ABOUT FACE LIFT
The following is information regarding face lift surgery which is important to review, understand and discuss with family or friends before choosing to proceed with this surgery.
GOALS OF FACE LIFT SURGERY: The goal of face lift surgery is to partially reverse the signs of aging which are due to skin laxity, fat accumulation, and loss of facial contour due to skin sagging. Some wrinkles will be “effaced” or smoothed out by the procedure, but deep crevices and creases, particularly around the nose and lips, will be improved through the face lift procedure. In any given patient, these goals may be only partially met.
LIMITATIONS OF THE PROCEDURE: The face lift procedure does not affect the forehead, eyes, or upper lip. In addition, deep wrinkles, skin blemishes, and scars will not be improved. The procedure cannot create younger skin nor can it alter developmental asymmetries or prevent continued aging. It is important to realize that this procedure does not make you “look younger” but gives you a refreshed, more youthful appearance for your age. The effects of the face lift may be present for up to 5-10 years, but eventually, the aging process will cause a recurrence of the original condition.
ALTERNATIVES TO THE PROCEDURE: Face lift surgery is an elective procedure designed to help reverse some signs of aging. Without the surgery, the face will continue to age as expected. In certain instances, a full face lift procedure may not be required to effect significant improvement. Chemical peels, laser treatment, or suction lipectomy without the face lift surgery may be alternatives in some patients.
SURGICAL TECHNIQUE/ ANESTHESIA/ RECOVERY: Face lift surgery is generally performed through incisions in front of and behind the ear which extend both into the temporal hairline and the posterior neck hairline. Through these incisions, the skin of the cheek, jawline, and neck is elevated from the underlying supporting structures along with, in some instances, the elevation of the deeper supporting layers. The skin and underlying supporting layers are then pulled upward and fixed in place with sutures. This results in a tightening of the skin and facial structures. In addition, obvious fat pockets overlying the jawline and underneath the chin are frequently tightened in the midline to sharpen the chin and jaw angle. The procedure is usually performed under anesthesia, but in certain instances can be performed under local anesthesia with heavy intravenous sedation. The procedure can be combined with upper face procedures such as forehead lift or eyelid surgery. The procedure may be performed in the hospital or in a surgical center. An overnight stay is usually recommended to observe the extensive areas of dissection for possible bleeding. The facial sutures are usually removed around 1 week after surgery. There is considerable swelling and bruising of the facial tissues resulting in black and blue marks and facial distortion. The swelling will greatly subside within 10 days to two weeks, although there may be some residual swelling for several months following the surgery. It is generally recommended that at least a 2-week absence from work be expected. In addition, physical activity, particularly bending and vigorous exercise be curtailed for 3 to 6 weeks following surgery. Bandages are usually placed around the head on the first day and evening of surgery but are removed within a day or two of surgery. It is possible to wash one's hair 48 hours after surgery. Makeup can be worn starting 8-10 days following surgery. The entire surgical procedure takes approximately 4 hours. Blood loss is generally minimal and a transfusion is rarely required.
RISKS AND COMPLICATIONS: Surgical complications accompanying this procedure can include bleeding or fluid collection underneath the skin which may necessitate a return to the operation room for removal. Bruising and discoloration of the facial skin along with swelling as far down as the clavicles or upper chest is not unusual following this procedure and is not considered a complication. Occasionally small pockets of fluid accumulation occur for several days to several weeks following surgery which requires needle drainage in the office. Occasionally, the scars in front of the ear or behind the ear are reddened or thickened and may require secondary procedures. Skin dimpling, wrinkling, or permanent creases may occur.
There is usually a change in the hairline which is generally subtle, but in some patients, it may be obvious. In men, the beard pattern around the ear may be altered. In patients of both sexes, there may be hair loss in the temporal area or behind the ear. Numbness of the earlobes may occur as a result of the dissection in the neck. There is usually numbness of the skin for a period of two weeks to months following surgery which improves with time. As the nerves return, it is common to experience a tingly or irritating sensation in the facial skin. I some instances, the nerve branches which innervate the muscles of the cheek or around the mouth may be traumatized during the surgery resulting in weakness of the muscles. This is generally a temporary condition and usually corrects itself within three to six months. In very rare instances, permanent nerve damage may occur with alterations in facial expression. Some patients experience a period of psychological depression following surgery because their expectations for an improved facial appearance are not immediately evident due to the expected and normal postoperative swelling and bruising. This temporary psychological alteration improves as the facial appearance improves. There may be areas of lumpiness or irregularity in the skin for several weeks to months following surgery which again generally resolves as healing progresses. Return to work can be anticipated within 1 week of surgery and full normal activities within 4-6 weeks of surgery. Even though the risks and complications cited above occur infrequently, they are the ones that are peculiar to the operation or of the greatest concern. Other complications and risks can occur but are more uncommon. Any and all of the risks and complications can result in: Additional surgery, hospitalization, time off work, or expense to you.
The practice of medicine and surgery is not an exact science. Although good results are expected, there can be NO guarantee nor warranty expressed or implied by anyone as to the results that may be obtained. Many factors beyond the control of the surgeon affect both short and long-term outcomes, including but not limited to, each patient’s individual skin quality, genetic makeup, a tendency toward scarring, and other health factors. On occasion, secondary surgeries may be indicated or desired to obtain optimal results. If such procedures are performed, there may be additional charges incurred by you.
COMMENTS: If a smoker- must be off cigarettes for 3 weeks before and 3 weeks after surgery. There is a much greater risk for scarring, poor healing, hair loss, and skin loss in smokers.
Must be off all products containing Aspirin for 3 weeks before surgery and after surgery. Some medications, such as Motrin and Advil may also affect clotting. You must stop all herbal medications 2 weeks prior to surgery. Check all medications with us.
If there is any item that you do not understand, please call the office. An explanation or additional information will be provided.