Face Lift (Rhytidectomy)

Rhytidectomy, more commonly known as a face lift, is a procedure to improve sagging facial skin, jowls, and loose neck skin by removing excess fat, tightening muscles, and redraping skin. The procedure does not stop the aging process, but it can “set back the clock.” A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.

The best candidates for Rhytidectomy
The best candidate for a face lift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but face lifts can be done successfully on people in their seventies or eighties as well.

Face lifts are very individualized procedures. In your initial consult with the surgeon, he will evaluate your face, including your skin and underlying bone and discuss your goals for the surgery.

If you smoke, the surgeon will recommend that you stop at least a week or two before and after surgery. Smoking inhibits blood flow to the skin and may interfere with the healing of your incisions. If you have short hair, you may choose to grow it out a bit before surgery to help camouflage the incisions.

How the surgery is performed
The surgeon performs the procedure by making incisions above the hairline at the temples and extending them in a natural line in front of the ear or just inside the cartilage at the front of the ear. The incision then continues behind the earlobe to the lower scalp. If work is required on the neck, a small incision may also be made under the chin.

The skin is separated from the fat and muscle below and some fat may be trimmed or suctioned from the areas around the neck and chin. Then the underlying muscle is tightened and the skin is pulled back and any excess skin is removed. Sutures are placed to secure the layers of tissue and to close the incisions. Sometimes metal clips are also used on the scalp.

Face lifts usually take two to four hours, depending on the extent of the procedure. The surgery is usually performed as an outpatient under general anesthesia, but the surgeon may recommend that you stay overnight at the hospital.

What to expect after surgery
Following the procedure, you may have a small, thin tube temporarily placed under the skin behind the ear to promote drainage of any blood that may collect. The surgeon will also wrap a dressing around your head to minimize bruising and swelling and promote healing. Bruising and swelling are normal after surgery. Keeping your head elevated and as still as possible for the first several days will help to keep the swelling down. Bruising typically subsides after two to three weeks. If a drainage tube was placed during your procedure, it will be removed one or two days after surgery. Bandages are typically removed after one to five days. Sutures will be removed after about five days. The sutures or clips along your hairline may be left in a few days longer, depending on your healing process.

Resuming work and other activities
The usual time for return to work is 10 to 14 days. Strenuous activity should be avoided for at least two weeks. Also, avoid alcohol, steam baths, and saunas for four to six weeks. You will need to limit exposure to sun for several months to promote healing of your incisions.