Facelift

CANDIDATES:
Usually men and women over 40, although some patients in their thirties may benefit from this procedure.

OBJECTIVE:
To improve the deep fold from the nose to the corner mouth, the jowls, jaw line and cheekbones. It can also help the loose skin, and �turkey gobbler� aspect of the neck by removing excess fat, tightening muscles, redraping skin. It can be done in conjunction with the forehead lift and blepharoplasty to correct the eyebrows and eyelids..

INCISIONS AND TECHNIQUE
There are different variations of facelift procedure. The incision is usually placed in front and behind the ear, and is hidden in the natural folds. From the back of the ear the incision goes into the scalp and is hidden by the hair. The ear lobe has to be free and natural, avoiding a stretched appearance. Sometimes a small incision underneath the chin can be used to help with the tightening of the neck muscles. If necessary the deeper tissues of the face and neck may also need to be repositioned. The skin is pulled up and back and the excess is removed. The aspect should look normal and not stretched. The fixing of the neck might involve liposuction or liposculpture to improve contour. One of the most important aspects of the facelift is the reposition of the lost volume. This can be achieved either by folding and suturing the deeper structures or by injection of fat, which is aspirated from another area.

OPERATING TIME
Two to four hours.

ANESTHESIA
Local with sedation, or general.

IN/OUT PATIENT:
Usually outpatient. Some patients may require a 24 hour stay.

RECOVERY:
Back to work: 10 to 14 days. More strenuous activity: 2 weeks or more. Bruising: 2 to 3 weeks. Must limit exposure to sun for several months.

RISKS:
Complications from facelifts are not frequent. Hematoma (the accumulation of blood under the skin), infection, bleeding and reactions to anesthesia. Some incisions can be visible due to individual variations in healing and might have to be revised. Temporary injury to the nerves that control facial muscles or feeling are rarely permanent. Asymmetry or change in hairline.

DETAILS:
A facelift does not correct wrinkles around the mouth. The choice of procedure will depend on the thickness, texture and elasticity of the skin, the degree of the wrinkles and folds. Usually excessive sun exposure produces more wrinkles and the facelift might have to be combined with a skin resurfacing procedure to eliminate them. The placement of the incisions will depend on the hairline Another procedure commonly associated with the facelift is the rejuvenation of the nose (See Rhinoplasty.) Smokers should stop smoking before surgery. Aspirin should be avoided to avoid increased bleeding. A bandage may be used to avoid bleeding and minimize swelling. Drains will be applied to avoid the accumulation of fluids. Recovery varies greatly. Sleeping with the head elevated helps minimize swelling and bruising. Bandages and drains should be removed in one or two days. Temporary asymmetry can be caused by the swelling and bruising and it is normal. Bruising should disappear in two or three weeks. Makeup can be applied after a few days. Numbness can last for several weeks. Sun exposure should be avoided for the first month. wait several weeks to evaluate the "new look." As the aging process continues, some patients want to make additional improvements in their looks. Some men might have to shave behind ears, where beard-growing skin is replaced.

DURATION OF THE RESULTS
Usually 5 to 10 years