Rejuvenation of the lower face
The facelift procedure is one of the most common techniques we utilize for facial rejuvenation. Modern techniques allow for excellent long-term results with surprisingly little recovery or discomfort. The facelift procedure is actually not well named: it is a neck and jowl lift directed to rejuvenation of the lower half of the face. A "brow lift" addresses the upper half of the face.
We all experience similar changes over time which result in the typical aging changes of the lower face. These include a loss of the youthful jaw line appearance and development of jowling. The area of the mid face is affected with more prominence of the folds of skin to the sides of the mouth and nose. The neck area often will lose its youthful contours in profile and develop "bands" of excess tissue. There is a general laxity of tissue due to the loss of structural support and also to the loss of elastic tissue and collagen in the skin. This loss of the resilience and spring to the skin quality adds to the lines and wrinkles.
Factors Associated with Skin Aging:
There is considerable variability from person to person; however, there are definite common causative factors for accelerated skin aging:
- Sun (UV) exposure is undoubtedly the most significant factor in aging. The use of high SPF factor sunscreens as well as protective clothing is very important. Sun tanning or use of tanning booths is highly destructive acting only as an 'aging machine.'
- Smoking causes a major acceleration of the skin aging process - probably due to vascular damage.
- Nutrition: extremes of weight or rapid fluctuation are detrimental. A well balanced diet is important.
- Skin care: the appropriate use of moisturizers coupled with basic high quality skin care is very helpful preventative maintenance. Northwest Face as both Dermatologists and Aestheticians on staff.
One of the most important considerations in the facelift procedure is the attention to many small details that together are very important in avoiding a "surgical" appearance. It is essential to avoid the typical "over-stretched" appearance we are all too familiar with. Important details that must be recognized include:
Hairline: It's important to not shift the position of the tuft of hair in front of the ear or to create a "notched" effect at the hairline behind the ear. It should be possible to wear the hair pulled back and not see a significant scar.
Tissue suspension: It is very important that the support structures under the skin are firmly re-supported and that the skin itself is not simply trimmed and pulled. By achieving strong support under the surface, the skin simply 'comes along for the ride' in a very natural and youthful direction.
Attention to these areas will result in an extremely pleasing natural and long lasting result. The overall expectation should be one of improvement and enhancement of facial youthfulness and vigor and an increased sense of beauty.
The facelift is performed with deep IV sedation administered by the MD anesthesiologist who is present. There is no discomfort whatsoever. The recovery from the anesthetic is usually about one hour, after which time you are able to go home. The actual procedure requires approximately three hours and involves a meticulous elevation and freeing of tissue. A second layer of supporting tissue is also elevated (the SMAS layer) and it is this layer that is firmly re-suspended. Excess fatty tissue is treated by liposuction particularly in the common fat pad under the chin area. Following this the skin tissue is "re-draped" in a natural direction with removal of all excessive and redundant skin. Meticulous closure along the incision lines then helps assure excellent camouflage of the incision. A wrap around dressing is then applied to reduce and tendency for swelling or bruising. The head turban pressure dressing is kept in place overnight and removed the following day in the office. Individuals may either go home if reasonably nearby or they may elect to stay at the hotel across from our Carillon Point office.
Recovery is rapid with a reasonable, socially presentable appearance between five days (with makeup) to approximately ten days (often without makeup). There is generally only minor bruising or swelling which is in the lower neck area. Pain is usually minor and rarely even requires medication. It is common to be up and reasonably active by the second day.
Post Operative Care
Cold compresses are placed in and around the face and neck areas. The patient is requested to keep the head elevated for one to two days. The dressing is removed the next day in the office. Hydrogen peroxide placed on Q-tips may be used to treat and clean the wounds in and around the ear. Bacitracin is placed on the incisions in front of the ear. Showering is encouraged and may begin the day after the procedure. It is important to refrain from performing any rigorous exercise or strenuous activity until at least two weeks after the surgery: lifting, bending over and exercising can increase bruising and will slow healing down. Any head movement should be minimized as well, and lateral stretching of the head (which might occur when driving) is not recommended for the initial week. Clips are removed after 5-7 days and makeup may be applied thereafter.
Swelling and discoloration are to be expected to a certain degree in the neck and behind the ears, but both generally dissipate within one to two weeks after the procedure. If one has flown in for the procedure, it is generally possible to safely fly back at one week following the procedure.
How Long Will the Facelift Last?
Following a face-lift procedure, the "hands of the clock" are essentially turned back on a permanent basis. Physiologically one is still the same age, but the appearance of the face is generally, of course, more youthful. There can be anywhere from 10 to 20 years of improvement in ones facial physiologic appearance. However, we will still age and the manifestations of the aging process will continue to exert their affects on the face as the years go by. Nevertheless, when comparing ones youthful appearance (after having had a facelift) to ones peers and/or siblings, the sense of a more youthful appearance continues over time. As a general concept one can expect that there is a return to baseline appearance in about 10 years; however, one is still 10 years ahead of peers. A percentage of individuals who undergo a facelift may desire a repeat face-lift after ~ten years. This is easily and very effectively accomplished.