Lifting


By: Dr Elie F. GHARIOS


WHAT IS FACELIFT

A facelift can tighten loose skin and muscle and remove excess fat to eliminate sagging. The best results are seen in the jowls and neck. A facelift may make you look younger but it cannot curb the ageing process. Depending on the condition of your face and skin, a facelift may improve the "laugh lines" between your nose, the corners of your mouth and/or the small vertical wrinkles around your lips.

Consequently, many facelifts are done in conjunction with other procedures including chemical peel, laser skin resurfacing, blepharoplasty, browlift , BOTOX and collagen injections. Many patients also opt for liposuction to remove excess fatty deposits around the neck.

A modified facelift, referred to as a "minimal" or "mini" facelift, is a good option for younger patients who do not require as much correction. It is not only faster but less invasive which means reduced swelling, scarring, bruising and risk.

(Forehead Lift)


What happens during the procedure

The procedure is usually performed in a one-day surgery, either operated by your surgeon or a hospital facility, and the entire operation takes between 3 and 5 hours. For multiple or extensive procedures, your surgeon may chose to perform the procedures in two separate sessions. Most patients can return home after the surgery or can stay in a nearby hotel or recovery facility for the first night. Some, however, chose to remain in the hospital or in a recovery facility for a few days so that medical staff can monitor the recovery process.

Facelift surgery can be performed under local anesthesia mild sedation or under general anesthesia if it is long. Before the surgery, your hair is held back with rubber bands on either side of your face. There is no need for your hair to be shaved, however, some hair near the incisions may need to be trimmed.

The incisions start above the hairline at the temples and continue along a line in front of the ear or just inside the cartilage at the front of the ear, behind the earlobe and back into the scalp. Another small incision is made under the chin for a neck lift. The muscles and sagging tissue are tightened and excess fat is removed. After the deep tissues are tightened, the excess skin is pulled up and back and then trimmed. The incisions are closed with stitches. The surgeon then applies a dressing to protect the entire area where the incisions were made. Although the scars are permanent, they fade over time and are hardly noticeable, as they are hidden either by your hair or the natural creases in your skin.


What to expect post-procedure

Following surgery, your entire face and neck is bandaged to minimize bruising and swelling. To drain any blood that might collect, a small drainage tube may be inserted under the skin behind your ear for a day or two. The extent of the post-operative swelling and bruising is dependent on whether you tend to bruise or swell easily.

The amount you can expect varies for each individual but past surgeries or injuries should be a good indication. Keep your head elevated, above heart level when lying down. You will be advised that you avoid as much activity as possible in order to avoid tension on the scars, and to report any undue discomfort.

There is pain and discomfort for several days after surgery and medication will be prescribed to alleviate it. Ice packs and cold-compresses will help reduce swelling and soothe pain but make sure the packs are not too heavy. Many patients use a water-tight plastic sandwich bag filled with frozen berries or peas.

Bandages are usually removed within 1 to 5 days and stitches can be removed after 5 days. Your scalp may, however, take longer to heal and complete healing of the scars can take up to a year. Some tightness and/or numbness of the skin can be expected, however, it will disappear in a few weeks.


How soon does normal life resume

You will be given more specific guidelines for gradually resuming your normal activities and will suggest you take it easy the first week. Strenuous activities like heavy housework, exercise and should be avoided for at least two weeks. Once the bandages are removed you can shower and gently shampoo your hair. It is important to get lots of rest and to stay away from alcohol, steam baths, and saunas for several months.

Most patients are back to work within 2 or 3 weeks but major social engagements might be avoided for a month or sixeeks until you feel comfortable with your recovery. The hair around your temples may be thin and your skin may feel dry and rough for several months.

Bruising and scars can be camouflaged with make-up. The results of a facelift are different according to the individual. Some people only ever have one facelift but others may have a second surgery 7 to 15 years later.


WHAT IS Necklift:

Is it a modified or limited facelift. This procedure concentrates on the neck area and can give a dramatic improvement to the neckline without having to have a facelift.

Some of the saggy and redundant neck skin can be removed through incisions behind the ear (sometimes these incisions extend in front of the ear) and under the chin area as well. The tissues under the chin may be tightened by placing a suture across the neck crease that will tighten and elevate the muscle. Loose skin may be tightened by pulling the skin upward and backward; excess skin can then be removed from behind the ear.

This modified facelift is not for individuals who have a considerable amount of loose skin under the jaw or in front of the neck (sometimes called a "turkey waddle"). For these patients a full facelift is needed to achieve the best results.