Facelift What is a Rhytidectomy? Did you know that a facelift is one of the top requested facial surgical procedures? A facelift, also known as rhytidectomy, can help rewind the clock, improve your self-confidence and make how you look more congruent with how you feel. There are many facelift types and techniques out there and Dr. Shvidler can go over various facelift options during your consultation and provide you with a customized plan to give you that youthful, rejuvenated natural look. The aging process Most of us desire to age gracefully and naturally but sometimes we develop premature signs of aging due to heredity, personal habits, pull of gravity, weight changes and sun exposure. All of these factors could contribute to an accelerated aging process. The signs of aging may first start appearing in the corners of the eyes with appearance of creasing and sagging of the eyelid skin. Forehead lines may appear and eventually become progressively deeper creases and folds. The cheek slowly descends downwards and lines around the eyelids become more evident. The nasolabial folds become more prominent and the upper lip thins out and elongates. Jowls may appear, creating a softer jaw line and there may be changes that occur underneath the chin with excess skin laxity and pleated creases in the neck skin. Sometimes we may carry unwanted weight in the lower face, jowl and neck. Is a facelift right for you? Achieving a great result and having a happy patient depends on a good doctor/patient relationship. As with any plastic surgery, being in good physical, psychological health and having realistic expectations is a key to a successful outcome. Having a thorough and honest dialogue with your doctor will assure that all of your expectations, desires and wishes are heard. Your physician in turn will explain possible options and limitations of surgery. The decision to proceed with surgery is based on mutual confidence and trust between a patient and a physician. During your consultation During your initial visit, Dr. Shvidler will ask what concerns you have about your appearance. Dr. Shvidler will also ask you about your previous experiences with cosmetic procedures, past medical history, and review your medications. Next, a physical exam would be performed focusing on the facial and neck region. During this exam, the skin type and laxity will be assessed. Dr. Shvidler will also examine the underlying bony facial structure. Preoperative photographs will be taken during your initial visit. These will help guide Dr. Shvidler in deciding the best operative plan. Dr. Shvidler will then offer several treatment options for your concerns. There are various types of face-lifting procedures; they may focus on lifting upper, mid or lower portions of the face and neck. Your treatment plan may also include a combination of procedures that may enhance the overall result. Frequently facelifts are performed in conjunction with forehead and eyelid rejuvenation surgery. In addition to facelift surgery, Dr. Shvidler may recommend volumetric structural fat grafting and laser resurfacing as adjuncts to the main procedure. Before – After What to expect during surgery The surgery is usually performed in the outpatient operating room suite. In the pre-operative room, you will have one more opportunity to ask Dr. Shvidler last minute questions. Dr. Shvidler will then mark the facelift incision sites in the area of the temple, just above and in front of the ear, and then continue under and around the earlobe, behind the ear, and then turn back into the hairline above the level of ear canal. A separate incision is marked under the chin and can vary depending on how much change is planned in the neck. The surgery is usually performed under general anesthesia but sometimes it may be performed under combination of mild sedation and local anesthesia. Patients do not have recollection of the surgery with either anesthetic choice. Depending on extent of your facelift, the procedure can take anywhere from 3-6 hours. Once the appropriate level of anesthesia is achieved, the face is thoroughly cleaned with an antiseptic solution including the hair bearing areas. Incisions are made in the previously marked sites with emphasis on strategically placing the incisions in the area where they are well hidden and will not be seen postoperatively. The skin is gently elevated by undermining it in the lateral face, temple, and neck regions. Some fat may be removed using suction-assisted lipectomy to contour the neck and facial regions. Deeper structures may be modified to further contour, lift, reshape and tighten the face. Small blood vessels are then meticulously sealed to prevent postoperative bleeding. Sometimes drains are placed underneath the skin to remove excess fluid building up under the skin flaps. The incisions are then meticulously closed after excess skin has been trimmed around the ears. At the end of the surgery, dressing is applied to the face and neck to help protect and hug the operated areas. Before – After What to expect during recovery Immediately after surgery the patient is in recovery for several hours and usually goes home the same night. Facelift surgery usually is not a very painful procedure and most patients tolerate it very well in the postoperative period. Appropriate pain medications are given as needed. Post operative nausea may be experienced after anesthesia, so medications are given to prevent that as well. During the first 24 hours after surgery, patients are instructed to minimize their activity. The first postoperative visit usually occurs 1 to 2 days after surgery, during which the dressing is removed, the incisions are cleaned and the wound is inspected for evidence of infection or fluid collection underneath the skin. Although the complication rates are extremely low, sometimes a small amount of fluid may occasionally form underneath the skin flap and this could be easily drained without discomfort during the first visit. The second visit usually occurs 7-10 days after surgery, during which all staples and sutures are removed and incisions are re-inspected. Subsequent visits occur in 3-4 weeks. By this time most patients are able to go back to work and most swelling, bruising and bumps will have resolved.