What Is a Face Lift?
Cosmetic face lift surgery, which is also called rhytidoplasty or rhytidectomy, can greatly improve your appearance by reducing sagging and wrinkling in the lower face and neck. A face lift can make you look younger and more refreshed and give you a new, vibrant look. The word rhytidectomy derives from
rhytis, the Greek word for wrinkles, and means excision of wrinkles, which is a pretty apt description of the procedure.
A face lift can correct or minimize wrinkles, and correct a jowly look. These telltale signs of age may be a result of gravity, the loss of elasticity in your skin, exposure to the sun or the stress associated with every day life. A face lift cannot correct problems around the eyelids or the thin vertical wrinkles around the lips, but if sagging skin, wrinkles, and jowls have started to appear around your middle and lower face, a face lift can probably help you.
The amount of improvement possible with a face lift depends on how much wrinkling and sagging is present before your surgery. If the signs of aging are minimal, then improvement from a rhytidectomy may be subtle. If the wrinkling and sagging is significant, then the results can be quite dramatic.
Are You a Candidate for a Face Lift?
According to the American Society of Plastic Surgeons, about 104,000 rhytidectomy surgeries took place in 2006. This is down a bit from the 134,000 or so face lift procedures that took place in 2000. Some of this drop can be explained by the rise in popularity and availability of other procedures to treat the aging face, such as dermabrasion or a type of a face lift procedure called a
thread lift that is counted separately.
Deciding whether you should have a face lift should be done carefully. Many factors must be taken into consideration.
You must be in good physical health. You have to be free of any active diseases or other medical conditions, such as diabetes, high blood pressure, or asthma, or have them under control. Pre-existing health conditions make it difficult for patients to endure the surgery and recovery period.
You need to be mentally healthy, too. The healing time after surgery can be long and complicated. You have to have patience and mental strength. Some people go through a period of depression after their surgery and this temporary depression can worsen a pre-existing mental illness.
You have to have realistic expectations about what a face lift can do for how you look. Before committing to a face lift surgery, you should discuss your expectations and how you want to look with your surgeon. You and your surgeon can look at before-and-after face lift photos to be sure you are in agreement on what you want as the end result. Remember, a face lift can boost your self-confidence by making you feel better about how you look. It cannot change anything else in your life.
Health insurance will almost never cover the costs associated with a face lift or similar cosmetic surgery procedures. You will be responsible for all the fees, including the costs of postoperative visits and prescriptions. However, financing can be arranged for a face lift surgery.
If you are trying to lose a considerable amount of weight, put off having a face lift until you reach your goal weight. If you have the lift now and lose weight, you may end up with more loose skin that will undo the work of your surgeon.
Face Lift Procedure Types and Techniques
There are several different types of face lifts. Some of these techniques are designed to improve the appearance over most of the face, while others are limited to specific areas. The different types vary by where the incisions are placed, whether they adjust skin only or skin and underlying tissue, what areas of the face they treat and how invasive they are.
When it comes to a face lift, one size does not fit all. Each of the techniques has variations and different surgeons may choose any or combine one or more of the techniques to create a customized procedure for you.
In addition, you can have other cosmetic surgery performed at the same time as a face lift, such as blepharoplasty to correct a droopy eyelid condition or a brow lift to correct a furrowed brow. A face lift can also be combined with liposuction under the chin. For that matter, it can be combined with cosmetic surgery to other parts of the body, such as liposuction of the abdomen or thighs or breast enhancement.
As research in cosmetic plastic surgery continues, new techniques and variations that offer improved results or greater safety are being created. The techniques for face lift include:
Standard, Conventional or Traditional Face Lift:
This is a procedure designed to rejuvenate an aged, sagging face. The incision lines are usually along or behind the hairline at the sides of the face. For most people, the incisions run from just above the ears, down and around the ears (where they are hidden in the natural fold in front of the ears) and then up and behind the ears. Excess skin is removed, and the remaining skin is lifted and sutured into place creating a face that looks tighter and younger. Some surgeons may perform a skin-only face lift, while others may move underlying fat and muscle.
Superficial (or Sub-) Muscular Aponeurotic System (SMAS) Lift:
The SMAS is the facial muscles and connective tissue that are responsible for facial movements. In this method, in addition to the skin being lifted upward and outward, the SMAS is also tightened. Some surgeons say that a SMAS lift lasts longer than a skin-only lift.
Neck Lift (Platysmaplasty):
The platysma is the muscle that runs down the neck vertically from the chin. This muscle can loosen and start to droop with age, leading to the appearance of a “turkey neck.” In platysmaplasty, this muscle is tightened and trimmed to create a more youthful appearance, and excess skin and fat are also removed. A neck lift is typically performed in conjunction with a face lift, but it can be performed independently, if there is no need to tighten the facial muscles or skin.
S-Lift:
This procedure can improve the appearance of the lower third of the face (including the jaw line, jowls, and neck) and is sometimes called a mini-face lift. An S-shaped incision is made in front of the ear, and skin and underlying layers are moved and pulled up and to the side and sutured into new positions. An S-lift can be combined with liposuction
Mini-Face Lift:
Some surgeons consider a procedure that lifts the skin of the face to the sides (laterally) using only incisions directly in front of the ear to be a mini-face lift. This type of procedure can improve the nasolabial folds, the creases that go from the nose to the corners of the mouth. An example of this type of procedure is a mid-face lift or cheek pad lift that lifts the skin vertically.
Deep Plane Face Lift:
This procedure is performed in a deeper plane than the standard face lift. This procedure is similar to a SMAS lift, but can be more beneficial to someone with sagging nasolabial folds.
Temporal Face Lift (lateral lift, lateral brow lift):
This procedure is a variation on a brow lift and uses incisions placed in the hairline at the temples. The tissues are moved to the side and diagonally up and away from the center of the face. This technique can smooth out small wrinkles in the forehead, around the eyes and in the area between your eyebrows at the top of your nose. A temporal lift can give a firmer look to the face by lifting and tightening skin around the cheeks. There are variations to this procedure, including the use of internal suture material for suspension and underlying muscle tightening.
Mid-Face Lift:
This procedure is used to create a more youthful appearance by tightening skin under the eye and improving the appearance of the nasolabial area, upper mouth and outer upper lip area. It can be a good choice for younger patients who may not need a full face lift. A mid-face lift does not affect the brows and may therefore be performed in conjunction with an endoscopic brow lift. A mid-face lift can be carried out two ways. The open technique uses an incision under the lower lash line and can include an additional small incision within the nasolabial fold. This technique is a great option for those who need a more vertical lift rather than a horizontal or diagonal lift, and gives a subtle result and rejuvenation, rather than a dramatically altered appearance. The endoscopic technique requires two short incisions in the scalp above the temples. This approach can improve the appearance of the outer eye, temple and brow.
Thread Face Lift:
A thread lift is a minimally invasive procedure that can create a younger look in people who have a small amount of sagging on their face. It uses special barbed sutures to grab the skin from below the surface and pull it into a more aesthetic position. You can find more information about thread lifts here.
How a Rhytidectomy Procedure Is Performed
The length of time required to complete a rhytidectomy depends on the technique used, but in general a face lift will take between 3 and 6 hours; longer if it is being combined with other procedures such as blepharoplasty. Most face lifts are performed either in a surgeon’s office or at an outpatient surgery clinic.
There are several phases involved in a face lift:
Preparation: During the preparation phase, you are "prepped" for surgery. Your surgeon will mark your face to indicate where he or she will make incisions, which are dictated by which technique is to be used. You will be scrubbed with an antiseptic agent to minimize the risk of infection. Your hair will be secured to ensure it will not get in the surgeon's way during the procedure. Usually, an intravenous (IV) line will be started. You will also be hooked up to monitors to keep track of your vital signs.
Anesthesia: The subject of anesthesia should be discussed between you and your surgeon before your surgery. Most face lifts are performed using local anesthesia, which numbs the face, and a sedative, which will make you feel drowsy and relaxed. You should not feel any pain, but you may feel some movement of your face as the surgery proceeds.
Surgery: During the procedure, your surgeon will follow the pre-marked incision lines made during the preparation phase. The exact surgery will depend on what type of face lift is being performed, but in most cases, your surgeon will separate the skin of the face from the fat and the muscle beneath it. Excess fat may be removed if necessary, and the muscles can be tightened to create a more taut and youthful appearance. The skin is then pulled back over the muscles, and any excess skin is removed. The incisions will then be closed and a dressing will be applied to protect the wounds and reduce swelling.
Recovery: During the recovery phase, you are awakened and moved to a recovery room where the staff can monitor you for about 2 hours. At this time, you may feel some pain, soreness, disorientation, nausea or coldness. The staff can give you pain relievers, antinausea medications and blankets.
