Facelift (Rhytidectomy)

WHY SURGICAL FACELIFT?

With aging, skin and soft tissue of the face loses its elasticity and tone. This is reflected as:

  • Sagging skin
  • Deepening of the folds
  • Increasing numbers and the depth of facial wrinkles
  • Increasing jowling and blunting of the jaw line
  • Alteration of facial shape from a more V-shape to a square shape

WHAT IS SURGICAL FACELIFT?

Surgical facelift is a procedure intended to restore the facial soft tissue back to its youthful position.

WHAT DOES A STANDARD FACELIFT PROCEDURE INVOLVE?

Generally speaking a standard facelift surgery involves:

  • Designing. This is where the skin markings are drawn on you before the surgery in accordance to the desired surgical outcome.
  • Sedation. We regularly use general anesthesia or twilight sedations to help you to relieve anxiety and be more comfortable.
  • Local anesthetic injection. Numbing medication is injected into the surgical area so that you don’t feel any pain.
  • Facelift surgery. Surgery is performed to produce the desired cosmetic outcome and frequently involves removing excess skin, tightening the loose SMAS muscle and the finishing off with suturing. The surgery typically takes two to two-and-a-half hours.
  • Recovery. After the surgery we ensure that you are fully awake before sending you home.
  • Discharge. You are sent home on the same day about 30 minutes after the surgery with strict discharge instructions.
  • Suture removal after one week.
  • Back to work in two to three weeks.
  • Six to eight weeks for swelling to completely settle.

WHAT TYPES OF FACELIFT ARE THERE?

Cutaneous (Skin Only) Facelift

The traditional facelift has been performed for many years. It is a technique where the skin is lifted from the underlying tissues and tightened backwards and upwards. While the overall facial appearance will be improved there is no improvement to the deeper facial tissues. This technique does not give a very long-lasting result and is therefore not used frequently by Dr. Del Corral.

SMAS Facelift

Beneath the skin of the face lies a deeper layer to which the muscles and soft tissue are attached (Superficial Musculo-Aponeurotic System – SMAS). This can be used to elevate the soft tissues of the face to provide a longer lasting result than with the classical facelift where only skin is tightened. This can be achieved either by removing a portion of the SMAS and tightening it (the SMASectomy Facelift) or by folding a portion of the SMAS itself to preserve volume (SMAS Plication Facelift). These types of facelift are useful when there is a need to restore fullness to the cheekbone area as well as removing jowls and redefining the neck. This is the facelift that Dr. Del Corral performs on most patients however the direction in which the muscles (SMAS layer) are pulled is individual to each patient.

The ‘MACS’ Lift (Minimal Access Cranial Suspension)

Suitable for patients with mild to moderate jowls but no loose skin in the neck. Permanent sutures are used to elevate the soft tissues of the face and suspend them in a more youthful position. This operation has a shorter scar behind the ears and a relatively quick recovery, although it may not be as long lasting as the SMAS facelifts.

The Short Scar Facelift

All of the facelifts above can be performed with a shorter scar which means that in addition to the normal scar in front of the ear, the rest of the incision behind the ear is limited and does not extend into the scalp. This does mean that the ability to tighten the neck may also be somewhat limited. Anybody with a moderate amount of loose skin in the neck will be better served with a slightly longer scar to accommodate this. However for patients who need tightening predominantly in the face it provides a useful alternative. These patients are usually in the younger age group (early 40s).

Neck Lift and Platysmaplasty

All deep plane (SMAS) facelifts tighten the muscle of the neck to improve both the jowl area and jaw line. The aim of a neck lift however is to eliminate vertical folds in the neck, to tighten the skin and reduce excess fat beneath the chin. This can usually be accomplished through the incisions made for a facelift although a small incision under the chin may also be required for fat removal or to tighten the neck muscles centrally (known as a platysmaplasty).

WHICH FACELIFT IS BEST FOR YOU?

There are now a number of options for effective facial rejuvenation surgery and the various types of facelift will be discussed with you in order to decide which would be most appropriate to produce the result you desire. All are designed to give a natural fresh look and will not produce a tight, mask-like appearance. The focus of this kind of surgery should, for the most part, be upon facial shape. A youthful face will have full, high cheekbones with a well-defined jaw line and neck contour. As the face ages it tends to become squarer. This trend is reversed by effective facial rejuvenation surgery. Dr. Del Corral will give you clear guidance as to what will be most suitable for you.

THREE MOST COMMON FACELIFT MYTHS

Myth #1:

“Facelifts produce an artificial, “operated” appearance to the face.”

Patients who are considering facelift surgery today are more educated than ever. The vast majority realize that a good facelift will produce completely natural-appearing results that will not look artificial or “over-stretched” in any way. That said, we can all think of examples of celebrities that have had poor, over-done results. The best way to reassure our patients of what to expect is to show them examples of patients who have had similar procedures. Our patients do not come asking us to make them look like they are 30 years-old again. They want to look like themselves–just healthier, more refreshed and rejuvenated.

Myth #2:

“A mini-lift is the way to go.”

Perhaps the biggest source of confusion that I encounter is patients asking for a mini-facelift or a “lunchtime facelift ” when it would be more appropriate for them to have a more complete procedure. Less is definitely not more–the last thing you want to do is have a procedure that produces a mediocre result or one that will last for only one or two years. A good facelift should give you effective results for seven to twelve years. Certainly a mini-faceilft is an excellent option for younger patients with early aging changes of the lower face, but if you are seeking correction of heavy jowls, sagging of the midface, or significant extra skin under the neck it may not be the right choice for you.

Facelift surgery is not like picking a fast-food combo. It should be more like a master chef crafting a perfect menu for you as an individual. That is why facelift surgery in particular needs to be performed by someone that can help you to make the right choices.

Myth #3:

“Facelifts are for women.”

Men are undergoing plastic surgery procedures at a record rate which is continuing to grow. The most popular facial rejuvenation procedures in men include eyelid surgery, facelift surgery, hair restoration, chin augmentation, neck liposuction and fat grafting to produce and maintain a healthy and masculine appearance.

HOW LONG DOES A FACELIFT LAST?

This is one of the questions most frequently asked by patients. The answer is that this type of surgery puts back the ageing clock by seven to 10 years, but of course, cannot stop it from ticking. Ten years after the surgery you will of course look older but will always appear seven to 10 years younger than you would have looked without surgery.

HOW WILL DR. DEL CORRAL ENSURE A NATURAL LOOK?

The foundation of a good outcome is a thorough consultation and analysis of how your face has aged which requires a review of photographs taken of you about 10 years ago and from your youth. You will be requested to bring these with you to the consultation with Dr. Del Corral (family photographs are all that is required). This will give an accurate impression of what anatomical changes have occurred and they will act as a “roadmap” so that your surgery truly rejuvenates rather than recreates an appearance you never had.

The next step is the surgery where Dr. Del Corral rejuvenates primarily by moving the soft tissues of your face (SMAS layer) so that rejuvenation of shape is achieved which is usually the main change from youth to middle age and not just by tightening skin. The skin will of course be tightened as well but now can be done without giving a “wind tunnel” appearance. The “roadmap” (i.e., your previous appearance from photographs) helps Dr. Del Corral decide the direction of pull of the SMAS so your procedure achieves a natural appearance maintaining the precise character of your face from youth.

WHAT KIND OF ANESTHESIA IS USED DURING FACELIFT?

Facelifts are usually performed under general anesthesia, which means that you sleep during the entire procedure. This is certainly the most convenient for the patient; details of the anesthesia will be discussed preoperatively by an anesthesiologist, which clarifies your specific anesthesia requirements. The anesthetist will be present during the entire procedure and control the anesthesia.

Alternatively, the so-called “twilight anesthesia” is available. It is also controlled entirely by the anesthetist; they will be calculated not intubated and ventilated. You fall into a deep, pain-free sleep.

Another alternative is the local anesthesia with injection of local anesthetic. With local anesthesia, you will also receive a sedative (either as a tablet or by intravenous injection in the arm vein) which puts you in a kind of twilight sleep. You are awake, but relaxed and insensitive to pain. You get to witness the operation, and you may feel a pull or the like.

WHAT TO DO AFTER THE FACELIFT?

In the first three to five days after surgery, you will feel mild pain in the entire area of operation, and a feeling of tension. Thus your facial expression is restricted and your head movement is limited. In general, you are given pain medication to alleviate the pain.

During surgery drains are placed that can be drawn from on the first day after surgery. Possibly also a compression mask is used, and removed usually after one to three days. Keep quiet in the first days after the face lift; keep your head elevated in order to reduce swelling.

After seven days, the first stitches are removed. The scalp needs a little longer to heal, so threads or brackets are left for a few more days.

After only a few days, you can resume your normal daily activities. Plan still time to rest in the first week after surgery. Sport should be avoided, in consultation with your doctor, for at least six weeks. Smoking and alcohol consumption should be reduced to a minimum after surgery.

At first your face will look unfamiliar to you. Your features will be altered by some swelling. The expression often seems a little stiff. The initial pale red scars fade more and more until you can see only narrow white lines. After two weeks you will usually be relaxed and recovered.

After 10 to 14 days, depending on the extent of the facelift, most patients can again resume their work. The remaining scars are initially obscured by many patients with a special camouflage makeup. Any remaining scars still visible can be covered with camouflage makeup.

CAN A FACELIFT BE REPEATED?

After 10 years, a facelift can be repeated easily. Some people deliberately choose the option of repeated repairs at shorter intervals, to avoid a dramatic change and rejuvenation of the face. In the U.S. this is known as “maintenance.”

I AM INTERESTED! WHAT DO I DO NEXT?

If you are considering a facelift we encourage you to contact us to schedule a consultation and/or treatment at Dr. Del Corral’s office. During this visit we will listen to your concerns and discuss your options. After careful analysis, we will tell you whether you are a suitable candidate for this procedure and inform you of the alternatives and potential risks of the procedure.

Before and After Photos