About the Facelift (Scroll down for Necklift)
The medical term for a facelift is Rhytidectomy which when translated from Greek literally means removal of wrinkles. While a facelift does improve wrinkles, it is really better thought of as an operation to removes sags and bulges. The facelift is the most effective way to eliminate the dreaded jowls and loose neck skin and produces a very pleasing lift to fallen cheeks. Altogether, the facelift restores the smooth and youthful contour that starts at the chin and flows naturally along the jaw-line up to the cheekbone.
Deciding when to move forward with a facelift is a very individual decision. Facelift, and necklift are not reserved only for older people anymore. The trend is toward younger people having facelifts and there are good reasons for this. Facelifts on younger people can be thought of as a maintenance procedure rather than a restoration procedure. The change from the preoperative to postoperative appearance is subtler and prone to comments such as, “you look good . . . did you lose weight?” With continued “maintenance” procedures, one can keep the most youthful appearance possible at any age without ever incurring a dramatic change. That is not to say, however, that people with more advanced “sags and bulges” should avoid having a facelift. It simply means that the pre to postoperative change will be greater.
The word facelift is a “catch-all” term that refers to any or all parts of the face. The face can be divided into four parts: the neck, cheek, temple, and forehead. For any individual, I customize the surgery to address the components that you and I agree are in need of rejuvenation. Typically, the neck and jowls are the regions that patients have the earliest and greatest concern over. If the changes are subtle, a simple neck lift (mini face-lift) may suffice. If changes are more advanced then a neck/cheek or neck/cheek /temple lift are required. The forehead and brow area is less consistent from person to person as to when or if it will sag. For some people, the brow has less to do with age and more to do with genetics. Frequently, the brow may not seem to be low, however, a forehead and brow lift may still be needed to fully correct sagging upper eyelids.
The procedure itself is usually done under a “twilight” anesthesia in which you are completely unaware of your environment. With this type of anesthesia you usually avoid the nausea and sore throat that accompany a general anesthesia. Afterwards, you will have cotton dressings surrounding your face; these are removed the morning after surgery and only an elastic strap under your chin is needed after that. Pain is minimal after a few days. You may return to light “desk-work” a couple of days after surgery but should plan to take three weeks before returning to public life in Austin if you desire discreteness.
Anyone who does not have a major medical problem is a candidate for facelift regardless of age. I have performed facelifts on people over the age of 80 with excellent results. People who use nicotine products should discontinue these products at least one month prior to surgery. Often times a visit to your primary care physician is advised prior to surgery just to be sure that we are as prepared as possible.
Before and four months after facelift, brow lift, upper and lower eyelid surgery with laser resurfacing to the eyelids
Before and 2 weeks after facelift with upper eyelid surgery
About the Necklift
The necklift is a procedure best suited for two types of patients. The first is someone who only needs loose tissue in the neck tightened and the second is a person who wants much of what a facelift provides, but with a shorter healing time.
The necklift is done through three very small incisions located under the chin and behind each earlobe. Each incision is about a half inch in length. Through these incisions any excess fat is removed and then the muscles deep to the skin are tightened. The skin is then laid back down over the deeper neck tissues where it heals in the new tighter position.
The first night after surgery a dressing is worn to hold pressure under the chin. This is removed the day after surgery and bruising is expected on the neck. Most of this bruising is gone by one week and a collared shirt will cover most of the bruising even before that. You need to take a week off of aerobic activities and two weeks off of weight lifting activities. Deskwork can be resumed usually a day or two after surgery.
Before and two months after necklift
Before and 6 weeks after necklift