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Facelift FAQs

What is a rhytidectomy?
Rhytidectomy, more commonly known as a facelift, is a surgical procedure able to improve the most visible signs of aging occurring in the lower two-thirds of the face. The procedure involves the removal of excess fat and sagging skin, along with a tightening of the neck muscles.

Are the results of a facelift permanent?
A facelift can improve your present appearance, serving to 'set back the clock', but it will not stop the aging process. Patients often find that the results of their facelift last for five to ten years, after which time they may opt to undergo a repeat facelift. By avoiding sun exposure, keeping your skin hydrated and maintaining your weight, you can help to maintain your results.

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What does SMAS stand for?
SMAS stands for Submuscular Aponeurotic System, which is a layer of tissue covering the deeper structures of the cheek area and connected to the platysma, or the superficial muscle covering the lower face and neck. Some facelift techniques involve a lifting and repositioning of the SMAS along with the skin, which allows the neck to be tightened, the jowls lifted, and the cheeks elevated.

Are there scars after a face lift?
The incisions for a facelift tend to be minimal and well-concealed, usually placed within the natural folds in and behind the ear and within the hairline. As such, the resulting scars allow for minimal visibility. Additional incision may be made beneath the chin if the neck requires work, but the resulting scars will fade with time to become barely noticeable. Endoscopic facelift surgery involves tiny minimal scarring.

How soon after facelift surgery can patients return to work?
After facelift surgery, patients are typically able to return to work within about two to three weeks. However, bruising and swelling can be noticeable for two to three weeks and may interfered with other social engagements.

Is there a difference between a facelift and rhytidectomy?
The medical term for a facelift is rhytidectomy, a term derived from the Greek word 'rhytid' which means 'wrinkle'.

Is there anything that can be done right after a facelift to lessen the appearance of scarring and bruising?
There are post-operative camouflage techniques, such as special camouflage cosmetics for both men and women, that can help disguise bruising, scarring, lines and discoloration as you heal. Your surgeon can provide you with more information about them.

What's the difference between a face lift and laser resurfacing?
Facelift surgery is intended to remove excess fat and lift sagging skin and muscle. Laser surfacing is not intended to tighten skin or correct sagging in the neck, but it will correct fine wrinkles or lines on the surface of the skin. Some patients undergo both procedures.

Are there any limitation to what a facelift can achieve?
With a traditional facelift procedure, the lower portion of the face including the cheeks, jowls, and the neck are corrected. A traditional facelift will not improve the upper portion of the face, which can include wrinkling between the brows, the position of the brows, and excess skin of the upper and lower eyelids or lower eyelid bags. These can be treated with a brow lift. In addition, a facelift cannot improve wrinkles around the mouth and typically does little for smile lines.

Is there much pain associated with facelift procedures?
After a facelift, patients tend to feel little pain but more of a mild discomfort, often in the back part of the neck. Any pain or discomfort that you experience can be relieved with oral medication and typically clears up within a day.

Is the head shaved prior to a facelift?
The head is not shaved before a facelift procedure. Many patients actually grow their hair out beforehand to better disguise stitches and scars as they heal.

Are there any bandages that must be worn after surgery?
After surgery, bandages may be applied to the head and neck. This helps to maintain the area and keep it immobile. Bandages are usually removed on the day after surgery, though the chin may have another light bandage placed around it.

Who is the best candidate for a facelift?
The best candidate for a facelift is a man or woman who is physically healthy, realistic in their expectations and looking to improve sagging skin of the face and neck. The best results are achieved with patients whose skin still has some elasticity and whose bone structure is well-defined and strong. Patients tend to range in age from their forties to sixties, though many facelift patients are also in their seventies and eighties.

What can I expect during a consultation for a facelift?
Facelifts must be customized to each individual patient. During a consultation, the surgeon should examine your face, including the underlying skin and bone, and take a thorough medical history. He or she will discus your goals, your options, and all details of the surgery.

Where is the facelift procedure performed?
Facelifts can take place in a surgeon's office, surgical center, or hospital. According to the American Society of Plastic Surgeons (ASPS), 62% of cosmetic surgery procedures performed by their member doctors in 2004 took place in an office, 21% in a hospital, and 17% in a free-standing ambulatory surgical facility.

What type of anesthesia is used for a facelift?
Most facelifts are performed using a local anesthetic combined with sedation, though general anesthesia may also be used.

How is the actual facelift procedure performed?
There are several different techniques, but you can generally expect the following: Incisions are usually made starting at the temples above the hairline, running in front of the ear or just inside of the ear and then continuing behind the earlobe to the lower scalp. An additional small incision may be made under the chin if the neck is being treated as well. Once the incisions are made, the skin is separated from the underlying fat and muscle. Fat in the neck and chin may be trimmed or suctioned, then the muscles will be tightened, the skin pulled back, and any excess skin removed. The incisions are then closed with stitches.

How long does the actual facelift procedure last?
Facelifts typically take several hours to complete. For more extensive procedures or those combined with other procedures, the surgical time may be longer or two separate sessions may be required.

Where are the incisions made for a facelift?
Incisions are usually made starting at the temples above the hairline, running in front of the ear or just inside of the ear and then continuing behind the earlobe to the lower scalp. An additional small incision may be made under the chin if the neck is being treated as well.

What is the recovery like after a facelift?
After surgery, a small tube may be placed beneath the skin to collect blood as it drains. The head may also be wrapped in bandages to minimize swelling and bruising. Patients may experience some discomfort, though this can be controlled with medication prescribed by your doctor. The face will likely appear puffy, bruised and pale at first. Numbness is also common, though this usually fades within a few weeks to months. To help control swelling, it's best to keep the head elevated as much as possible during the first few days. Patients are typically up and about within a day or two, though it's best to take it easy during the first week. Drainage tubes are typically removed within one to two days after surgery, while bandages are usually removed within one to five days. Stitches are usually removed about five days after surgery. Some bruising can remain for two to three weeks.

How much time will I need to take off from work after a facelift?
Most patients find that they can return to work within about ten to fourteen days after surgery, though many choose to wear special camouflage makeup to help disguise bruising.

When can I run or lift weights after a facelift?
Strenuous activities will need to be avoided for the first two weeks. This includes heavy housework and sex. Patients will also need to avoid saunas, steam baths and alcohol for several months.

When are the stitches removed after a facelift?
The stitches are typically removed around five days after the procedure.

What are the risks or complications of a facelift?
The potential complications associated with facelift surgery include adverse anesthesia reactions, asymmetry, bleeding, excessive scarring, hematoma, infection, nerve injury, and poor healing.

How much do facelifts cost?
According to the American Society of Plastic Surgeons (ASPS), the average surgeon/physician fee charged by their member doctors for facelift surgery in 2004 was $4,822. Being a surgeon/physician fee only, this does not include other related expenses such as the cost of anesthesia and the facility.

Does insurance cover facelifts?
Insurance typically does not cover procedures performed solely for cosmetic purposes. Check with your own insurance carrier regarding the degree and/or availability of coverage.

Is it possible to get financing for a facelift?
Financing is available for facial plastic surgery procedures. Your plastic surgeon should be able to provide you with further information about financing.

What should I look for in a surgeon to perform my facelift?
It's important that you do your homework and carefully choose the surgeon to perform your procedure. First, make sure that the surgeon is certified by the American Board of Plastic Surgeons (ABPS). This ensures that they've completed the proper training to safely conduct your procedure according ABPS standards. You can visit the ABPS's website at www.plasticsurgery.org to locate a certified plastic surgeon in your area. You should also ask any potential surgeon the following questions:

• Does the surgeon have privileges to perform surgery in an accredited hospital and, if so, which hospitals?
• How many facelift procedures has the surgeon performed?
• Where and how will the surgery be performed?
• Is the surgical facility accredited by a nation or state-recognized accrediting organization?
• What are the risks of your particular procedure?

Are there any medications that need to be avoided before surgery?
With any surgery, it's important that you monitor your medication and vitamin intake beforehand because some medications can interfere with anesthesia, inhibit recovery, or lead to blood loss or other circulation issues. Make sure that you tell your doctor prior to surgery about all medications, vitamins and herbal supplements that you take. Some medications that you may be required to stop taking may include aspirin, MAOIs, anti-inflammatory drugs, vitamin K, vitamin E, evening primrose oil, St. John's Wort, echinacea, melatonin, and others.

How long do the results of a facelift last?
Patients often undergo a touch-up procedure five to ten years after their facelift. Because the face will continue to age, a facelift cannot stop the clock. Nevertheless, you will look better years later than you would have without the facelift.

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