The Process Of A Face Lift Procedure

The most comprehensive method of facial rejuvenation is the facelift

. However, blepharoplasty is definitely a 'bigger bang for the buck' and should be considered either prior to, or together with, a facelift when aesthetic surgery of the face is being contemplated.

Having said that, it is important to understand what exactly a facelift is. It is an operation in which the facial skin is dissected off the underlying structures via an incision that is concealed around and behind the ear, and then drawn back under some tension. Excess skin is excised, the facial tissues tightened and the wound closed leaving an inconspicuous scar. It does not involve the brow or the eyelids, although it is certainly possible to perform a brow lift and/or blepharoplasty at the same time. A facelift is aimed primarily at the cheek, jowls and neck.

The most effective outcome of a facelift is seen in the jowls and in the neck. Its benefits in the mid face are less predictable but may be augmented by ancillary procedures such as fat injection. Facelifts that simply serve to tighten the skin are rarely effective. To be beneficial, it is necessary to tighten the underlying superficial musculo aponeurotic system (SMAS), a layer which is intimately connected to the muscles of facial expression. There are various methods of doing this but the superiority of one over another has not yet been established.

In younger patients, where a large skin excision is not required, a 'MACS' lift may be contemplated. Here the lift is performed through an incision that extends down the front of the ear, ending at the lobe. Undermining of the facial skin is limited and skin excision is minimal. However SMAS work is performed using non-absorbable sutures to plicate (tighten) the SMAS in the cheek and neck. This is not suitable for patients with a large redundancy of skin.

Beware of practitioners touting 'thread lifts,' 'week-end face lifts' 'mini face lifts' and the like. Getting a long-lasting result from a facelift takes a lot of hard work. The beneficial effects of such procedures barely outlast the postoperative swelling. Surgeons can perform several of these in a day, but the patient merely ends up with a keepsake scar, no benefit and empty pockets.

A facelift is usually performed under either general anesthesia or local anesthesia with intravenous sedation. Although a pure facelift is comfortably carried out on a day surgery basis under sedation, the addition of other procedures would lead me to recommend a general anesthetic and an overnight stay.

At your initial consultation, I shall take a detailed history and perform a thorough examination with the object of defining the esthetic problem, establishing your goals, formulating a treatment plan and ensuring that any pre-existing medical conditions may be appropriately managed to minimize risk at the time of surgery. You will have ample time to ask questions and discuss your options in a professional yet friendly setting. The surgery itself will be carried out in a safe environment (a hospital or an accredited ambulatory surgery center) and you will have a board certified anesthesiologist giving the anesthetic. You should be able to return to work in about a two weeks or even sooner if you can tolerate visible bruising.

by: Dave Stringham

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