Aging of the
face is inevitable. As the years go by, the skin begins to loosen
on the face and neck. Crow's feet appear at the corners of the
eyes. Fine forehead lines become creases and then, gradually,
deeper folds. The jawline softens into jowls, and beneath the
chin, another chin or vertical folds appear at the front of the
neck. Heredity, personal habits, the pull of gravity, and sun
exposure contribute to the aging of the face. As the aging population
grows, it is obvious why rhytidectomy has become the third most
desired facial plastic surgical procedure.
If you ever
wondered how a rhytidectomy, or facelift, as it is commonly called,
could improve your looks or self-confidence, you need to know
how a facelift is performed and what you can expect from this
procedure. This section can address many of your concerns and
provide you the information you need to begin considering facelift
surgery.
Successful
facial plastic surgery is a result of good rapport between patient
and surgeon. Trust, based on realistic expectations and exacting
medical expertise, develops in the consulting stages before surgery
is performed. Dr. Maloney can answer specific questions about
your specific needs.
Is
a Facelift For You?
As with all facial plastic surgery, good health and realistic
expectations are prerequisites. Understanding the limitations
of rhytidectomy is crucial and psychological stability is vital.
There is no ideal in a facelift. Rather, the goal is to improve
the overall facial appearance. Skin type, ethnic background, degree
of skin elasticity, individual healing, basic bone structure,
as well as a realistic attitude are factors that should be discussed
prior to surgery. This procedure is sometimes performed on patients
in their thirties, and successful surgery has been performed on
patients in their eighties. A facelift cannot stop aging, nor
can it turn back the clock. What it can do is help your face look
its best and give you a look of health and a more youthful appearance.
A side benefit is that many patients experience increased self-confidence.
Before deciding
on a facelift, you should discuss with Dr. Maloney whether the
overall effect will be more successful if additional changes are
made in the chin and neck areas through other facial surgery.
Many patients decide to have facial liposuction to remove excess
fatty deposits in conjunction with a facelift. If several flaws
need correction, more than one procedure may be necessary for
the best overall result.
Making
the Decision For a Facelift
Your choice of a qualified facial plastic surgeon is of paramount
importance. Dr. Maloney has lectured exclusively across the country
and written articles on facelifting. The Learning Channel has
even filmed his technique. During the preliminary consultation,
Dr. Maloney will examine the structure of your face, skin texture,
color, and elasticity. Computer imaging and photographs will be
taken so he can study your face. Individual risks will also be
examined, especially those related to medical situations such
as high blood pressure, a tendency to scar, smoking, and any deficiency
in blood clotting. Dr. Maloney will take a thorough medical history,
as well as assess the patient's mental and emotional attitudes
toward the surgery. Because a realistic attitude is crucial to
the success of the surgery, the surgical procedure and realistic
expectations will be discussed.
After the decision
to proceed with a rhytidectomy is made jointly by you and Dr.
Maloney, he will describe the technique indicated, the type of
anesthesia, the surgical facility, any additional surgery, the
pros and cons to include possible complications, and costs of
the procedure.
Understanding
the Surgery The placement of the incisions is one
of the most important parts of the procedure, and every case is
individualized. Dr. Maloney commonly begins the incision in the
area of the temple hair in women, then follows the curves of the
ear in a "S" shaped fashion going behind the small cartilage
in front of the ear. The incision flows up behind the ear in the
crease and then into the hair. Once again, the incisions are customized
to the patient's concerns and anatomy. The skin is raised outward
before Dr. Maloney repositions and tightens the underlying muscle
and connective tissue. Some fat may be removed with liposuction,
as well as excess skin. For men, the incision is aligned to accommodate
the natural beard lines. In all cases, the incision is placed
where it will fall in a natural crease of the skin for camouflage.
After trimming
the excess skin, Dr. Maloney closes the incisions with fine sutures
and/or metal clips, which permit surgery without shaving hair
from the incision site. Depending on the extent of the surgery,
the process can take two hours. The procedure can be performed
under local, twilight, or general anesthesia depending on the
patient's desires. Following the surgery, Dr. Maloney will apply
a dressing to protect the entire area where the incisions have
been made. If a patient is claustrophobic, a drain can be used
instead.
What
to Expect After the Surgery
Even though most patients experience very little pain after surgery,
Dr. Maloney will still prescribe medication. Some degree of swelling
and bruising is unavoidable, and Dr. Maloney may instruct you
to use cold compresses to keep swelling to a minimum. If a dressing
has been applied, it will be removed within one day. He will also
instruct you to keep your head elevated when lying down, to avoid
as strenuous activity as possible, and to report any undue discomfort.
Though there are few risks in facelift surgery and thousands are
performed every year, some risk exists in any surgery.
In some cases,
a drainage tube may have been inserted during surgery. This will
be removed on the first or second day after surgery. All sutures
and staples are usually removed within five to 10 days following
surgery. Surgeons generally recommend that patients avoid vigorous
activity for three to four weeks. Patients should prearrange for
post-surgery support from family and friends.
Recovery usually
takes two to three weeks, though many patients go back to work
in two weeks. Scars are usually not noticeable after enough time
has passed for them to mature. In any case, they are easily disguised
in natural skin creases, by the hair, or, in persistent cases,
by makeup until total healing has occurred. Bear in mind that
the aging process continues after surgery and that some relaxation
of tissues will occur over the first few weeks.
Facial plastic
surgery makes it possible to correct many facial flaws and signs
of premature aging that can undermine self-confidence. By changing
how you look, cosmetic surgery can help change how you feel about
yourself.
Insurance does
not generally cover surgery that is done purely for cosmetic reasons.
Surgery to correct or improve genetic deformity or traumatic injury
may be reimbursable in whole or in part. It is the patient's responsibility
to check with the insurance carrier for information on the degree
of coverage.
The placement of the incisions is one
of the most important parts of the procedure, and every case is
individualized. Dr. Maloney commonly begins the incision in the
area of the temple hair in women, then follows the curves of the
ear in a "S" shaped fashion going behind the small cartilage
in front of the ear. The incision flows up behind the ear in the
crease and then into the hair. Once again, the incisions are customized
to the patient's concerns and anatomy. The skin is raised outward
before Dr. Maloney repositions and tightens the underlying muscle
and connective tissue. Some fat may be removed with liposuction,
as well as excess skin. For men, the incision is aligned to accommodate
the natural beard lines. In all cases, the incision is placed
where it will fall in a natural crease of the skin for camouflage.