Facelift (Rhytidectomy)

What is a facelift?

If you are bothered by the signs of aging in your face, a facelift may be right for you. Technically known as rhytidectomy, a facelift is a surgical procedure to improve visible signs of aging in the face and neck, such as:

Sagging in the midface
Deep creases along the nose extending to the corner of the mouth
Deep creases below the lower eyelids
Fat that has fallen or is displaced
Loss of muscle tone in the lower face may create jowls
Loose skin and excess fatty deposits under the chin and jaw can make even a person of normal weight appear to have a double chin

As a restorative surgery, a facelift does not change your fundamental appearance and cannot stop the aging process.

Rejuvenation procedures typically performed in conjunction with a facelift are brow lift, to correct a sagging or deeply furrowed brow, and eyelid surgery to rejuvenate aging eyes.

A facelift can only be performed surgically; non-surgical rejuvenation treatments cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate and complement the results of surgery.

Is a facelift right for me?

A facelift is a highly individualized procedure and you should do it for yourself, not to fulfill someone else's desires or to try to fit any sort of ideal image.

Facelift surgery is a good option for you if:

You are physically healthy
You don't smoke
You have a positive outlook and specific, but realistic goals in mind for the improvement of your appearance

What to expect during your consultation with Dr. Markmann

The success and safety of your facelift depends very much on your complete candidness during your consultation. You'll be asked a number of questions about your health, desires and lifestyle.

Be prepared to discuss:

Why you want the surgery, your expectations and desired outcome
Medical conditions, drug allergies and medical treatments
Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
Previous surgeries

Dr. Markmann may also:

Evaluate your general health status and any pre-existing health conditions or risk factors
Discuss the options available to you for facelift and facial rejuvenation
Examine and measure your face
Discuss your options and recommend a course of treatment
Discuss likely outcomes of a facelift and any risks or potential complications
Discuss the type of anesthesia that will be used

Prior to surgery, you may be asked to:

Get lab testing or a medical evaluation
Take photographs for your medical record
Take certain medications or adjust your current medications
Stop smoking well in advance of surgery
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Special instructions you receive will cover:

What to do on the night before and morning of surgery
The use of anesthesia during your brow lift
Post-operative care and follow-up

Dr. Markmann will also discuss where your procedure will be performed. A facelift may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

You will need help

Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night or two following surgery.

What Happens During facelift surgery?

Step 1 - Anesthesia

Medications are administered for your comfort during the surgical procedure. Surgery will be done under general anesthesia.

A variety of other procedures can further enhance the outcome of a facelift. They include:

Facial implants
Wrinkle reduction by injection
Soft tissue augmentation to recontour the facial structure
Resurfacing techniques to improve the tone and texture of facial skin

Step 2 - The incision

Depending on the degree of change you'd like to see, your facelift choices include a traditional facelift, limited incision facelift or a neck lift.

A traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp. Fat may be sculpted or redistributed from the face, jowls and neck, and underlying tissue is repositioned, commonly the deeper layers of the face and the muscles are also lifted.

Skin is redraped over the uplifted contours and excess skin is trimmed away. A second incision under the chin may be necessary to further improve an aging neck. Sutures or skin adhesives close the incisions.

Traditional Facelift

An alternative to a traditional facelift uses shorter incisions at the temples, continuing around the ear and possibly within the lower eyelids or under the upper lip.

Limited Incision

Sagging jowls, loose neck skin and fat accumulation under the chin may be corrected with a neck lift. The neck lift incision often begins in front of the ear lobe and wraps around behind the ear ending in the lower scalp.

Neck Lift

Step 3 - Closing the incisions

Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear.

Removable or absorbable sutures
Skin adhesives
Special clips
Surgical tape

Step 4 - See the results

The visible improvements of a facelift appear as swelling and bruising subside. Your final result should not only restore a more youthful and rested appearance, but also help you feel more confident about yourself.

Important facts about the safety and risks of brow lift surgery

The decision to have a facelift is extremely personal and you'll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Dr. Markmann will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

The risks include:

Unfavorable scarring
Poor wound healing
Bleeding (hematoma)
Infection
Skin discoloration, sensitivity or swelling
Correctable hair loss at the incisions
Facial nerve injury with weakness
Facial asymmetry
Skin loss
Numbness or other changes in skin sensation
Fatty tissue found deep in the skin might die (fat necrosis)
Anesthesia risks
Fluid accumulation
Pain, which may persist
Skin contour irregularities
Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
Deep vein thrombosis, cardiac and pulmonary complications
Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location, unacceptable visible deformities at the ends of the incisions (It may be necessary to perform additional surgery to improve your results)
Possibility of surgery for revision

Be sure to ask questions: It's very important to ask questions about your facelift procedure. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress. Don't be shy about discussing these feelings with Dr. Markmann.

When you go home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.

Be careful

Following Dr. Markmann's instructions is a key component to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Avoid wearing any clothing that must go over your head. Dr. Markmann will give you specific instructions on how to care for yourself.

Recovery

When your procedure is completed, a bandage could gently be placed around your face to minimize swelling and bruising. A thin tube may be present to drain any excess blood or fluid that may collect under the skin.

You will be given specific instructions that may include: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with Dr. Markmann.

Be sure to ask Dr. Markmann specific questions about what you can expect during your individual recovery period.

Where will I be taken after my surgery is complete?
When do I return for follow-up care?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery? When will they be removed?
Are stitches removed? When?
When can I resume normal activity and exercise?

The results will be long-lasting

It may take several months for swelling to fully dissipate and up to 6 months for incision lines to mature.

Life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend the results of your rejuvenated, more youthful appearance.

The Cost?

Cost is always a consideration in elective surgery. Prices for facelifts can vary widely. A surgeon's cost for facelift surgery may vary based on his or her experience as well as geographic office location.

We offer patient financing plans, so please ask. Cost may include:

Surgeon's fee
Hospital or surgical facility costs
Anesthesia fees
Post-operative garments

Your satisfaction involves more than a fee

When choosing a plastic surgeon for brow lift surgery, remember that the surgeon's experience and your comfort with him or her are just as important as the final cost of the surgery.

Most health insurance does not cover cosmetic surgery or its complications.

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