usually outpatient. Some patients may require a 24 hour stay.
Recovery:
Back to work: 10 to 14 days. More strenuous activity: 2 weeks or more.
Bruising: 2 to 3 weeks. Must limit exposure to sun for several months.
Risks:
Complications from facelifts are not frequent. Hematoma (the accumulation
of blood under the skin), infection, bleeding and reactions to anesthesia.
Some incisions can be visible due to individual variations in healing
and might have to be revised. Temporary injury to the nerves that control
facial muscles or feeling are rarely permanent. Asymmetry or change in
hairline.
Details:
A facelift does not correct wrinkles around the mouth. The choice of procedure
will depend on the thickness, texture and elasticity of the skin, the
degree of the wrinkles and folds. Usually excessive sun exposure produces
more wrinkles and the facelift might have to be combined with a skin resurfacing
procedure to eliminate them. The placement of the incisions will depend
on the hairline Another procedure commonly associated with the facelift
is the rejuvenation of the nose (See Rhinoplasty.) Smokers should stop
smoking before surgery. Aspirin should be avoided to avoid increased bleeding.
A bandage may be used to avoid bleeding and minimize swelling. Drains
will be applied to avoid the accumulation of fluids. Recovery varies greatly.
Sleeping with the head elevated helps minimize swelling and bruising.
Bandages and drains should be removed in one or two days. Temporary asymmetry
can be caused by the swelling and bruising and it is normal. Bruising
should disappear in two or three weeks. Makeup can be applied after a
few days. Numbness can last for several weeks. Sun exposure should be
avoided for the first month. wait several weeks to evaluate the "new look."
As the aging process continues, some patients want to make additional
improvements in their looks. Some men might have to shave behind ears,
where beard-growing skin is replaced.
Duration of Results:
Usually 5 to 10 years.
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