|
Information, costs, and side effects
Good
candidates for face lift surgery:
- People with sagging skin in the face and neck
- People with skin that still has some elasticity
- People with in good health
- People maintaing a stable weight (at least 6 months)
- People with a strong bone structure
- People with realistic expectations
If you do not meet all of these criteria, but meet some of them,
you may still be a good candidate for a face lift. If you have good
skin tone, it is more likely that your skin will respond well to the
surgery.
You are also at increased risk for complications if you have diabetes,
poor circulation, heart, lung or liver disease, smoke, have a family
history of blood clots, take certain medications, etc. You'll want
to discuss your medical history thoroughly with your physician before
you choose to undergo surgery.
Initial
consultation
At the initial visit, your doctor will likely ask you to describe
in detail what you would like improved. Be specific about what you
would like done. If your surgeon fully understands your expectations,
they'll be able to determine whether your goals are realistic. Your
physician will examine your skin, hairline, and structure of your
face to determine which techniques will be employed, where incisions
will be made and what results can be achieved. Your skin type, thickness
and texture, your age, if you are a smoker, and pre-existing sun damage
will all effect the final result.
The
average cost of face lift surgery
Face Lift Cost Range: $6,000-$12,000
Average Total Cost: $8,500
Surgeons fee: $5,000
Anesthesiologist: $1,200
Facility fee: $1,700
Hospital fee: $600
Basic
procedures and techniques
Anesthesia: General or Sedation
Location: Hospital, surgical center or office
Surgery time: 2-4 hours.
A face-lift will remove excess skin and tighten the soft tissues of
your face, chin and neck. It can improve the jawline, sagging cheeks
and loose neck skin. To get an idea of the results you might have,
place your fingers on the center of your cheeks and press the skin
up and back. Skin folds can be tightened and reduced, but not eliminated.
If you softly pinch the skin in front of your ear, you'll see how
much skin be excised during the procedure. A face-lift cannot
improve your forehead, eyelids, eyebrows, wrinkles around the mouth
or your skin texture. Some patients also undergo a forehead lift
and eyelid surgery at the same time of the face lift to create a
uniform appearance. To reduce wrinkles, smooth skin texture and
tone, you may also want to consider laser resurfacing, chemical
peels, botox injections and dermabrasion.
Depending on your face and problem areas, your surgeon may choose
a two-layer face-lift, a skin-only face lift, a deep (subperiosteal)
face lift, neck lift, laser or endoscopic lift.
In a two-layer face-lift (the most common procedure and generally
the most effective), incisions are usually made in the contour of
the ears, beginning in front of and extending around the earlobe
and back into the hairline. After the incisions are made, the skin
is separated from the facial muscles and skin fat (the doctor may
remove excess fat) and the skin is pulled up and back to tighten
the muscles of the face and neck. The surgeon may tighten the underlying
tissue, the submuscular aponeurotic system (SMAS), that tightens
the neck and lifts the cheeks. The skin is then pulled back and
any excess trimmed off.
The incisions are then closed with stitches, and metal staples may
be placed in the scalp. If you have elected to smooth your chin
and neck, there may also be a small incision hidden underneath your
chin. A small drain tube may be placed under the skin to collect
excess blood and prevent swelling. The incision is then sutured
closed. The head is then bandaged to prevents fluid collection.
If drainage tubes have been placed, the doctor's office will give
detailed instructions for emptying the drains at home.
Recovery
Pain Level: Moderate discomfort. 1-3 days of pain medication
Swelling and bruising: 2 weeks or more
Numbness: lasts several weeks
Bandages: Changed in 1-2 days (drains and removed first
2-5 days)
Work: Return after 1-3 weeks
Exercise: Wait 2-3 weeks
Sun protection: Six months with SPF 15 or higher
Final result: Seen 1-4 months following most facelifts
Source: www.plasticsurgery.org
When surgery is completed, you will be taken into a recovery area
where you will be closely monitored. A bandage may have been wrapped
around your face to minimize swelling. You may be permitted to go
home after a few hours, although some patients may stay overnight.
Your face and eyelids will be swollen and bruised after surgery.
This will be most pronounced the first few days and lasts anywhere
from one to six weeks after surgery. Most bruising will disappear
within two weeks. It may take months to fully heal. The speed of
recovery depends upon the type of skin, age and healing ability
of the patient. Most patients can resume everyday activities about
two weeks after surgery.
Your face may feel numb for a few weeks or even months. This is
normal and usually subsides. Scars take longer to fade, but because
they are hidden in hairlines, behind the ears and in natural folds,
they shouldn't be very noticeable (assuming there are no complications).
Your appearance will improve dramatically each day following your
surgery. Typically, you will need assistance for the first couple
of days, but then you can care for yourself. You probably won't
feel comfortable allowing others to see you for at least a week,
and you may not want to return to work for another 1 to 2 weeks
after that. You may want to allow 4 to 8 weeks before attending
any major social engagements.
You can shower by the second or third day, but be careful not to
tug on the drainage tubes or to rub the incisions. All lifting,
straining, bending and any vigorous activity is to be avoided until
all bruises have faded and such activities do not cause any discomfort.
To minimize bleeding and swelling, refrain from vigorous exercise
for first 2 to 3 weeks. Pain can usually be controlled with pain
medication.
For faster recovery:
- Keep your head elevated as much as possible to reduce swelling
- Apply ice packs to minimize swelling
- Do not take aspirin or anti-inflammatory medications
- Do not smoke or be exposed to secondary smoke during recovery
- Avoid exposure to direct sunlight
- Use a sunblock (minimum 15 SPF) to protect your skin
Expect that your facelift will turn back the clock approximately 7-10
years. You will continue to age on your new face. The results of your
facelift may be dramatic or subtle, depending on how you looked before
surgery. Since the healing process is gradual, you should expect to
wait at least several weeks to fully realize your results. Additional
minor changes, or settling, may occur over several months.
Risks
and complications
Although complications and bad results are infrequent for face-lifts,
they do occur. Some complications require further surgery. Complications
can cause slow healing, abnormal scarring, discomfort, inconvenience
and permanent deformity.
Complications, especially blistering and skin death, are seen much
more frequently in smokers. One major study concluded that smokers
had a 1500% increase in complications following a face-lift. It
is strongly advised to quit smoking as soon as possible, but at
least a month prior to surgery and for four weeks following the
procedure.
You can help minimize your risks by choosing a board certifed surgeon
and carefully following the advice and instructions of your surgeon.
Scars
Surgical scars are permanent. However, the incisions are
placed so that they are not normally noticeable except on very close
observation (they usually run in the natural contours of the ear
beginning in front of the earlobe and extending behind the ear into
the hairline).
Related
procedures
Chemical Peel: The chemical peel is a non-invasive
technique that is designed to restore wrinkled, blemished, unevenly
pigmented or sun-damaged facial skin. Using a chemical solution
usually of phenol, trichloroacetic acid or alpha-hydroxy (fruit
acid), the skin's top layers are peeled away, allowing for new cells
to grow that produce a smoother, tighter, younger-looking skin surface.
Phenol: Phenol is the strongest of the chemical
peel solutions. It is mainly used to treat patients who have blotches
on the skin caused by pregnancy, sun exposure, birth-control pills
or illness, or on people with coarse facial wrinkles, severe sun
damage or pre-cancerous growths. Because it lightens the treated
areas of the skin, phenol is most often used for full-face peels.
However, in patients with fair, unfreckled skin, phenol can be used
on specific facial regions, where the contrast with the untreated
areas won't be obvious. Phenol is used primarily on the face, scarring
may result if it is applied elsewhere.
Trichloracetic Acid (TCA): TCA peels employ a milder
chemical formula than phenol peels. A TCA peel is used primarily
to treat fine surface wrinkles, superficial blemishes or pigment
problems. Because TCA peels do not produce the same bleaching effect
as phenol peels, they may be preferred by darker-skinned patients
for partial peels on specific regions of the face. The results of
a TCA peel are usually less dramatic and much shorter-lasting than
those gained from a phenol peel. In fact, sometimes more than one
TCA treatment may be needed to achieve the desired result. However,
a TCA peel treatment requires less time than a phenol peel, and
the recovery from a TCA peel is usually shorter than with a phenol
peel.
Glycolic Acid: Is the mildest of the peel formulas.
This type of peel, sometimes called an alpha-hydroxy acid peel or
"fruity" acid peel, can provide smoother brighter-looking
skin in people who can't spare the time needed to recover from a
phenol or TCA peel. Patients who have glycolic acid peels are usually
seeking only a fresher look and have only minor skin problems, such
as fine wrinkling, areas of dryness or uneven pigmentation. When
glycolic acid is applied to the face at a concentration of about
70 percent, it is considered a "peel," even though the
acid solution doesn't penetrate the skin as deeply as it does for
a phenol or TCA peel. Treatments are usually performed in a series
– perhaps one peel a week for about six weeks. Glycolic acid
can also be mixed with facial wash or cream at a concentration of
about 10-14 percent and used as part of a daily skin-care routine
to improve the skin's texture.
Because chemical peels involve some risks and long-term considerations
regarding exposure to the sun, prospective patients should take
care to find a properly-trained plastic surgeon. After the patient's
preparation for surgery, which may involve several weeks' use of
Retin-A or fruit acid on the area to be treated, the doctor will
apply the chemical solution to the skin area to be treated. The
chemicals will usually cause a stinging sensation, depending on
which solution is used. After the treatment, which can last up to
two hours for a full-face treatment, the doctor applies petroleum
jelly or another occlusive compound to help with the healing process.
After the peel, patients should expect considerable swelling. After
seven to ten days the swelling subsides and new skin begins to form.
Complete maturation of the new skin and lightening of the pinkness
may take up to six months when using phenol, and patients must take
care to avoid exposure to direct sunlight as it can cause blotching
on the treated area. During recovery, patients maintain a regime
of medication to speed healing and can apply makeup to camouflage
the treated area.
Laser Skin Resurfacing: Men and women of all ages
can benefit from laser resurfacing. The ideal patient for this procedure
has fair, healthy, non-oily skin. Patients with olive skin, brown
skin or black skin may be at increased risk for pigmentation changes
no matter what type of resurfacing method is recommended. The plastic
surgeon will evaluate the patient's skin characteristics and make
recommendations accordingly.
Also, individuals who have taken accutane in the past 12-18 months
or are prone to abnormal (keloid-like) scarring, or those with active
skin infections on the treatment area, may not be appropriate candidates
for this procedure.
Having laser resurfacing can help enhance the patient's appearance
and self-confidence, but it won't completely remove all facial flaws
or prevent aging.
Laser surgery is a relatively quick procedure. It usually takes
anywhere from a few minutes to one and a half hours, depending on
how large of an area is involved. When the imperfections are especially
deep, the surgeon may recommend that the resurfacing be performed
in two or more stages.
During the procedure, the activated laser is carefully passed back
and forth over the skin until the surgeon reaches the level that
will make the wrinkle or scar less visible.
When the procedure is over, the surgeon may choose to treat the
resurfaced skin with applications of protective creams or ointments
until healing is complete. Some surgeons choose to apply a bandage
over the treated areas, which will cover and protect the healing
skin for the first five to ten days.
For more information, view face
lift before and after photos.
|
