Rhytidectomy – Facelift Surgery Overview

Rhytidectomy is a word not many people have heard of or know about, but it is actually more well-known than people may realise. Commonly known as a “facelift,” rhytidectomy is a cosmetic surgery that is performed by a plastic surgeon. This surgery is typically requested by people who would like to remove some of the effect of ageing in order to make the face look younger and the skin more perky. The outcomes which one may expect from rhytidectomy include:

• Removal of excess skin
• Tightening of sagging skin
• Removal of drooping cheeks around the jawline
• Lifting the corners of the mouth
• Reducing the visibility of the creases between the cheeks and the lips
• Increases self-confidence and helps to boost self-esteem

Rhytidectomy is typically combined with other facial cosmetic procedures, such a brow lift, to give the overall desired effect of having a more youthful experience. Before deciding whether you would like to have a facelift procedure, it is important to understand the composition of skin and how it is affected by age and how the procedure is carried out.

What is the skin made of?

The skin is made up of different fibres called collagen and elastin. Collagen is found everywhere in the body and is a protein that that helps to sustain the structure of the body. Elastin is what give skin and other body structures the ability to stretch and recoil. These two structures are affected by the process of ageing. Additionally, in the deepest layer of skin, there is a layer of fatty tissue that is for padding the skin and giving a fuller appearance.

As we age, these fibres become weaker and degrade and the fatty tissue under the skin decreases. This causes the effects of ageing that is commonly seen on the skin. Additionally, gravity, face movements and ultraviolet light contribute to the ageing of the skin. All these changes cause the skin to sag, stretch and lose its ability to recover.

Things that affect the level of success of a rhytidectomy surgery include skin type, ethnicity, individual healing, basic bone structure and overall attitude regarding the surgery all contribute to the outcomes and should be discussed with the surgeon.

Who is eligible to have rhytidectomy?

As one gets older, the skin and the appearance of the face changes. This may cause one to feel self-conscious about their looks or have low self-esteem. Getting a facelift procedure helps to give the face a more youthful appearance. With any cosmetic surgery, it is important to make sure that the decision to get the surgery is done out of your own will and desire to change your appearance, rather than at the request of someone else. Having said this, there may be some patients who do NOT qualify to receive the surgery, for one or other reason. The following would make one a good candidate for rhytidectomy surgery:

• Being physically fit and healthy to undergo surgery
• Dissatisfaction with the shape or look of the face
• If there is excess or sagging skin
• If you have creases and wrinkles that are of concern

Before having the surgery, it is imperative to have a conversation with your surgeon regarding all your medical conditions and relevant medical history because certain health conditions may affect the type of anesthetic or your eligibility to have the surgery.

Left: desired facelift effect Right: signs of the aging face – By GBdeZeeuw – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=22527732

Details of the facelift procedure

After speaking to your surgeon about the concerns you have regarding your face and where you would like changes to be made, the surgeon will decide how best to achieve the result you are looking for. Once this has been decided, you will be given anesthetics for the procedure to ensure that you are comfortable and do not feel pain. There are different anesthetic options which can either be local anesthetic (where the patient is awake or a little drowsy for the procedure) or a general anesthetic (where the person is completely asleep and unaware). This decision is made based on the extent of the surgery and what is going to be done.

The surgeon makes a small incision in the hair line of the patient, at the temples, and another one just above and in front of the lobe, circling the ear before returning to the point of origin. The skin is then raised in order to reveal the underlying muscle and connective tissues. These tissues are first repositioned and tightened. Some fat may be removed or repositioned in order to give the desired facial outcomes.

Excess, stretched or sagging skin is then shaved off, and then the incisions can be closed with fine sutures of metal clips. This procedure is done without shaving the hair in order to hide the scar that will form from the surgery. On some occasions, a drain may be placed under the skin for approximately two days in order to drain any excess blood and other fluids from building up under the skin.

Once this is all done, the face and incisions are covered with sterile bandages. A face lift will typically take between 2 to 5 hours long, after which point most patients can go home on the same day.

After the facelift surgery

Most people will experience minimal pain following a facelift, your surgeon will still prescribe medication for you to combat any pain that you may experience. Like most surgeries, there will be some degree of bruising and swelling, which is normal and unavoidable, but will resolve after some time.

For the first few days following your facelift, it is advisable to do the following:

• Use cold compresses to minimize the swelling
• Keep your head elevated when resting
• Take pain medication as prescribed by your surgeon
• Avoid exposing the incisions to pressure
• Do not wear clothing that requires to be placed over the head

Your surgeon will give you instructions regarding the continuation of daily activities, such as bathing, washing hair and other physical activities.

You will return to your surgeon a day or two after the facelift. This is in order to remove the drainage tube and to assess the incisions and rebandage the face. The stitched/staples only get removed after approximately a week after the surgery. Your surgeon will carefully check if the incision has healed adequately and whether there are any ingrown hairs that need to be removed.

Understand that a “facelift” is not a procedure that lasts forever and the effects of ageing will again show up. A facelift is said to last for approximately 5 to 7 years before it will release, however, even after this, a person will still look younger than they did before they had the surgery.

Like all surgeries, there are risks that are involved. It is uncommon to get complications from a facelift surgery if it performed properly. Most facial cosmetic procedures are safe and carry low risk of complications. Some complications that may occur include:

• Infection after surgery
• Bruising and swelling
• Damage to the facial nerve, which is usually temporary
• Hematoma or seroma
• Unsatisfied with the final outcome
• Delayed wound healing

If you are interested in feeling more comfortable with your body and having improved self-esteem, contact your plastic surgeon in order to discuss whether you are eligible for rhytidectomy surgery and which option would best suit what you are looking for.

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