Facelift And Rhytidectomy

What is a "facelift" or "rhytidectomy"?

A facelift or rhytidectomy is a procedure where excess skin is removed from the face, with the incision usually being in front of the ear area and the skin is pulled up. That is what is classically called a facelift. A facelift or rhytidectomy does not include either the eye area or the forehead area.

How is facelift performed?

There are a variety of different ways that a facelift is performed, but for the most part all types of facelift do the same procedure. That means elevating or increasing the amount of soft tissue on the face, raising it from where it's down here to up here. And then on the skin, a facelift usually entails removing or resecting extra skin, skin that's been sagging or hanging down. And really what's changed in facelift procedures is the size of the incision and where the scars are. In the old days facelifts used to make a big scar, which would go from in front of the ear to right behind the ear, and now these days we're making shorter scar facelifts. But the facelift procedure itself is pretty much the same. Remove excess skin, tighten the underlying structures.

Who can get a facelift?

Any patient that has complaints of their face, whether it is sagging cheeks, jowling, extra skin of the neck area, or they're just really unhappy with their facial appearance, is probably a good candidate for a facelift. You need to check with your medical doctor to make sure there are no medical reasons that you can't have a facelift.

Is a facelift painful?

We, as plastic surgeons, try to limit as much pain as possible with the facelift procedure. And there are variety of different anaesthetic agents that we can use to limit the amount of pain that's involved in a facelift. But in some respects, the first day or two after a facelift are rather painful and over the course of the week that pain usually subsides rather well.

What are the risks and complications associated with facelift?

There's been a lot in the media recently about certain patients dying during facelift procedures, and these deaths were at some of the most reputable hospitals in New York and within the country. The risks of facelifts are usually associated either with underlying conditions or with the anesthesia. The other concern is that patients having facelifts are usually older patients, either in their 50s, 60s, or 70s, so the risk of anesthesia and complications during a facelift certainly goes up. For the most part, facelifts are safe and effective when done under the proper precautions.

What incisions or scarring should I expect with facelift?

Facelift surgery has really undergone a shift in the last couple of years, and what's happened is we have made shorter and shorter scars. There's something classically called the short scar facelift, where the incision is primarily just in front of the ear. If you're a candidate for a short scar facelift, obviously that'll give you the smallest scar. But some patients need to have the classic facelift scar which extends into the hairline back here. In either sort of facelift, you may also have a small incision right here in the chin area if your doctor is going to remove fat or tissue from your neck during the facelift. But most facelift scars heal very nicely with almost no scarring.

What should I expect after facelift surgery?

I don't like to scare my patients, but I always tell them that you're going to look like you got beaten up right after facelift surgery. I always joke that patients hate you the first day or two, but once they start seeing results and the swelling and bruising goes down, they're very happy with the facelift surgery.

What post procedures should I follow after a facelift?

Usually within the first few days after facelift surgery there is significant bruising and swelling, and there are stitches that may be removed from your plastic surgeon in his office. He may also put garments or special wraps on your face to help compress the facelift flaps. Other options include keeping your head elevated. In general, a facelift does not have many post-op requirements. Keeping your head elevated and keeping the incision sites clean and moist is pretty much all that needs to be done after facelift surgery.

Will I have to take time off from work after a facelift?

You're going to have significant bruising and swelling after a facelift. So if your having facelift surgery I would suggest that you consider either a week or two off from work. It's not necessarily a matter of being able not to function after a facelift, but you're going to be black and blue and swollen. So if you're going to meet clients as part of your work, or patients, or have any social interaction, you're probably going to be pretty bruised up for a week or two. I would consider working at home as better off.

Will I be able to put lotions or soap on my face after a facelift?

Many plastic surgeons have their own skin care regimens after plastic surgery, to make sure that the facelift flaps heal well. There are a variety of different regimens, so it's really up to your own plastic surgeon to determine what he or she thinks.

How long will my facelift last?

A good facelift should last you about 10 years. Obviously, if you start seeing sagging or loosening of the skin before that, you may want to have a revision or secondary facelift. But for most good facelifts, about 10 years.

What are the costs associated with a facelift?

A facelift is considered a cosmetic procedure, so medical insurance will not pay for it. The costs are usually threefold: the doctor's fee, the anesthesia fee and the facility fee. The facility can either be for the doctor's office, a surgery center or a hospital. If you choose to stay over in a hospital after a facelift, which many patients do, there is obviously that included fee.

Can I get other plastic surgery procedures at the same time as receiving a facelift?

Many times the facelift doesn't address other parts of the face, such as the eye area and the brow area. Often a facelift is combined with an eyelift and a browlift for a total facial rejuvenation. In fact, a facelift can be performed with other surgeries at the same time.