FACELIFT

What is it?
Cervicofacial rhytidectomy (facelift) is a cosmetic surgery that involves removing and tightening redundant skin of the cheeks, jowls, and neck. In most instances, the procedure imparts a rested and refreshed look and has a tendency to lessen the effects of aging from 5 to 15 years. Most patients note an alleviation of their “dis-ease” of facial aging within months of the procedure and by 6 months to one year; have a general comfort concerning their appearance. Many relate that they no longer think about their appearance after the surgical recovery period.

Who is the best candidate?
Best candidates are those patients who are seeking facelift results for themselves and are not doing it because someone else wishes for them to have it done. The best results are realized in those between 45 and 55 years of age who have reasonable expectations concerning the results of the procedure. Persons who have medical problems such as recent cardiovascular disorders (heart attack and stroke) or bleeding disorders may not be candidates for surgery.

How is the procedure done?
Tumescent facelift, the type of facelift performed at Piedmont Cosmetic Surgery and Dermatology Center, is done in an in-office surgical suite. Tumescent solution, which contains lidocaine and epinephrine, is injected under the skin to anesthetize the area and reduce bleeding. The solution also helps to establish the surgical plane in which the surgeon will be working. Chin liposuction may be performed prior to the surgery to reduce excessive fat in this area. Next, the surgeon cuts the skin in front of, below, and behind the ears. The skin is lifted and separated from underlying structures by a process called undermining. This undermining also establishes the cheek and neck flaps. The surgical plane that is created is well above the muscular layer, which contains vital nerves that allow for facial expression. The surgeon then tightens the underlying muscles with 4 to 10 non-absorbable sutures and cuts away ½ to 2 inches of redundant skin of the cheek and neck flaps. The surgery is completed by suturing or stapling the skin of each flap with the skin on the temporal scalp, the skin surrounding the ear, and the skin next to the posterior scalp. Most facelifts are performed in less than 4 hours.

What happens postoperatively?
Dressings are changed daily for the first two days after surgery. Sutures and staples are removed between 7 and 14 days. Scars are expected but should be minimal, particularly those in front of each ear. Swelling and bruising is greatest during the first week and resolves in 1 to 3 weeks. Most people can get out in public in 7 to 10 days and return to work in 14 days.

How long will the results last?
Most patients are satisfied with the results of their facelift and enjoy a youthful, refreshed appearance for 5 to 10 years. Some elect to undergo second and possibly third facelift procedures with excellent results, although subsequent facelifts are more technically demanding.

What are the potential complications?
While most people experience minimal difficulties with a facelift procedure, it is possible to experience one or more of the following:

• Skin infection
• Blood collection under the skin (hamatoma) or excessive tissue fluid under the skin (seroma)
• Nerve damage
• Persisting numbness around the ears