Facelift (Rhytidoplasty) is performed to tighten and lift excess face and neck skin. Wrinkles can be smoothed and sagging reduced.

Before Surgery

Prior to surgery, a medical history of the patient is taken in order to evaluate the general health of the patient. A careful examination is also conducted. The physician and patient discuss together how the face will look and what results can realistically be expected. The goal of the surgery is to produce a pleasing natural appearance. Photographs are taken before and after surgery in order to determine the amount of improvement. The type of anesthesia to be used, the procedure, and possible risks and complications are also discussed by the physician.

Preoperative instructions may include the elimination of certain drugs containing aspirin for several weeks before surgery in order to minimize the possibility of excess bleeding. Antibiotics may be prescribed to prevent infection. Patients may be instructed to shampoo their hair the night before surgery, and a small amount of hair at the temples or around the ears may be shaved.

The Procedure

The surgery can be performed at an outpatient surgical facility or a hospital, depending upon the physician's and patient's preference. It can be done under general anesthesia with the patient asleep or local anesthesia in which the area is numbed and the patient remains awake. Premedication is usually administered to relax the patient.

In the basic procedure, the surgeon works on one side of the face at a time. Incisions are made inside the hairline at the temple, running in front of the ear then around the earlobe and behind the ear, ending in the hair of the scalp. Loose skin is separated from underlying tissue and is pulled up and back and excess skin is removed. Connective tissue and sagging muscles are tightened, and in some cases, fat deposits are removed from beneath the chin and neck. This may necessitate an additional small incision under the chin. Tiny sutures are used to close the incisions. A rhytidectomy may take from three to five hours or more depending on whether other procedures are done at the same time.

After Surgery

After surgery, loose bandages which are applied to the area are usually removed the next day. Patients who are operated on in a hospital are released the day of surgery or after an overnight stay. Pain connected with the surgery is minimal to moderate and is controlled with oral medication. The surgeon determines when sutures are removed. This may be done in stages in order to minimize scarring. Scars from the incisions fade significantly with time and are, for the most part, inconspicuous because they are made within natural creases. Swelling and discoloration disappear in a week or two. Swelling can be reduced by keeping the head in a slightly elevated position when reclining. A tightness or numbness of the treated area may be present for awhile, and there may be slight changes in the normal hair pattern around the incision.

For several weeks after surgery, patients are advised to avoid the sun as much as possible and to wear sunscreen when going out of doors. Healing is gradual and final results may not be apparent for several weeks. The amount of improvement varies, depending on the initial condition of the patient and the extent of surgery. In most cases, a single procedure achieves the desired results while in some cases, additional procedures may be indicated. Most patients who have had a facelift are delighted with their more attractive, rested appearance.

Each year thousands of rhytidectomies are successfully performed. There are certain inherent risks connected with every surgical procedure which should be discussed with the physician prior to surgery. Patients can minimize complications by carefully following directions given by the physician.

Source from Samual A. Botta, M.D. Coraopolis, PA

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