Facelift (Rhytidectomy)
If your considering a facelift . . .
As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear arround the neck.
A facelift (technically known as rhytidectomy) can't stop this aging process. What it can do is "set back the clock", improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.
If your considering a facelift, Dr. Washak's web site will give you a basic understanding of the procedure - when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient. Please ask Dr. Washak about anything you don't understand.
The Best Candidates for a Facelift
The best candidate for a facelift is a man or a woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is stong and well-defined. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well.
A facelift can make you look younger and fresher, and it may enhance your self-confidence in the process. But it can't give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with your Dr. Washak.
A facelift can improve the deep cheek folds, jowls, and loose, sagging skin around the neck that come with age. Facelifts are very individualized procedures. In your initial consultation Dr. Washak will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery.
Dr. Washak will check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. Be sure to tell Dr. Washak if you smoke, or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.
If you decide to have a facelift, Dr. Washak will explain the techniques and anesthesia he will use, the type of facility where the surgery will be performed, and the risks and costs involved. Don't hesitate to ask Dr. Washak any questions you may have, especially those regarding your expectations and concerns about the results.
Dr. Washak will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it's especially important to stop at least a week or two before and after surgery; surgery inhibits blood flow to the skin, and can interfere with the healing of your incision areas.
If your hair is very short, you might want to let it grow out before surgery, so that it's long enough to hide the scars while they heal.
Whether your facelift is being done on an outpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two if needed.
Where Your Surgery Will be Performed
A facelift may be performed in a surgeon's office-based facility, an outpatient or inpatient basis, but some surgeons may hospitalize patients for a day when using general anesthesia. Certain conditions such as diabetes or high blood pressure should be monitored after surgery, and may also require a short inpatient stay.
Most facilities are performed under local anesthesia, combined with a sedative to make you drowsy. You'll be awake, but relaxed, and your face will be insensitive to pain. (However, you may feel some tugging or occasional discomfort.)
Some surgeons prefer a general anesthesia. In that case, you'll sleep through the operation.
Incisions usually begin above the hairline at the temples, follow the natural line in front of the ear, curve behind the earlobe into the crease behind the ear, and into or along the lower scalp. Facial neck tissue and muscle may be separated, fat may be trimmed or suctioned and underlying muscle may be tightened. After deep tissues are tightened, the excess skin is pulled up and back, trimmed and sutured into place After Your Surgery
There isn't usually significant discomfort after surgery; if there is, it can be lessened with the pain medication prescribed by Dr. Washak. (Severe or persistent pain or a sudden swelling of your face should be reported to your surgeon immediately.) Some numbness of the skin is quite normal; it will disappear in a few weeks or months. Dr. Washak may tell you to keep your head elevated and as still as possible for a couple of days after surgery to keep the swelling down.
If you've had a drainage tube inserted, it will be removed one or two days after surgery. Bandages, when used, are usually removed after one to five days. Don't be surprised at the pale, bruised, and puffy face you see. Just keep in mind that in a few weeks you'll be looking normal.
Most of your stitches will be removed after about five days. Your scalp may take longer to heal, and the stitches or metal clips in your hairline could be left in a few days longer.
Getting Back to Normal You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first.
Dr. Washak will give you more specific guidelines for gradually resuming your normal activities. They're likely to include these suggestions. Avoid strenuous activity, including sex and heavy housework, for at least two weeks (walking and mild stretching are fine); avoid alcohol, steam baths and saunas for several week; limit your exposure to the sun for several months. Above all, get plenty of rest and allow your body to spend its energy on healing.
At the beginning, your face may look and feel rather strange. Your features may be distortorted from the swelling, your facial movements may be slightly stiff, and you'll probably be self-conscious about your scars. Some bruising may persist for two or three weeks, and you may tire easily. It's not surprising that some patients are disappointed and depressed at first.
By the third week, you'll look and feel much better. Most patients are back at work about ten days to two weeks after surgery. If you need it, special camoflauge makeup can mask most bruising that remains.
The chances are excellent that you'll be happy with your facelift - especially if you realize that the results may not be immediately apparent. Even after the swelling and bruises are gone, the hair around your temples may be thin and your skin may feel dry and rough for several months. Men may find they have to shave in new places - behind the neck and ears - where areas of beard-growing skin has been repositioned.
You'll have some scars from your facelift, but they're usually hidden by your hair or in the natural creases of your face and ears. In any case, they'll fade with time and should be scarcely visible.
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