A number of face-life procedures (called rhytidectomies) are available. Facelifts can provide individuals with a more youthful, if not necessarily younger, look. The degree of improvement, however, depends on a number of factors including age, bone structure, skin type, and personal habits, such as smoking and sunbathing.
The Procedure.
When a face-lift is a relatively simple procedure, it can take about two hours under local anesthetic in a doctor’s office.
Complicated face-lifts are done under general anesthesia in a hospital and can take three to six hours.
The face lift procedure may be one of the following:
SMAS (superficial musculoaponeurotic system) is the most common face-life procedure. The surgeon makes an incision at the hairline and separates the skin from the underlying tissue and muscles. The muscles are tightened and excess fat and tissue, such as fat under the chin and neck, are removed.
The endoscopic subperiosteal or subgaleal face-lift is a less invasive surgical technique. The surgeon raises facial structures rather than cutting away flaps of skin. Only a few half-inch incisions are made, and scarring is minimal.
Neither SMAS nor the endoscopic version is effective for the middle part of the face, particularly the deep lines (naso-labial folds) that run down from the nose beside the mouth. Some time after the SMAS facelift, the upper face begins to age again while the lower area still retains its shape, causing the face to look imbalanced. Other approaches, such as one called composite facelifts that lift most muscles in the face are being investigated.
Recovery Process.
Recovery normally lasts from several weeks to several months. Swelling and discoloration are common. Some patients report tingling or numbing sensations after surgery, which generally subside as damaged nerves regenerate.
Complications.
Rhytidectomy is not without risks. A postsurgical hematoma is a collection of blood that can occur after a rhytidectomy. In one study major hematomas occurred in 2.2% and minor hematomas in 6.65% of patients. They generally develop within two weeks of the surgery and require drainage. Even minor hematomas need fast treatment to prevent greater complications, including infection, changes in pigmentation, fluid buildup, and prolonged recovery time.
Other less common complications may include the following:
Infection.
Excessive bleeding.
Asymmetrical facial muscles.
Delayed healing.
Scarring.
Permanent injury to the nerves that control facial movements.
It should be noted that these complications are rare, particularly with a skilled surgeon, but the more complex the face lifts, the greater the risk.