BEVERLY HILLS | MALIBU | BAKERSFIELD | FRESNO CA
Several factors cause the changes we see in our face seen as we age. We all know the skin loses elasticity and this leads to looseness of the skin of the face. But there is also a loss of support for the underlying structure of the face and this leads to a dropping of the cheek and formation of the jowls. The goal in facial rejuvenation is to address the loss of skin elasticity which generally involves some degree of skin removal, along with restoring the fullness to the face lost with the aging process
I have written a detailed description of the progression of aging of the face that can be read by clicking here.
People age at different rates and in different ways. The need for rejuvenation in one's 40's is different than the need in the 60's. I do not approach a facelift only one way. I perform several types of facelifts and choose what I am going to do depending upon your particular facial shape and degree of aging. By approaching facelifting in this manner, I am able to get the best result for you with the least amount of "downtime". I also combine a facelift with other procedures such as brow lift, eyelid surgery, midface lift, facial implants and fat grafting to customize the rejuvenation process for you and achieve the greatest possible result. However, sometimes less is more so I also perform what I call "mini-facelifts" for those that do not yet need a full facelift.
I find people are often confused about facelifting and necklifting. Facelift procedures are used to treat the areas of the face other than the forehead or eyelids. The neck is often the first place facial aging begins to show and so tightening of the neck (necklift) is a common request. What you need to know is the surgical procedure to treat the neck effectively is the same as that is used to do a "facelift". So when someone asks me to help them with a necklift, I basically talk about performing a facelift procedure. Similarly, a necklift is always part of the facelift procedure – I do not separate the two because the surgical procedure to address both the face and neck is the same.
One aspect of facial rejuvenation I concentrate on is the raising and filling the cheek. Having a high, full cheek is a property of a youthful face. When you look at pictures of other facelifts, pay attention to the change in the cheek fullness. Usually there is not much. I use several methods to produce a full cheek – fat grafting, cheek implants and the subperiosteal midfacelifting techniques. I will explain these methods I use to produce a full cheek at your consultation.
I like seeing pictures of when you were younger (preferably pictures of you not smiling) so I can look at the changes that have occurred over time. By looking at how you have changed, I can better discuss a plan for surgery that will achieve a natural look.
WHAT TO EXPECT WITH FACELIFT SURGERY
A facelift surgery requires a general anesthetic so you will be totally unaware of the surgery and be comfortable the whole time. The surgery varies in length depending on how much is being done but typically lasts between 3- 4.5 hours. Our office will help arrange all he necessary things you need to do in preparation for your surgery and organize what you will need after the surgery.
People often worry about discomfort after a facelift procedure but in reality, discomfort is not a complaint I often hear. There is more a sensation of numbness associated with the facelift surgery than discomfort. Healing time can vary but is generally between 10 days for minilifts to 3 weeks for a full facelift.
I can perform a facelift with other procedures such as blepharoplasty or forehead lifts and many patients choose to complete many procedures at the same time. Sometimes, I recommend you stay overnight in the hospital after a facelift to insure a smooth recovery and for your comfort. I use dissolving sutures (stitches) in all my facelift procedures.
FACELIFT AND MINIFACELIFT - AFTER YOUR SURGERY
NORMAL THINGS: You will have a loose netting around your face which is used to hold gauze in place. The gauze is to collect any oozing from the incisions. You may change the gauze as needed. If the netting feels too tight you can cut it with scissors to loosen the fit. Once the incisions have sealed, usually the next day, you may remove the netting. Keeping hydrated is important so take plenty of fluids. A small amount of oozing is normal from the incisions the first couple of days. The face and neck will swell from the surgery and is usually the most the first morning after the procedure. The swelling should be soft, however. If the swelling in the face or neck is firm and painful call me. Do not be alarmed if one side of your face is slightly more swollen or numb than the other. This is common and usually disappears within a few weeks after a facelift.
MEDICATIONS: Take the Vicodin for pain every 4 hours if you need it for discomfort. Take it less often if your discomfort is controlled. If you get nausea from the Vicodin try taking a half a pill at a time. Take the antibiotics (Cipro) and Arnica as directed. The Medrol is to help with swelling. Take it as directed in the package.
ACTIVITY: Keeping your head and shoulders elevated helps with reducing the swelling. Sit with your back and feet elevated on the couch. Sleeping in a recliner chair for the first 2 nights will help decrease swelling. Walking is important to keep from getting blood clots in the legs so try to get up and walk every couple of hours while awake. Light activity can be performed as tolerated but strenuous activity must be avoided for 3 weeks or bleeding may occur.
ICE and HEAT: Ice may be applied to the face and eyes the first night and off and on the next day. After that, ice will not make much difference. Never put heat on your face after a facelift. Heat will make you swell and you might possibly burn your skin where it is numb.
SHOWERING and WASHING YOUR FACE AND HAIR: You may wash your face the night of surgery if you desire. Bland soap and water is acceptable. Remember your face will be numb in places so be careful with the water temperature. You can shower the day after your surgery and wash your hair. I suggest to not use a washcloth but to just use your fingers so that you will not break the delicate sutures around our ears. You may shower with the drains in place – just be careful. You can clip the bulbs to something placed around your neck while you shower.
MAKEUP and SKIN CARE: You can wear makeup 2 days after your surgery but avoid getting the makeup near the incisions. If you are using Obagi: the cleanser, toner and sunscreen can be used after the first week but wait for 4 weeks for the Retin – A and Clear.
DRAINS: You may have one or two drains from the surgery. If you do, empty the drains in the toilet when the bulbs become half full. Squeeze them to put them back on suction. If a drain comes loose and falls out, don't worry your body will resorb the fluid.
SUTURES: I only use dissolving sutures in facelifts. However, sometimes even the dissolving sutures will create a small area of irritiation. I occasionally need to remove a suture in the office. It is best if you let me or one of my staff remove the suture.
THE HEALING PROCESS: The first night and the following next day are the most difficult. After that, you should start feeling better. The swelling takes a good week or so to decrease with a minilift and longer with a full facelift. Bruising usually is more noticeable several days after the surgery and then subsides. You may notice it hurts to chew because a facelift works around the chewing muscles. Feeling "down" after a facelift is common. Just know the feeling will go away with time. Call me or my staff if you have any concerns at any time. The full healing process from a facelift takes many months for all of the swelling to resolve, the numb areas to return to normal and the smile and facial muscles to fully return to normal.