As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck. A facelift can't stop this aging process. What it can do is "set back the clock," improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.
The best candidate for a facelift 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 facelifts can be done successfully on people in their seventies or eighties as well. A facelift can make you look younger and fresher, and it may enhance your self- confidence in the process. But it can't give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
A facelift usually takes several hours-or somewhat longer if you're having more than one procedure done. For extensive procedures, Dr. Bolitho may opt to schedule two separate sessions.
Depending on the degree of change you'd like to see, your facelift choices include a traditional facelift, limited incision facelift or a neck lift.
A traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp. Fat may be sculpted or redistributed from the face, jowls and neck, and underlying tissue is repositioned, commonly the deeper layers of the face and the muscles are also lifted. Skin is redraped over the uplifted contours and excess skin is trimmed away. A second incision under the chin may be necessary to further improve an aging neck. Sutures or skin adhesives close the incisions.
An alternative to a traditional facelift uses shorter incisions at the temples, continuing around the ear and possibly within the lower eyelids or under the upper lip.
Following surgery, a small, thin tube may be temporarily placed under the skin behind your ear to drain any blood that might collect there. Dr. Bolitho may also wrap your head loosely in bandages to minimize bruising and swelling.
Sagging jowls, loose neck skin and fat accumulation under the chin may be corrected with a neck lift. The neck lift incision often begins in front of the ear lobe and wraps around behind the ear ending in the lower scalp.
There isn't usually significant discomfort after surgery; if there is, it can be lessened with the prescription pain medication. Some numbness of the skin is quite normal; it will disappear in a few weeks or months.
Most patients are advised to keep their head elevated, to keep the swelling down.
If you've had a drainage tube inserted, it will be removed one or two days after surgery. Bandages, when used, are usually removed after one to five days. Don't be surprised at the pale, bruised, and puffy face you see. Just keep in mind that in a few weeks you'll be looking normal.
Most of your stitches will be removed after about five days. Your scalp may take longer to heal, and the stitches or metal clips in your hairline could be left in a few days longer.
You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first.
After a face lift, you should avoid strenuous activity, including sex and heavy housework, for at least two weeks (walking and mild stretching are fine) and avoid alcohol, steam baths, and saunas for several months. Above all, patients are advised to get plenty of rest and allow your body to spend its energy on healing.
At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff and you'll probably be self-conscious about your scars. Some bruising may persist for two or three weeks, and you may tire easily. It's not surprising that some patients are disappointed and depressed at first.
By the third week, you'll look and feel much better. Most patients are back at work about ten days to two weeks after surgery. If you need it, special camouflage makeup can mask most bruising that remains.
Complications that can occur include hematoma (a collection of blood under the skin that must be removed by a surgeon), injury to the nerves that control facial muscles (usually temporary), infection, and reactions to the anesthesia. Poor healing of the skin is most likely to affect smokers.
"From the moment I first interviewed with you, I have felt I was in very kind, gentle, sophisticated and extremely talented hands. It is very exciting to find a hidden treasure in a sea of cosmetic surgery offices. My heartfelt thank you to you all."
"I feel so fortunate to have had somebody who not only performed my surgery exceptionally well but also did it with compassion. I will forever be grateful for your efforts."
"I had a surprisingly positive experience! Dr. Bolitho's work is top notch and I am completely pleased with the results. He and his staff were exceptionally caring, attentive to detail and knowledgeable. My surgery and recovery went off without a single complication. I will be recommending Dr. Bolitho to anyone who asks for a referral. I couldn't be happier with the care I received!"