Goal:
To improve upon the naturally occurring age-related laxity of
the cheeks, jowls and neck to give a more youthful but natural
appearance.There
is much confusion about the procedure we call “facelift”. Just
what is a facelift? Does it really lift the entire face? What is a
“partial lift” versus a “mini-lift”? What about these smaller
in-office lifts or the ones you see advertised on television?
If you continue reading this, you will soon understand just what a
facelift really is. Anytime we perform a surgical procedure designed
to help support the tissues of the face that have begun to sag due to
the aging process, then this becomes a type of facelift. Some are more
extensive than others, and some are rather minor. Choosing the best
technique for an individual patient depends on factors such as age,
facial structure, sun damage and the hopes and goals of that patient
for improvement.
The older one becomes, with more extensive loss of support, then a
“bigger procedure” is necessary. But many younger patients request a
more youthful face but do not want to wait until their aging is
advanced, and therefore, a more limited but earlier procedure serves
them best.
The best facelifts are natural looking, do not involve changing how a
person really looks, and require a limited amount of healing and
downtime, in our opinion. The goal is an improved appearance, and not
a changed appearance.
The “plastic” or pulled look that was the signature of a facelift of
old is no longer the result now being obtained. In fact, the best
lifts often go unnoticed: the patient simply looks fresher, younger,
and rested.
And while fillers and other less invasive procedures do sometimes
“buy” a patient time, they cannot take the place of a surgical lift. A
facelift can improve support for the skin and other soft tissues,
helps smooth the jaw line tightens up the neck and gives a “slimmer”
appearance to the face.
Another way of describing this is to turn back the clock of age,
improving the most visible signs of aging by removing excess fat,
tightening underlying muscles, and re-draping the skin of your lower
face and neck.
Note: we are not trying to create beauty. We are simply trying
to remove the external unwanted aging changes that have begun to
conceal the beauty that has been there all along.
Typically, most facelift candidates are in their 40s, 50s or 60s. In
certain cases the procedure can be performed on older individuals
depending on the health and vitality of that patient. However, best
results are achieved with patients who still have relatively good skin
elasticity and a strong facial bone structure. In preparation for
facelift surgery, you will need to abstain from smoking one month
prior to the procedure and at least one month during the recovery
period in order to increase the circulation necessary for normal
healing.
Also, there are other factors each patient is asked to control such as
the consumption of aspirin, other anti-inflammatory drugs and many
herbs and supplements prior to surgery since these drugs may lead to
increased bleeding during the course of the facelift.
The Surgery
A facelift can be done alone, or in conjunction with other facial
procedures such as forehead lifts, eyelid surgery and/or skin
resurfacing.
Anesthesia for a typical lift is usually a deep sedation type
(“twilight”) with an anesthesiologist. (Dr
Chatham typically uses an anesthesiologist he has worked with for
20 years, one very skilled in this type of anesthesia.) A general
anesthetic can be utilized if it appears to be in the best interest of
a given patient. Incisions are carefully made around the ears, and
into the hairline. The muscle layer beneath the cheek and neck skin is
identified and supported with strategically placed sutures.
The surgery usually last approximately three hours, followed by time
in a recovery room. Some of our patients are discharged home while it
is the best interests of others to spend one evening. Although a
facelift will improve and enhance the contour of your face and jaw
line, it will not correct sun or wind damage or fine wrinkles that
have developed on the skin’s surface. To treat these conditions,
additional skin care will be needed, which is available at the Chatham
Facial Plastic Surgery. See our skin care and laser section of this
site. These options can be discussed during your initial consultation.
Note that in some younger patients who are primarily interested in a
lesser procedure, we may recommend a “Little Lift”. In
these cases, the best option may be an in-office procedure taking
about 90 minutes, using local anesthesia. Many patients take some
Valium pre-op for relaxation. Smaller incisions and fewer sutures are
used. Healing is quicker and return to activities is quicker, as well.
Not every patient is a good candidate for this. But it may right for
those wanting an improvement but not an entire facelift. (Human nature
desires the simplest way with the maximum effect. We understand this
but we are not magicians! We strongly encourage our patients to remain
realistic.)
We take all of our surgeries very seriously, striving for improvement
but also safety and comfort. Pros and cons, including risks and
possible complications, will be discussed with each preoperative
patient. We make every effort to keep problems to a minimum.
The Recovery
There is some discomfort the evening of surgery, and analgesics are
helpful. The following morning a wrap- around dressing is removed by
Dr Chatham. Written instructions are given to each patient and family.
Swelling and bruising usually peak at 3 days, and one looks better at
about one week when sutures are removed. However, most patients
require about 2 weeks of time before healing is to the point where
they can drive, get out socially or return to work.
As bruising and swelling fade within 2 or 3 weeks, makeup can be
applied (even some men will use a concealer temporarily if necessary).
As with any facial surgery, healing continues for about one year as
small irregularities settle and sensation in the skin and ears
improves.
After the recuperation period many of our patients say, “I wish I’d
done it sooner."
Many patients ask, “How long will it last?” This depends on
many factors –age, heredity, physical and emotional stress levels, sun
& cigarette smoke exposure—and it is impossible to predict how a
person will age over the ensuing years. But in general, if a patient
had an identical twin with identical health and lifestyles, and one
twin had a face lift and the other did not, then the one who did will
for many many years appear to the “young twin”. Plus, follow-up
procedures (“tuck ups”) can be performed to keep you looking as good
as you can for even many more years.
Call today to schedule an initial consultation with
Donn Chatham, M.D. at the Chatham Facial Plastic Surgery. Don’t
let wear and tear or age -related flaws conceal your vigor and your
inner facial beauty!
Visit our
plastic /
cosmetic surgery
offices located in
Louisville, Kentucky (KY) and
New Albany, Indiana (IN). |
