With age, the effects of gravity and repetitive muscle contraction, quantitative changes occur to the soft tissues of the face, giving one a tired appearance. Skin becomes loose, fat pads descend, and muscle banding occurs in the neck. Wrinkles appear in the skin, along with other qualitative changes, signaling a mature countenance.
The procedure known as a facelift is designed to temporarily reverse some of the quantitative changes that occur with aging, though surely not all changes. Through inconspicuous incisions around the ears, the tissues of the face can be accessed, repositioned, and redundant tissues removed. By its very nature, facelifts only "set back the clock"; the constant pull of gravity cannot be suspended.
The facelift may be combined with other procedures, such as eyelid surgery (blepharoplasty), forehead lifting (browlift) ,or chin augmentation, either at the time of the facelift or in a staged approach.
Your surgeon will gather a thorough medical history, with particular emphasis on your weight, underlying medical problems such as diabetes or high blood pressure, history of cigarette smoking, and bleeding tendencies. Skin care regimen is reviewed as well.
Following this, a thorough directed physical examination of all of your facial features is carried out, including upper face or brow, eyelids, midface or cheeks, and neck. Examination of the chin as it relates to your other facial bone structure is also reviewed. The doctor vocalizes what he sees to give you a comprehensive overview of how he perceives your appearance has been affected by aging, with an eye to how each component relates to the other, and what might be done to improve each surgically. You may not wish to take advantage of every avenue of treatment that is available for rejuvenation, but at least you should know about every available approach and what each can offer. Plastic Surgery is an art, and the application of any particular line of treatment must be tailored to the patient's goals and desires.
Beyond what your surgeon will provide in terms of surgically treatable quantitative aging, there are several other areas that can improve your appearance that may be of equal, or even greater, value. These would include injectable filler materials (lines, lips, scars), skin care (addresses qualitative aging such as sun damage, prominent blood vessels, and wrinkles), cosmetic dental treatment (this can make a striking improvement in appearance), new hair styling, cut, or coloring (this also helps distract attention from the fact that surgery was done), and makeup consultation. When you see someone who looks years younger than her age, it is likely there is more to it than just a talented plastic surgeon.
Frequently, to communicate visually what is possible with surgery, Your Surgeon will offer to demonstrate the anticipated effect of the facelift using a very sophisticated computer-imaging program. After taking a digital image of your face, he can "morph" your image, thus showing you how the facelift would make you appear. Though not a warranty of the effect of surgery, this offers the best educated guess technology and good judgment has to offer.
Complications following facelifts are infrequent and usually minor. Nevertheless, individuals vary greatly in their physical reactions to surgery, their healing tendencies, their scarring potential, and certainly in their psychological reaction to the effect of surgery.
Complications that can occur include infection, hematoma (a collection of blood under the skin that must be removed by the surgeon), injury to nerves that control facial muscles (usually temporary), and reactions to medications. Poor wound healing is usually seen in cigarette smokers, and so Your surgeon will most likely not perform a facelift unless you are committed to DISCONTINUE CIGARETTE SMOKING FOR AT LEAST A MONTH PRIOR TO OPERATION AND FOR TWO WEEKS AFTERWARDS.
Scars from facelifts are usually very inconspicuous, but in some ethnic groups they may be more obvious as a consequence of that person's particular tendency to form thick scars. This cannot be predicted prior to operation, but treatment is available to minimize the appearance of thickened scars. Certainly, any history of poor quality scars should be mentioned to your surgeon at the time of the consultation.
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