Are You a Candidate for a Facelift?

	Facelift with eyelid surgery and chin implant.

Almost anyone whose face shows the effects of aging and environmental damage can benefit from a facelift.The procedure is performed with excellent results in both light- and dark-skinned individuals in their thirties to sixties or seventies and even in their eighties if they're in good health. People who are mildly to moderately overweight may enjoy some improvement f ro m a facelift (but less than those in the normal weight range), as can those with flaws in bone structure, deep lines, thick folds, and heavy sagging. Expectations and a tt itude, as discussed earlier, are the most important qualifications.

	Facelift with modified deep chemical peel.

Your Facelift Procedure

An SMAS facelift procedure takes two to four hours. Incision placement can vary. It's common for the surgeon to make an incision in the hairline from the temple to the ear, vertically in f ro nt of and behind the ear, and horizontally in the hairline, and another incision under the chin. Placement might be slightly different in men to prevent beard-growing skin from being rea tt ached behind the ear. The operation involves several basic steps:

• The skin is separated from underlying fat and muscle.
  
• Some of the fat may be trimmed or suctioned.
  
• Sometimes the SMAS is incised, lifted, and replaced so that the back edge overlaps the surrounding tissue; other times it is folded over itself. Lifting the SMAS brings the skin up and backward.The skin is redraped and the excess is trimmed.
  
• The skin is reattached.To prevent noticeable scarring, the redraped skin is not pulled tight and the incisions are closed without tension.Your doctor may use a combination of skin clips, removable sutures, and absorbable sutures.

After Your Facelift

You'll be given detailed postoperative instructions, similar to those outlined in Chapter 3. With instructions in hand, go home and relax! The first few days are critical for healing, though you'll need to be careful for several weeks. Any jarring of your face - by anything from a small child's sudden movement to a swinging door - could undo some of what your doctor so skillfully accomplished.Your doctor will likely emphasize that you should avoid bending over or lifting. When you do this, blood rushes to your head and can put pressure on delicate, healing tissues.You may be asked to avoid turning your head back and forth for the first few days.

Don't be surprised if your face feels numb, stiff, and a little sore at first. After a week or so you can probably return to work, depending on the type of work you do. Strenuous activity should be avoided for the first two weeks.Your doctor will give you detailed instructions for self-care at home.

Combining Facelifts with Other Procedures

Your facial plastic surgeon may suggest you have additional procedures before, after, or at the same time as your facelift. For example, many doctors routinely perform liposuction, using a suction tool to remove fat from under the skin, with a facelift. Similarly, your doctor may recommend lip augmentation, chin or cheek implants, a Endoscopic Forehead Lift, eyelid surgery, or nose reshaping. Facelifts won't eliminate all facial wrinkles or flaws in the skin, so if you wish to eliminate more wrinkles and improve the texture of your skin, you may wish to consider a chemical peel or laser skin resurfacing.

Questions to Ask Your Doctor?

• After my surgery, should I use nonprescription products on my face to help the incisions heal? What products should I avoid?
  
• Can you give me a sample soft diet to follow after surgery? Should I avoid sodium to reduce swelling?
  
• How long will I need in-home assistance after surgery?
  
• I have heard that therapeutic massage can promote healing. Do you recommend this practice?
  
• How long will my facelift last?
  
• Will I need camouflage makeup and instructions to apply it?

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