Facelift

Face surgery or facelift (Rhytidectomy)
Known as Rhytidectomy, facelift, is the surgical procedure that aims to suspend the face skin, as well as the removal of excess that becomes pending with time. Therefore, it consists on improve flaccidity and attenuate facial wrinkles.

Usually, surgery involves the skin of the neck, the area under the chin, cheeks and the temporal region, and occasionally the forehead and eyebrows. It should always keep the own characteristics of each face, and the rude features will be attenuated. This means that a 40 years old patient appears to be 20.

The surgery visually slows down the aging process, but does not interrupt the evolutionary process of the body. In general, we can mention this time in 5-8 years. There will be patients who look for the surgeon before the time and others who will never have to have a surgery done for this purpose.

The facelift can only be done surgically; nonsurgical rejuvenation treatments do not provide the same results, but they can help delay the time at which the facelift becomes appropriate, in addition to complementing the results of surgery. The surgery of the face is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to adapt to any sort of ideal image.

As a repairing surgery, the facelift does not change its appearance and does not stop the aging process.

Preoperative
In the preoperative, you must:
- Avoid use of aspirin and/or medicines that contain aspirin for 2 weeks before surgery. These drugs interfere with blood coagulation and may cause bleeding;
- Not smoking in the three weeks before surgery;
- Tell the doctor in case of flu, cold or any infection in the 2 weeks before surgery;
- Take 5 drops of arnica tincture daily in the morning 15 days before surgery;
- Wash the head and face with an antiseptic soap (SABOFEN) before heading to the hospital. Do not wear makeup or creams on the day of the surgery;
- Bring to the hospital: clothes easy to put on and not from the head, comb, sunglasses, scarves for the head and personal items;
- Not dye your hair for 40 days after surgery;
- We ask not to cut the hair before surgery because longer hair facilitates combing and helps hiding the stitches in the postoperative;
- Not bring jewelry to the hospital.

Anesthesia
Anesthesia is usually local with sedation and anesthesia assistance, but as preference or indication, it may be general.

Hospitalization
In general, the patient is hospitalized on the day of the surgery in the morning and will be discharged in the morning on the next day.

Based on texts by SBCP.

Operation
Regardless of anesthesia (local or general), there will be no pain during the surgery, which usually lasts from three to four hours on average.

Depending on the degree of change that you want, your rhytidectomy surgery options include a traditional facelift, facelift with limited incision or neck Iift. An incision of traditional lifting, often begins in the scalp in the temporal region, continues around the ear and ends at the bottom of the scalp. Fat can be sculpted or redistributed in the face, double chin and neck. The underlying tissue is repositioned, commonly in the deeper layers of the face and the muscles are elevated. A second incision below the chin may be necessary to improve the aging aspect of the neck. Sutures or skin patches are used to close the incisions.

An alternative to traditional facelift uses smaller incisions in the temporal region, continuing around the ear, and possibly inside of the lower eyelids or under the upper lip. Double chin, flaccid skin on the neck and fat accumulation under the chin can be corrected with neck lift. The neck lift incision begins, often in front of the earlobe, passing behind the ear and ending at the bottom of the scalp.

Once healed, the lift incision lines are well hidden in the scalp and in the natural outlines of the face and ear.

Postoperative
In the postoperative, usually are used compressional dressings on the head and neck, helmet type for 1 or 2 days. In this period the patient will do cold compresses on the eyelids, which will help to reduce the formation of ecchymosis and edemas. On the discharge day, the dressing is removed and it is already possible to wash the head with liquid and antiseptic soap, use the hairdryer and go home. The patient will receive frequent visits from the staff on the first days until being able to make revisions in the clinic. The stitches will be removed between the fourth and fourteenth days in stages.

Makeup can be worn after the fourth day, and on the end of the day, it should be completely removed using moisturizing cream or cleansing oil.

The hair will be cut by the surgical team on the day of the surgery only in a small area behind the ears and above them, that is where it will be cut and removed the skin excess. The hairstyle will hide the marks.

Should be avoided important appointments up to 3 to 4 weeks after surgery. Also in the postoperative, one can feel a certain dampening in the skin of the neck and the front of the ear region and/or tension in the neck region. Slowly it becomes normal. Smoking Patients should not undergo to this surgery unless the cigarette use is suspended 20 days before and 20 days after the operation.

Caution
- Do not smoke for 3 weeks;
- Relative rest for about four days and with the head up (2 to 3 pillows);
- Cold compresses and diluted arnica tincture on the eyelids many times a day, at least for two days;
- Regular diet;
- Avoid efforts or lower the head for 1 week;
- Avoid the sun or strong light for 30 days;
- Wash the head with neutral shampoo from the third day; dyes should not be done for 40 days after surgery;
- Light rest for another 7 days and return to normal activities slowly, as you feel able to do so;
- Practice sports after two months. Start with moderation;
- Warn in case of serious pain, severe edema or abnormal bleeding.

Scar
Any surgery leaves permanent scars (less extensive as they are), despite the tendency of becoming less visible with time. The obligation of the surgeon is to place the scars in places hidden by the natural furrows or by hair, so that they hardly become visible with time or bring problems. Pruritus (itching), burning or numbness may eventually occur on the scars. This is temporary and tends to disappear with time.

When the procedure is completed, a bandage can be gently placed around your face to minimize swelling and bruising. A drain can be temporarily placed under the skin to drain any excess blood and fluid that may accumulate.

It may take several months to swelling disappear and up to six months for the incision lines be with normal appearance. Permanent sun protection helps keep the rejuvenated appearance by minimizing aging or sun damage. In addition, a healthy lifestyle also helps to extend the results obtained with surgery, giving you rejuvenated and young appearance.

Important: Do not rely on information from well-meaning friends. Get the necessary information directly from the doctor and you will avoid having doubts and anxiety in the postoperative period.

People are afraid to submit themselves to this surgery because they see bad cases that scare due to changes and exaggeration performed. Our goal is to have the desired improvement (never change) and to note a general, subtle benefit, without drawing attention that the person had submitted to the procedure. As it is about face, people keep in memory those exaggerations that can be numerous, but the good surgical cases were not perceived. Thus, this is why face surgery is always related to bad cases. Facts like major change on the lips, cheeks and eyes should always be avoided, as well as other factors that denounce the surgery, such as the position of the scars around the ear (they must be unapparent), loose lobe and without being “pulled”, the position of the “hair foot”, which must not be high (one that most stigmatize patients), etc.

"The good surgery, so, is the one that resolves the complaints of the patient, but does not draw attention and does not ‘scream’.”

In this procedure, the hospitalization is 24 hours, so there will always be an overnight stay in the hospital or clinic. We usually use a band around the face and head in the hospitalization period, in the discharge there will be no more dressing, and the patient will leave with washed hair. In general, the patient will be very swollen, which should last for about 10 days, especially if associated with other facial surgery (eyelids or nose). It is not uncommon to feel tight in the neck on the first days after surgery.