UNDERSTANDING AGING
Different faces age differently. Some similarities are very common to all aging faces. As one ages, the fat pads that are prominent in youthful cheeks thin and drop from the cheekbone downwards, the groove between the corner of the mouth and the nose deepens. In addition, the lower fat pad in the cheek tends to droop, forming the jowl. Fat accumulates underneath the chin and in the jowls, and the muscles of the neck tend to sag. The skin also continues to age with wrinkles, age spots, and broken blood vessels.
Facial aging patterns are determined by genetic makeup. Environmental factors, however, can significantly accelerate the aging of the face. Smoking is the most significant culprit in accelerating facial aging. Sun exposure and significant weight fluctuations may also contribute to an aged appearance to the face. Reversing these processes is the goal of facelift or cervicofacial rhytidectomy.
ABOUT FACELIFT
The original facelift was predominantly a skin tightening procedure. We have learned, however, that tightening only the skin is not the best way to rejuvenate a face. In order to create a natural appearance to the lifted face, surgery must restore the drooping deeper tissues of the face. Deep plane rhytidectomy or face-lift achieves just that. By directly addressing the drooping fat in the mid-face, jowl and neck, a deeper suspension may be performed. This creates a very natural appearance to the lifted face, avoiding a “stretched” look. A successful facelift may dramatically improve the nasolabial fold or groove between the nose and corner of the mouth. Jowls may be dramatically reduced and a firm jaw line may be established. Muscles may be tightened under the neck and fat may be removed and recontoured. Loose folds of skin underneath the neck may be significantly tightened.
Face-lifts are usually done under intravenous sedation combined with local anesthesia. This allows a painless surgical procedure that most patients sleep through. If medically necessary, general anesthesia may be used as well. Some patients choose to stay in the hospital overnight, but many others may go home after surgery.
The incision for the face-lift curves under the “sideburn” and hides in the folds of the ear. The incision curves underneath the earlobe, back behind the ear, and back into the hairline. Occasionally, a small incision is performed underneath the chin as well. Surgery itself takes approximately four hours. Face-lift surgery is often combined with other rejuvenating procedures including brow or forehead lifting, eyelid surgery (blepharoplasty), and cheek or chin augmentation. Careful consultation with Dr. Finn may best determine which combination of procedures will work best for you.
ENDOSCOPIC FACELIFT
Select patients may be candidates for a procedure with much smaller incisions, called endoscopic facelift. With this procedure, a small incision is made behind the temple hairline and the endoscope is used to dissect and reposition the fat pad of the cheeks. This lifts the middle part of the face and softens the nasolabial fold. The main limitation of the procedure is that the jowl area is only mildly improved, so this procedure is limited to those patients with isolated midface problems. Midface lift is often combined with an endoscopic forehead lift. In both procedures, there may be some swelling in the area below the eyes for four to six weeks.
BEFORE AND AFTER
Although a facelift is generally a very safe procedure, complications may occur with any surgery. There are several things you may do to minimize the risks for complications.
Any smoking may seriously impede wound healing and dramatically raise the risk for scarring. Please be candid with your surgeon if you are a smoker, as the procedure itself may need to be modified for you. All smoking must be stopped for at least two weeks before and two weeks after any facelift procedure. If you are considering facelift surgery, please discuss your smoking with our doctors and we may help prescribe a regimen to help you quit smoking.
It is vitally important to avoid any aspirin or aspirin-containing products as well as any anti-inflammatories such as ibuprofen or naproxen (including Motrin, Aleve and Advil). It is generally fine to be taking Tylenol (Acetaminophen). It is also important to avoid any vitamin E supplements within two weeks of surgery. All these medications tend to contribute to bleeding problems following surgery. If you have any questions about the medications you are taking, please call our office for clarification. It is also very important that appropriate blood pressure be maintained. If you are on an antihypertensive medication, it is important to continue on that medication both before and after surgery.
We have found other medications tend to help reduce bruising and swelling. Vitamin K cream applied to your skin two weeks before surgery tends to reduce bruising. Some patients choose to take "Arnica Montana," a homeopathic herb that is thought to reduce swelling and bruising. Both of these products are available through Aesthetic Solutions. At times, taking steroids in the post-surgical time period will help decrease swelling.
Following surgery, patients wear a large fluffy dressing for one to two days. After this is removed, patients may wash their face and hair gently. Sutures and staples are removed between one and two weeks. It is important to minimize activity following surgery and to keep the head elevated as much as possible. Ice packs are helpful for the first twenty-four hours.
Bruising and swelling are typical and may be dramatic after surgery. This resolves in varying amounts of time, generally within ten days to two weeks, and much of the bruising may be concealed with makeup at one week following surgery. Pain is surprisingly minimal following surgery, and the cheeks and ears may feel numb for several weeks.
IMAGING
At our state of the art facility, you may learn what a face-lift may do for you. By using computer imaging, Dr. Finn may simulate the changes possible with surgery. It is important to understand the limitations of face-lift surgery and to maintain realistic expectations for the outcome. Only with candid, trusting communication with your surgeon may you be fully prepared for your procedure.
5821 Farrington Road
Suite 101
Chapel Hill, NC 27517
Tel: 919-403-6200
Fax: 919-403-6242
info@aesthetic-solutions.com