What is a facelift (rhytidectomy)?
If you are thinking about having a facelift, the good news is that great strides have been made in modern facelift techniques. While early facelift operations tightened only the skin, modern facelifts remove excess skin, laxity (looseness) of facial muscle, and excess fat often found in the lower face and neck. The facelift procedure, also known as a rhytidectomy, can improve the contour of your lower jaw or jowls and soften lines from your nose to the corners of your mouth.
A facelift is only one technique that surgeons can use to restore youth and beauty. Once the loose skin, fat, and muscle have been tightened, laser and other peeling techniques can improve the quality of the skin. Your surgeon may be able to perform a facelift with other procedures, including surgery on the forehead, eyelids, or nose. Fat grafting can also be incorporated with facelift surgery.
Who is a candidate for a facelift (rhytidectomy)?
The best candidates for facelift surgery are those patients who demonstrate the signs of facial aging mentioned above, but who still have some skin elasticity. Generally, this includes patients who are in their 40s to 70s, although older patients occasionally are candidates for surgery.
It is extremely important that you are in good general physical and mental health, and it is crucial that you have realistic expectations. A facelift is not meant to completely alter your appearance or make you look like someone else. It is a way to "turn back the hands of time" and restore your once-youthful appearance, but it is not a method to solve personal problems or psychological issues.
It also is important to recognize that not every person needs or is willing to undergo a facelift operation. Younger patients may obtain significant benefit from smaller or more minimally invasive procedures. A mini-facelift or neck lift are alternative options.
Older patients may choose a smaller procedure to address a particularly bothersome area of the lower face or neck. Liposuction (removal of fat using a suction device), neck lifts, and brow lifts are examples of such procedures.
At the consultation, your surgeon will examine your facial proportions and may suggest additional minor changes, such as enhancing the chin with an implant. He or she may also take photographs of you to assess your situation. During this time, your surgeon will discuss what type of procedures would be recommended.
How your facelift is performed is as unique as you are. Everyone ages differently. For instance, environmental factors (such as sun exposure) and certain facial characteristics can make the face age faster. Examples of specific facial characteristics include things like a small chin or overactive forehead muscles.
Your surgeon will ask for a detailed medical history that includes information on diseases that can cause complications. In addition, your surgeon also may ask questions about your emotional and psychological outlook regarding the surgery. Your decision to have a facelift is deeply personal and your surgeon will be there to assist you in the decision-making process.
Improving your skin quality
The facelift repositions muscle, skin, and fat. Additional procedures such as laser skin resurfacing or chemical peels can improve the quality of skin that has been aged by the sun. The severity of the skin's aging or sun damage dictates what type of skin resurfacing agent might be suggested. These agents include glycolic acids, Retin-A®, laser resurfacing, or chemical peels.
What is the best choice for you when considering a facelift (rhytidectomy)?
While a facelift is often an excellent procedure to reverse facial aging, additional procedures performed at the same time often enhance the result. In other instances, more minor, alternative procedures may be the best choice. A plastic surgeon can help you understand your options and determine what is right for you.
What should I expect during facelift surgery (rhytidectomy)?
You should wear loose, comfortable clothing on the day of surgery. Ideally, you should wear a button-down blouse or shirt that does not need to be pulled over your face. You should plan to have someone with you who can drive you home after facelift surgery and stay with you the first 48 hours. If possible, you may consider hiring a nurse who can tend to you for the first 24 hours after you've arrived home.
If you are a smoker, follow your surgeon's instructions on quitting smoking. Quitting smoking will promote healing and ensure proper recovery. If you take aspirin, prescription medications that thin your blood, or certain vitamins, your surgeon may instruct you to stop taking these for a certain period of time before and after your facelift.
Your surgeon will make the incisions in the area of natural creases--that is, at the temple in front of your ear, continuing around your ear, and behind it. Your surgeon then accesses the muscle and connective tissue to make the appropriate manipulations. Your surgeon may also remove excess fat or skin during the procedure.
Depending on your personal circumstances, the facelift can take anywhere from two to six hours. After the surgery is complete, your surgeon will close the incision site with sutures and apply a soft bulky dressing. It is extremely important to follow your surgeon's instructions on how to care for and handle the bandage.
Setting up a home recovery area
Before you undergo facelift surgery, make sure you take the time to establish a recovery area in your home that includes the following:
- Freezer bags or bags of frozen vegetables
- Gauze, clean towels, and washcloths
- A telephone that is within reach of the area where you will be sitting or lying most of the time
- Ointments or creams as recommended by your doctor
- Magazines or books
- A supply of loose, comfortable shirts that button down
- A thermometer to check for fever
- Ice (only if recommended by your surgeon
Risks / Benefits
Are there complications and side effects from facelift surgery (rhytidectomy)?
Yes. Tightness, numbness, and subtle swelling possibly will last several months.
The effects of your new look will last for five to 10 years, in general. You will continue to age after the facelift operation; however, your aging will not be accelerated. Another facelift usually can be repeated at five or 10 years or at a later date, if you desire.
Of course, there may be risks associated with any type of procedure. Please consult your healthcare provider if you have any concerns or questions.
Recovery and Outlook
What should I expect during recovery from a facelift (rhytidectomy)?
You will experience bruising and swelling that will last for about two to three weeks. Some people heal more quickly and others will heal more slowly. Even though you may not wish to go out in public during the early recovery period, you should begin to feel fine in the first several days after surgery.
In most cases, your surgeon will remove your bandages just a few days after facelift surgery. Your doctor will want to see you several times during the two- to three-week period after surgery in order to assess your bruising and swelling and to remove your sutures. Most people can return to work in two to three weeks, so it is very important that you schedule time off from work accordingly.
When to Call the Doctor
When should I call my doctor if I have issues after a facelift surgery (rhytidectomy)?
You should contact your doctor immediately if:
- You have bleeding that saturates the dressing
- You have extreme swelling associated with pain and pressure
- You experience a fever of 100 degrees or higher
- You experience abnormal discharge from incision site, including pus
- You have sutures that come out before you are due to have them removed
Does insurance cover facelift surgery (rhytidectomy)?
Insurance carriers generally do not cover surgery that is cosmetic or elective, so you probably will have to pay out-of-pocket for facelift surgery. Make sure that you receive all of your surgeon's costs in writing. It is a good idea to ask for detailed charges that you will incur for anesthesia, follow-up care, any required prescriptions, etc.
It is important to note that some insurance carriers will increase your premiums after you have undergone cosmetic surgery. In addition, undergoing a facelift may affect future coverage. Make sure to ask your insurance carrier about its policies and how those policies will affect you.