A thorough history and physical examination are necessary before proceeding with any aesthetic procedure. Patient medical condition, current medicines, prior surgical history and allergies all part of pre-op evaluation. Thorough physical examination in a well-lit room should be carried out to evaluate each anatomical subunit of the face as well as conditions of the skin.
Detailed examination of facial nerve function for comparison postoperatively. A pre-operative workshop should include pre-op photographs in 3 views (lateral, Anterio- posterior and oblique) Age appropriate laboratory test as per hospital guidelines are done like CBC, Coagulation panel, HIV, Hepatitis C, TSH, LFT, RFT, ECG and chest x ray. The routine pre-op screening will uncover cases of undiagnosed disease such as diabetes. Myocardial function, thyroid disorders, anaemia and likewise. Special factors have to be considered in such cases as patients having hypertension or taking aspirin may cause postoperative hematomas. Chronic smoking may also contribute to post-operative skin necrosis in some cases. Therefore patient preparation must include avoidance of sun exposure, alcohol, tobacco for 2 weeks before surgery. Use of aspirin, non-steroidal anti-inflammatory drugs, estrogens and anti-coagulants should be stopped two weeks before surgery. Facelift is an elective surgery. Therefore all such precautions are mandatory. Also psychological status is extremely important for many factors including stress and ability to adequately follow instructions.
A facelift is the most dramatic procedure for looking younger and attention must be paid to the recovery process as well.
The first day after surgery patient may feel unsteady, sleepy. Complete rest is absolutely necessary during this time. Elevate the head and talk as little as possible. An adult caretaker alongside you is necessary during the first 24 hrs. Pain medication will continue for 5 days after surgery. After that, you might no longer need them.
During the first postoperative week, any activity must be kept to a bare minimum,only what is required to take care of oneself. Surgical dressing and drains will be evaluated by the doctor and changed or removed in a day or two. Patient that undergoes facelift is likely to swell and bruise. Don’t be alarmed if the face appears swollen after the dressing is removed. It goes down quickly. Bruising on the neck and around mouth and eyes are also common.
During the second week, the patient may still have some swelling and bruising around affected areas and also feel numbness which is very common in such surgeries and will eventually resolve naturally over the upcoming weeks. Stitches might be removed anytime during this period depending on the nature of the surgery and healing process. Strenuous activities should still be avoided although many patients start feeling normal and are ready to resume work and begin doing a light form of exercise like walking.
After 4 to 6 weeks normal activities can be resumed. This is also the time when patients begin to see real improvements in their facial contour. Scars go through multiple stages of healing. They look worse before but eventually begin to fade with time.
In short, patient can start normal activities within two weeks but final settled in result is a month or so away.
Contemporary facelift surgery is a combination of art and science and requires significant experience to become proficient. Many subtle technique sensitive steps and nuances must be appreciated by the surgeon to provide predictable results with few complications. It is an ultimate feel younger cosmetic procedure and a surgeon attempting this procedure should be very comfortable dissecting a SMAS (superficial musculoaponeurotic system) flap. Thorough understanding of the anatomy of nerves, restraining facial ligaments, musculature and submandibular gland relative to dissection is essential. Cosmetic surgeons can have many subspecialties within the field. Therefore basically a surgeon who has a thorough knowledge and is well versed with the anatomy of the maxillofacial region is important to give great results. His years of training in this area of expertise and also experience of performing this particular procedure are important. Every facelift patient is a walking advertisement therefore very important to look at the before and after pictures of the patients operated by him. In general, things to consider while walking into a facial cosmetic surgeon’s office are his qualification, his training, his experience, his success rate, his operating room facilities, and his team which must include certified anesthesiologist, dermatologist and support staff. All play a crucial role in the smooth functioning of the surgery and aftercare. At the end doctor who is willing to listen and answer all the queries of the patient and who gives correct and honest information and expectation to the patient makes for a good surgeon.
Word facelift means different things to different people. Proper communication between doctor and patient plays a very important role in overall happiness after the treatment. People think facelift involves complete rejuvenation of the face when in reality facelift primarily treats the lower portion of the face and neck. It will have little effect on generalized upper face wrinkling and additional procedures such as eyelid tuck, bow lift, skin resurfacing and facial implants may be required. Clinical results also vary among patients due to factors such as facial shape, lean body weight, and position of throat, floor of the mouth and facial features. After surgery pressure type bandages and drains are normally placed and these are removed after a day or two under the guidance of the doctor. Patients that undergo facelift surgery are likely to swell and bruise especially when performed with multiple other procedures. They should not be alarmed when after removal of the dressing if the face appears swollen. It goes down quickly. Numbness is also very common with most facelift procedures and will resolve naturally over the coming weeks. Facelift scars generally heal in an excellent manner but they look worse before they look better. Scars will go through multiple stages of healing and at times look better or worse. It may take a few months to begin seeing the final results of a facelift. Patience is the virtue to be kept at all times here.
A facelift is a customized procedure and is different for every patient and situation. It varies from extremely conservative to aggressive and specific procedure determined by the amount of ageing, general health, personal habits such as smoking, drinking alcohol and eating habits. This surgery is mostly done under general anaesthesia. Pt can go back home the same day. Incision placement is determined by the surgeon’s judgment. In many cases, incision is started inside the hairline at the side of the head and continued in a natural skin line around the ear lobe and extends at the back of the scalp. After initial incision skin is separated from underlying fat and muscle. Skin is generally stretched upwards and backwards and excess skin is removed. Suspending the skin in the right direction can make a facelift appear normal. The operated look is frequently caused by pulling the skin in an incorrect vector. In some cases, a small incision is frequently necessary under the chin and fat deposits beneath the chin and neck may be removed and deeper layer of neck tissue maybe corrected. After the excess skin and fat are removed remaining skin is gently laid back over the rejuvenated facial tissues without over tightening the skin. Incisions may have dissolvable sutures or you might have to return to the surgeon to have stitches removed. Normally patients will have drainage tube after surgery as well as bandages wrapping on their face. We take all precautions to place scars in the most hidden areas and spend time using plastic closure techniques to ensure best possible scar. Occasionally we need to perform minor revision or laser of the scar to improve their appearance. A facelift is primarily performed to improve sagging tissues of the lower portion of face and neck, therefore multiple simultaneous procedures such as eyelid tuck, brow lift, skin resurfacing and facial implants are done along with facelift in order to address all aspects of the ageing face.
‘Rhytidectomy’, this word is derived from Greek words ‘rhytis’ and ‘ektome’ which literally means the removal of wrinkles in English. ‘Cervicofacial’ refers to the area of neck and face. Although inaccurate it is a technical term for a facelift. They both mean the same. Facelift remains the ultimate rejuvenating cosmetic procedure which is different for every patient and situation depending upon ageing, general health and personal habits of the patient.
Ideal facelift surgery is a procedure that attempts to reverse visible signs of ageing in face and neck such as sagging skin, jowl formation, loss of neck contour, skin wrinkling, perioral wrinkling, and prominent frown lines. It is a surgical procedure which may include removing excess skin, lifting facial muscles and skin tightening.
All these help to make face appear younger. Although additional procedures to supplement facelift may be necessary for better results.
