A face-lift (rhytidectomy) is a cosmetic surgical procedure to create a younger appearance in your face. The procedure can reduce the sagging or folds of skin on the cheeks and jawline and other changes in the shape of your face that occur with age. During a face-lift, a flap of skin on each side of the face is pulled back, and tissues below the skin are surgically altered to return the contour of the face to a more youthful shape. Before the flap is sutured closed, excess skin is removed.
A necklift (platysmaplasty) is often done as part of a face-lift to reduce fat deposits, sagging skin on the neck. A face-lift won’t decrease fine creases or wrinkles in your skin or damage from sun exposure. Other cosmetic procedures can address the appearance or quality of the skin itself.
One of the main concerns is facial rejuvenation of wrinkles. A wrinkle or rhytide is a crease in the skin. Skin wrinkles typically appear as a result of aging processes such as glycation. Non-enzymatic glycosylation is the result of typically covalent bonding of a protein or lipid molecule with a sugar molecule. Such as glucose, without the controlling action of an enzyme.
In this chapter, Pritish Kumar Halder briefly explains different approaches of facelifting as well as indications, advantages, and disadvantages of various modifications of facelift surgery, complications, and post‐operative care.
Why it’s done
As you get older, the appearance and shape of your face is altered because of normal age-related changes. Your skin becomes less elastic and looser, fat deposits decrease in some areas of your face and increase in others. Asian people have thicker skins than Caucasians. Therefore, their chief problem is tissue drooping and have less wrinkles in their face. Due to their relatively thick skin, the weight of their tissue is considerably more than other groups and performing facelift surgery is more difficult. Wrinkles begin to form in the early 30s. They usually start in anatomic regions with the thinnest skin such as the periorbital area. Skin and subcutaneous fat loses its volume and the collagen with age and elastic fibers lose their elasticity. Which results in superficial wrinkles.
Face-lift technically means removal of wrinkles by surgery to give a more youthful appearance to the face. Although the history of this surgery goes back to more than one hundred years ago. In recent decades it has become more popular because demands of being youthful in middle and senile ages have increased among people. Age-related changes in your face that may be reduced with a face-lift include the following:
- Sagging appearance of your cheeks.
- Excess skin at your lower jawline (jowls).
- Deepening of the fold of skin from the side of your nose to the corner of your mouth.
- Sagging skin and excess fat in the neck (if the procedure includes a neck lift).
- A face-lift isn’t a treatment for superficial wrinkles, sun damage, creases around the nose and upper lip, or irregularities in skin color.
How you prepare
Initially, you’ll talk to a plastic surgeon about a face-lift. The visit will likely include:
Medical history and exam- Prepare to answer questions about past and current medical conditions. i.e. previous surgeries, previous plastic surgeries, complications from previous surgeries, history of smoking, and drug or alcohol use. Your plastic surgeon will do a physical exam, may request recent records from your doctor or order a consultation with a specialist if there are any concerns about your ability to undergo surgery.
Medication review- Provide the name and dosages of all medications you regularly take. Its including prescription drugs, over-the-counter drugs, herbal medications, vitamins and other dietary supplements.
Facial exam – Your plastic surgeon will take photos of your face from different angles and close-up photos of some features. The surgeon will also examine your bone structure, shape of your face, fat distribution and quality of your skin. It helps to determine your best options for face-lift surgery.
Expectations- Your surgeon will ask questions about your expectations for the outcomes of a face-lift. He or she will help you understand how a face-lift will likely change your appearance and what a face-lift doesn’t address. Such as fine wrinkles or naturally occurring asymmetry in your face.
Before a face-lift:
- Follow medication directions-You’ll receive instructions about what medications to stop taking and when to stop.
- Wash your face and hair-You’ll likely be asked to wash your hair and face with a germicidal soap the morning of the surgery.
- Avoid eating- You’ll be asked to avoid eating anything after midnight the night before your face-lift. You will be able to drink water and take medications that have been approved by your surgeon
A face-lift surgery can cause complications. The risks include:
- Hematoma-A collection of blood (hematoma) under the skin causes swelling and pressure is the most common complication of face-lift surgery. It is treated promptly with surgery to prevent damage to skin and other tissues.
- Scarring-Incision scars from a face-lift are permanent but typically concealed by the hairline and natural contours of the face and ear. Rarely, incisions can result in raised, red scars.
- Nerve injury-Injury to nerves, while rare, can temporarily or permanently affect nerves that control sensation or muscles. Surgical interventions may offer some improvement.
- Hair loss-You might experience temporary or permanent hair loss near the incision sites. Permanent hair loss can be addressed with surgery to transplant skin with hair follicles.
- Skin loss-Rarely, a face-lift can interrupt the blood supply to your facial tissues. This can result in skin loss (sloughing). Sloughing is treated with medications, appropriate wound care and, if necessary, a procedure to minimize scarring.
- Blood-thinning medications or supplements-Medications or supplements that thin the blood can affect your blood’s ability to clot and increase the risk of hematomas after surgery.
- Medical conditions-If you have a medical condition that prevents blood clotting, you won’t be able to have a face-lift. Other conditions, such as poorly controlled diabetes or high blood pressure, increase the risk of poor wound healing, hematomas and heart complications.
- Smoking-Smoking significantly increases the risk of poor wound healing, hematomas and skin loss after a face-lift.
- Weight fluctuation-If you have a history of repeated weight gain and loss — factors that affect the shape of your face and condition of your skin . The outcome of the surgery may not be satisfactory or may be satisfactory for only a short time.
Self-care at home during the first three weeks will help your recovery and minimize the risk of complications:
- Follow wound care instructions as directed by your surgeon.
- Do not pick at crusting scabs that develop on your wound.
- Follow instructions on when you can begin using shampoo and soaps and what kinds you can use.
- Wear clothes that fasten in the front (rather than clothes that are pulled over the head).
- Avoid excessive pressure or motion on and around the incisions.
- Not to using makeup.
- Avoid vigorous or aerobic activity or sports.
- Avoid direct sun exposure to the incision for three weeks and use a sunscreen of SPF 30 or higher thereafter.
- do not use coloring, bleaching or perming hair for at least six weeks.
In the weeks after a face-lift, you might style your hair to hide any remaining signs of the incision. You may also choose to delay attending major social events for a couple of months, when you are likely to feel back to normal.