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Facelift or rhytidectomy is perhaps a misnomer and should have been called a neck lift for this is the area most affected by lower facelift surgery. A full facelift may also involve the eyes and forehead with blepharoplasty and foreheadplasty. There are many types of facelift with the trend over the years to make the result more natural looking and longer lasting. Depending on your plastic surgeon's physical exam of the changes occurring in your face that are to be addressed, a skin only facelift may be recommended, skin and deeper layer lifting, or all of this with defatting under the chin and repositioning of the muscle in the neck or platysmoplasty may be recommended.
The way the face ages besides hinging on our family genes, is also affected by our environment, by the loss of skin elasticity over time, and the thinning and stretching of the tissues. We see overhanging and drooping skin with gravity, changes in texture and static wrinkles with exposure to the sun and cigarette smoke, and dynamic wrinkles such as frown lines and "crow's feet" with muscle action.
Surgical treatment such as facelift is directed towards the gravity changes. In the face this is seen as lax skin of the cheeks and neck area, jowling or puffiness around the jawline, and deepened nasolabial folds between the nose and mouth. The lips may also thin requiring lip augmentation. The nasolabial folds are not predictably treated with the facelift and so fillers to this area such as collagen or fat grafts may also be recommended or desired. In the neck the separating muscles may form bands seen down the front of the neck, and these are addressed with a platysmoplasty at the time of facelift. Foreheadplasty or browlift and blepharoplasty or eyelid surgery are always considered whenever eyelid surgery is done, the determination of need being performed by your plastic surgeon on physical examination, and by your desires.
The other area examined by your surgeon is the foundation for the skin holding the results up, that is the bone structure. If the bone of the cheeks falls behind the most forward part of the eyeball on lateral view cheek implants may improves the foundation of the cheek skin. Similarly, if the chin falls behind a vertical line from the lip a chin implant may help.
The facelift may result in scarring in front of the ears, sometimes into the ear to hide the mid portion of this in a woman, behind the ears, into the hair, under the sideburns, and under the chin. Every effort is made to hide these scars as much as possible and for this reason most of the tension holding the lift is put behind the ears.
Risks include bleeding problems, infection, numbness, muscle weakness, healing problems such as loss of skin and thickened or keloid scarring. Risks are increased with cigarette smoking and high blood pressure.
The surgical treatments such as facelift do not address the textural changes in the skin and the dynamic wrinkles. Because of this Botox, skin care, peels and laser may be recommended as well.
Facial rejuvenation surgery is being performed much more frequently now with fewer complications. As with any elective cosmetic procedure, care should be taken to make sure that you are comfortable with your surgeon and that you understand and are willing to undertake the risks involved.
For those wanting a less invasive procedure, not able to undergo anesthesia, or not wanting scars in front of the ear, the minimally invasive Threadlift(TM) procedure is a newly available option.
