Facelift (Rhytidectomy)

By Dr Leow Aik Ming

Facial aging reflects the dynamic, cumulative effects of time on the skin, soft tissues, and deep structural components of the face, and is a complex synergy of skin textural changes and loss of facial volume. Many of the facial manifestations of aging reflect the combined effects of gravity, progressive facial bone resorption, decreased soft tissue elasticity, and redistribution of subcutaneous fullness.

Facelift, or rhytidectomy, is a cosmetic surgical procedure that improves visible signs of aging in the face and neck. The aesthetic goal to is to rejuvenate and improve facial contours and overall appearance through the tightening of facial tissue and muscles, and the repositioning of skin. This helps remove wrinkles and droopiness from the eyes, face and neck, creating a more defined facial structure and overall rejuvenated appearance. It is important to be aware that facelift does not stop the aging process.

Most facelift techniques focus on the lower facial areas, such as the jawline, jowls and cheeks. A facelift can also focus on the midface or the forehead. In some techniques, deeper facial tissues may be repositioned or tightened to restore a more youthful contour. Today, many different techniques such as traditional facelift, limited incision facelift or MACS (Minimal Access Cranial Suspension) facelift exist with outcomes that can be consistently reliable, safe, and durable. The selection of different types of facelift techniques will depend on the area of the face that is targeted and the amount of desirable changes.

Other procedures that might be performed in conjunction with a facelift to achieve desirable aesthetic results are brow lift and eyelid surgery to rejuvenate aging eyes or neck lift to improve the neck contour. Fat transfer or fillers may be suggested to replace the depleted fat volume in the face. Complementary treatments such as dermabrasion, peels or laser may be offered to improve the quality and texture of the skin.

Facelift surgery can only be performed surgically. Non-surgical rejuvenation treatments cannot achieve the same results as facelift, but may help delay the time at which a facelift becomes appropriate and complement the results of surgery. Some non-surgical treatments, such as stem cell facelifts, are of unproven benefit.

Ideal Candidates for Facelift:

The best candidates for a facelift are men and women who are looking for an improvement in their appearance and have realistic expectations. A facelift can make a person look younger and fresher. It may enhance self-esteem but it won’t give a totally different look, nor can it restore the health and vitality. Always remember that when a person decides to undergo any cosmetic surgery, it is for oneself and not for others. Always be ready for a recovery period of a few weeks if you want a long-lasting result.

Postoperative Expectations for Facelift:

After surgery, the head and face will be loosely bandaged to help reduce swelling and bruising. Depending upon the situation, a drainage tube may be inserted behind the patient’s ear to prevent blood and fluid from collecting under the skin. Pain medication is usually prescribed to make the patient feel as comfortable as possible following surgery. During the facelift recovery, patients should allow for adequate healing time. Expect some postoperative swelling, numbness, and bruises for about 2-3 weeks. All incisions and dressings should be kept clean and dry. For the first few days, the head should be kept elevated and immobile in order to minimize swelling. Most of the stitches will be removed in about 5-7 days.

Strenuous exercise should be avoided for at least the initial two weeks after surgery. Alcohol or hot saunas should be avoided for several weeks. During the facelift recovery period, extra rest is very important to promote proper wound healing. The outcome of face lift results will be apparent gradually once the swelling and bruises resolve.

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