Rhytidectomy (Face Lift) Overview - Evolution - Frequently Asked Questions - Photos (Before and After) Procedure Overview Back to Top As we age, our facial features undergo predictable changes characterized by development of wrinkles and soft tissue sagging. Wrinkling is most prominent in the forehead, around the eyes and around the mouth regions. Soft tissue sagging is most visible in the brows, cheeks and neck contributing to loss of brow height, deep nasolabial folds (smile lines), jowls, and redundant neck skin. Many patients consider facial rejuvenation surgery because they want to look as young as they feel. Evolution of Face Lift Procedures Back to Top Facial rejuvenation surgery has evolved as we have gained a greater understanding of the anatomic changes that occur with aging. Early face lifts involved simply tightening the skin. This is still the practice of some plastic surgeons and many non plastic surgeons who attempt to perform plastic surgery. With modern techniques the results can be drastically improved, more natural and more durable if the underlying soft tissues are reshaped as well. This allows reshaping without the excessively pulled or face-lifted look of older techniques. In today's high paced lifestyle, many patients would prefer less aggressive operations with decreased downtime. There has been a general "shift" in the thinking of many plastic surgeons regarding face lift procedures. Many patients are still best served by "full face-lift" techniques, namely those with a great deal of excessive skin. However, in a number of patients, similar results can be accomplished with a less aggressive surgery. A "mini-facelift" uses shorter incisions and less skin undermining. The amount of skin elevation is limited to give access to the deeper tissues which are reshaped to their elevated, more youthful position. These procedures have been marketed extensively by both plastic surgeons and non-plastic surgeons. They are generally marketed as the lift procedure with the being replaced by some version of quick, swift, speedy or some other adjective implying an easier procedure with less downtime. In actuality, they are all modifications of the s-lift or MACS lift described recently in 2000 - 2002. In the appropriate candidate, these procedures can give excellent results with a quicker recovery and less expense. Dr. Yates is well experienced with all types of facial rejuvenation and will let you know at the time of the consultation if you are a candidate for a less invasive procedure. Frequently Asked Questions Back to Top How is the procedure performed? Rhytidectomy can be performed under either general anesthesia or sedation with local anesthetic. Incisions are made in well hidden areas beneath the chin, in front and around the ears as well as in the scalp behind the ear. Many patients would benefit from a brow lift as well in which case the incision is carried further into the front of the scalp within the hairline. The skin and deeper soft tissues of the cheeks and neck are lifted and reshaped to provide a more youthful appearance. As each patients "problem areas" and specific needs are different, the procedure is tailored to the individual patient. How much younger will I look following the face lift? This is a hard question to answer, it would be misleading to tell a patient that they will look exactly as they did 5, 10, 15 or even 20 years ago. Generally, however, a patients perceived age can be decreased by about ten years. What should I expect from the recovery period? After the procedure you will have a head dressing and drains. These are removed in 1-2 days and a compressive bandage is applied to reduce swelling. There is moderate pain for a few days following the procedure for which you will be given pain medications. Bruising and swelling is quite significant for the first several days following the procedure. You can expect to be "presentable" in public in 3-4 weeks although some mild swelling will last for up to a year. What risks are associated with the procedure? Dr Yates will thoroughly discuss the rare but potential risks at the time of your consultation. These generally include; bleeding, scarring, infection, asymmetry, nerve injury, tissue loss and unhappiness with cosmetic result. The risk of poor healing is much higher in smokers, Dr Yates requires patients to refrain from smoking for 6 weeks in preparation for surgery. What about non-surgical options? There has also been an influx of "hot" new non-surgical techniques of facial rejuvenation. Botox is now the number one cosmetic procedure performed in the United States. It is important to understand that Botox only treats specific wrinkle patterns such as those around the eyes. There has been a lot of press about the non-surgical "lunch hour facelift". These use non-ablative lasers and radio frequency ablation (RFA) to tighten the collagen in the skin. Although there is certainly some benefit from these procedures, they are quite expensive and could never achieve the results seen with a surgical procedure. The major advantage of these procedures is limited "down time" following the procedure.