Face and Neck lift
Facelift and/or necklift surgery is in effect a procedure to restore a youthful appearance to the face. This aesthetic surgery aims to repair any facial or neck sagging that has developed throughout the years. In this surgery, the various tissue types found in the face and neck are lifted back into their original locations, and any excess skin is removed without creating an artificial and undesired look. The goal of this surgery is to restore a more youthful and vital appearance while conserving the overall harmony of the face and neck. The operation is performed under general anesthesia, and duration of surgery is approximately 2.5 hours.
It is recommended to refrain from smoking at least one month before surgery, and to arrive after any outstanding medical test values are normalized (such as blood pressure, sugar levels, etc.). Furthermore, one should stop taking any blood thinners at least 2 weeks before surgery.
Sagging of facial and neck skin becomes visually apparent usually after age 40-45. Therefore, surgery for face and/or neck lift is performed at these ages and older.
During the pre-surgical consultation certain aspects of the face and neck are assessed, such as overall quality of the skin, existing asymmetry, wrinkles and folds, sunshine damage, sensation, and muscle activity. Once finished, the goals of surgery will be discussed.
The overall quality of the skin will dictate the chances of success of this procedure. In cases where the patient presents with very dry and non-elastic skin, with considerable sunshine damage and wrinkles, it may be necessary to incorporate various facial treatments prior to surgery (such as facial peeling).
Facelift surgery can be performed along with other treatments, such as eyelid lifting, eyebrow lifting, botulin toxin injections into areas of wrinkles (such as in the forehead, around the the eyes), usage of filler material (around the lips, and along the nasolabial fold), and earlobe shortening. Furthermore, one can have fat tissue (adipose tissue) injected into the cheekbone areas.
At times, it may be necessary to have only the lower third of face lifted along with some treatment of the neck region. In such a case, a “mini” facelift is all that may be necessary.
The incision lines for this surgery are located along the frontal hairline, or farther within the hair-bearing areas of the head such as the temporal region (only if necessary). Then in front of the ears or along the hairline in back of the head. During this surgery, the facial and neck skin is separated from the underlying tissue. This underlying tissue is tightened and lifted in order to improve the framework onto which the skin will be re-draped. Note that only a small amount of skin will be removed in order to avoid any facial appearance that looks overly “stretched”. In some cases, liposuction around the chin and neck can be performed as well. If it appears necessary to tighten tissue in the neck area, a small incision underneath the chin will have to be made. In a “mini” facelift, it is unnecessary to lengthen the incision lines beyond the ear and towards the back hairline.
The incision lines of the operation are sutured without any tension. Some of the sutures are absorbed, and some are removed after approximately one week. Note that this surgery is planned such that any remaining scars will be incorporated into the naturally existing and inconspicuous lines and folds of the face. This is done to camouflage the scars as much as possible.
Towards the end of surgery, and only if necessary, a drainage tube is placed into each side of the area operated on. This is to collect any possible fluid accumulation. The drains are usually removed the following day. The suture lines are coated with an antibiotic cream, and the head is subsequently bandaged. Removal of the bandages is carried out after several days. In most cases, an overnight admission is necessary for observation.
The initial recovery period is approximately 2 weeks. During this time, one may experience local bruising, swelling and edema, reduction in sensation in the areas operated on, slight tenderness, and weakness along the sides of the mouth (rare). These signs disappear after the first few weeks after surgery, in most cases without any treatment at all.
Shampooing the head should be avoided for at least 3 days after surgery. Shaving can be resumed after approximately 1 week. Any haircutting should be postponed until about 3 weeks after surgery.
The final results of surgery become apparent only after several months, once all swelling and edema has subsided. Complete healing of the scars may take even longer but, as stated above, the scars are camouflaged regardless. The efficacy of neck and/or facelift surgery usually lasts between 5 and 10 years, but may in fact be shorter in certain people. The length of efficacy is dependent on several factors such as age, quality and type of skin, smoking status, sunshine damage, existing skin conditions, medications, etc. These causes are hard to modify before surgery.
The complications of surgery are rare, and may include:
1) Bleeding that my necessitate drainage in the operating room
2) Skin compromise that may lead necrosis along the suture lines
3) Reduction in sensation of facial skin and ears
4) Damage to nerves of facial muscles
6) Hypertrophic or keloid scarring
7) Disruption of hairline location, or balding in areas of scarring
8) Earlobe distortion
9) Deterioration in any preexisting facial asymmetry
10) Necessity for an additional operation to repair or improve results
Further information regarding this surgery will be made available from the physician during the pre-surgical consultation.