Facelift or rhytidectomy is an attempt to use surgical means to correct the changes which occur in the natural process of aging.
Facial skin can sag because of weight loss, the lifelong effects of gravity, the effects of smoking, or other reasons. With a successful facelift, the tightening of the facial skin and supporting tissues can “turn back the clock” from 5-10 years.
The ideal candidate for facelift is at a body weight that is normal or slightly under that which is normal for their height. They also have strong facial bony features (chin, cheekbones, etc.).
The best patients are non- smokers and they do not have a long history of sun exposure or skin cancers or excessive sun exposure, which leads to premature aging of the skin. Patients who smoke, are obese, and who do not have prominent facial bones may receive some benefit from facelift procedures but they will not have the quality of outcome seen in the ideal patient.
The Plastic Surgeon should discuss the expectations with regard to possible outcome in some detail. Patients with unrealistic expectations are not good candidates for cosmetic surgery, including facelift. Although a successful facelift can temporarily set the clock back, no cosmetic procedure can permanently forestall all the effects of aging. Some patients will require other procedures such as chemical peel to achieve the results they want.
A facelift is almost always done as an outpatient surgical procedure. Although some patients prefer to have a general anesthetic, most rhytidectomies are carried out under local anesthesia with sedatives providing a “twilight sleep” . This allows the patient to recover quickly post op and to go home the evening of surgery. They must have a friend or spouse to drive them home and to stay with them the first night.
In general terms, a facelift requires an incision which curves from within the hair of the forehead down in front of each ear and back into the hairline on the back of the head. If a browlift is being performed as well, the incision may continue over the top of the head (in the hair) to allow lifting of the forehead and eyebrows.
The skin is undermined and tightened and some of the supporting tissues deep to the skin may also be tightened. Liposuction is sometimes done if there is excess fatty tissue under the skin. Occasionally, if there are visible cords in the neck, another small incision may be necessary under the point of the chin so the surgeon can repair the neck muscles and restore a youthful look to the neck and jawline.