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Facelift (Rhytidectomy)
The face-lift is a surgical procedure that is designed to restore a youthful appearance to the face and neck area. It is intended to restore youthfulness, and set back the clock a few years.
Clinically the face is divided into upper, middle and lower thirds. The face-lift is designed to restore a more youthful appearance to the lower 2/3 of the face and the neck. The traditional facelift alters the face by focusing on the cheeks, jowls, neck and temples. To a lesser extent the lower lids may be positively affected as well. The operation relies on the removal of excess skin, the re-positioning of underlying fat pads, and the tightening of select facial muscles.
The facelift is not designed to provide rejuvenating changes to the eyelids, forehead or brow. Nor does it address persistent wrinkles around the mouth. Rejuvenation procedures in these areas are separate and require eyelid (blepharoplasty), brow lift surgery, or skin resurfacing (laser, dermabrasion, or chemical peel). It is possible to combine facelift surgery with eyelid and brow lift procedures or some minor resurfacing around the mouth but they are not part of the same surgical procedure, and are not described in this section.
Limited attempts at facial rejuvenation are now being performed with barbed sutures that redistribute skin and underlying tissues. These may be an option if you are looking for a procedure that is not as invasive and significant in terms of change and recovery time. However, as tissue planes are not developed using these techniques, they do not provide the same quality or extent of facial rejuvenation as formal face-lifts. Called mini-facelifts, these procedures will not be detailed further in this section. If you are interested, we suggest that you discuss this option with your surgeon.
Preparation:
Prior to any surgical procedure, it is important to take appropriate preparations to increase safety, and maximize the benefits of the procedure. First, patients should not take anti-inflammatory drugs such as Aspirin®, Motrin®, Ibuprophen, or Advil®, due to their effects on the body's blood clotting, for at least two weeks prior to surgery. Tylenol ES®, is a painkiller that can be used for those who suffer from chronic pain. Any use of herbal supplements or other alternative medicine should be discussed with your surgeon. Finally, alcohol should be avoided for at least a week prior to the surgery date.
Additionally, any medical condition or medications that are used must be disclosed to your surgeon prior to the procedure. Conditions such as high blood pressure are important considerations in a procedure like face-lifts where bleeding and hematomas are a real risk.
Smoking is a very important factor in face-lift surgery. Chemicals from smoking can cause vasoconstriction of blood vessels, which restricts the blood supply to the newly re-draped and transferred tissues. Smoking must be stopped at least 2 to 3 months prior to surgery in order to eliminate the risk of further tissue loss. It is important to understand that all smokers, regardless of quantity, are at an increased risk of tissue death following invasive procedures, and for this reason, some surgeons may refuse to operate on smokers.
The Procedure:
Although these procedures have been performed for decades, recent advancements in the field of plastic surgery have developed new methods that lead to more longer-lasting results.
The condition of the skin, location of hairline and extent of rejuvenation required will be evaluated prior to the operation. The incision starts in the hair behind the temples, follows the contour of the ear, and ends in the hairline behind the ear. A small incision is often made in the crease under the chin to allow the surgeon access to the neck area where the incisions are well concealed.
Tissue planes are developed that allow redistribution of the underlying fat pads and then removal of excess skin. These redistributions restore the youth to the face and the removal of excess skin removes may unwanted wrinkles. Fat may be removed from the neck and muscle repositioning hides the fatty or ropy look of the aging neck.
A mid-face lift may be recommended by a surgeon. In this procedure, the cheek below the lower eyelids are lifted and rejuvenated. This form of lift may be included as part of a formal face-lift, or used in isolation. These lifts are performed at a tissue plane between the facial skeleton and overlying tissues. They can be incorporated as part of a brow lift or as part of a lower eyelid (blepharoplasty) procedure.
The Recovery
Typical recovery time following a face-lift surgery is approximately 3 to 4 weeks. A facial bandage or garment is often used in the days following surgery, as well as OTC or prescription painkillers. Bruising and swelling of the face, neck, and the eye area is common, and peaks at 4 to 5 days following the face-lift. This is a normal part of the recovery process, and should subside within 2 to 3 weeks.
Expectations
Scarring from the procedure will take approximately 12 to 18 months before they can be assessed. Prior to assessment, it is essential that the scarred area is protected from the sun (using 45 o 60 SPF sunscreens) to prevent permanent darkening of the scars. Despite this, patient satisfaction with this procedure is typically high.
Complications:
A discussion of potential complications is essential with every discussion about a surgical procedure. It is important to know that although complications from surgery are possible they are not common. Some possible complications associated with a rhytidectomy are listed into both early and late complications:
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For a more detailed discussion on expected results, recovery, and specific complications, please see your individual surgeon.
Cost
Facelift surgeries are considered to be elective procedures, and are not covered under the Canadian Medical Plan and the final cost for such a procedure will be at the discretion of the plastic surgeon that is performing the procedure. The average cost of this procedure, as published by the Canadian Society of Aesthetic Plastic Surgery is $8000 (with a range of $6000-$12,000).
DISCLAIMER
This website does not cover all of the medical knowledge related to rhytidectomy or mid-face lifts nor does it deal with all possible risks and complications of surgery on the face, neck, and associated structures. Although it is designed to provide the patient with greater depth of information in some areas, it is not intended to substitute for the in depth discussion between patient and surgeon that must occur prior to any surgical procedure.
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