DESCRIPTION
As we age some of the most visible
signs of aging first appear in the face. These changes
occur gradually. As tissues begin to lose their support
and skin continues to lose its elasticity, noticeable
signs of sagging begin to be noticed by patients. A
rhytidectomy or facelift procedure is designed to rejuvenate
and re-fresh the facial and neck regions. By refreshing
the area of the neck, jowls, nasolabial creases (nose-cheek
folds) and re-shaping the cheek and temporal regions
we are able to essentially rejuvenate the area. This
procedure is not meant to stop Father Time and the continued
process of aging. It can, however, recuperate a more
youthful appearance. Because it has limitations, you
must be cognizant that we cannot state that it will
take 5, 10 or 15 years off your looks. Suffice it to
say that the end point should be a more refreshed and
youthful look. Facelifts are most commonly performed
on individuals between the ages of 40 to 60. Men and
women who undergo this procedure commonly combined it
with other ancillary procedures such as a blepharoplasty
(eyelid surgery).
PROCEDURE
A rhytidectomy can be performed
under local anesthesia with intravenous sedation or
general anesthesia. The procedure is performed as an
outpatient allowing you to go home afterwards. Various
techniques exist for performing a rhytidectomy. However,
in your case, an incision will be made the begins in
the hair-bearing temporal region of the head, extending
around the natural contour of your ear, around the lobule
of the ear and extending into the back of the neck and
into the hairline. A small incision underneath the chin
may also be utilized. The skin is then carefully dissected
form the underlying tissues. Once the skin is freed
up, it is pulled in an upward and outward fashion and
the excess is trimmed. Additionally, the underlying
"muscle/fascial" layer (called the SMAS) will
likewise be tightened in order to restore contour to
the face. Any additional procedures will then be performed.
A compressive head dressing is then applied and you
will be taken to the recovery room.
POST-OP RECOVERY
You will be allowed to go home
after your surgery. You will need to wear the dressing
for the first 24-48 hours.
You will experience a feeling of tightness and discomfort
in the first 24-48 hours. This is normal. Pain is
infrequent following a rhytidectomy . However, pain
medication will be provided for you and we suggest
that all your post-operative medications be purchased
prior to surgery. You should not be the person controlling
the meds to avoid self-medication. At home, it is
suggested that you rest. You will be asked to come
to the office the next day. At this point some bandages
may be removed.
We will need to see you within the week for suture
removal. Most patients require 14 days recovery before
returning to work and/or driving a car unless your
work requires strenuous activity in which case you
may need 3 weeks. Exercise may be continued after
6 weeks. Always check with us. Household chores may
be started within the second post-operative week.
Every patient is unique and will recuperate differently.
If you feel great, don't over do it.
COMPLICATIONS OF RHITIDECTOMY
Although complications are not frequent and percentages
will vary, you need to be aware that the following
complications may occur:
KELOID OR HYPERTROPHIC SCARS, MOTOR &/OR SENSORY
NERVE DYSFUNCTION ALOPECIA (loss of hair), HEMATOMA,
CONTOUR IRREGULARITIES, HYPO OR HYPERPIGMENTED SCARS,
DISTORTION, INFECTION, HEMATOMA, LOSS OF TISSUE
Some of these complications if severe enough, may
delay recovery time, require further surgery for correction
at additional costs and may involve other specialists
within the medical field. Please be aware that smokers,
diabetics and overweight individuals have a higher
incidence of complications when compared to those
who don’t smoke, have diabetes and/or are overweight.
You should also note that patients undergoing combined
procedures (i.e. rhytidectomy and blepharoplasty)
also have a higher complication rate than those undergoing
a single procedure.
WHAT & WHAT NOT TO
EXPECT
These procedures are considered
refreshing, rejuvenating and enhancing in nature. They
are not meant as a retardant to the natural process
of aging. Nor are they meant to totally change someone's
looks. We have found that one of the key factors in
achieving patient satisfaction is patient expectation.
No guarantee implied or in writing is given regarding
how young you will look. The end point of this surgical
procedure is to make you look more rested, refreshed
and rejuvenated. A suggestion is made by Dr. Perez-Gurri
based on his professional experience as to the procedure(s)
best suited to achieve your aesthetic goals. Remember
that many things are taken into consideration but the
one limiting factor is the skin elasticity and availability
of good tissue.
There seems to be an inverse relationship with expectation
and satisfaction. That is, the higher the expectation,
the lower the satisfaction. Body image is unique and
what the patient frequently sees may not be what is
seen by the surgeon. Therefore, it is important that
you become keenly aware of your expectations for the
procedure, know its limitations and fully discuss any
concerns that you may have regarding the procedure with
Dr. Perez-Gurri. We encourage questions and have allowed
ample time to answer them personally or with our literature
and videotapes. Please realize that the results obtained
through a rhytidectomy are not permanent. Gravity continues
to have an effect on the tissues and the aging process
and laxity of tissues continue at the same rate as before.
Every patient is different and will have a unique experience.
OTHER QUESTIONS
Does smoking affect my results?
Yes. Multiple studies have been done that show that
smoking has an adverse effect on tissues and often times
will delay healing. We ask that you stop smoking for
2-3 weeks prior to your surgery. Although this will
not prevent all complications of healing, it will more
probably than not improve pulmonary function.
How long does the procedure take to perform?
It will vary from 3-5 hours depending on how many procedures
are performed in conjunction with the rhytidectomy.
Are my results permanent?
No. The normal processes of aging & gravity that
cause continued laxity of the tissues eventually lead
the tissues to sag again. There is no sure way of predicting
how long this process takes in any particular individual.
On average, rhytidectomy results may last 5-7 years.
Will I be very swollen and bruised?
Probably. Every patient will be different. However,
most patients will experience significant swelling and
moderate bruising following their facelift. Do not be
frightened. Swelling usually reaches its peak during
the first 48-72 hours.
The above information has been compiled as a benefit
to you. We hope that this document has served to better
inform you on the proposed procedure. We encourage dialogue.
Dr. Perez-Gurri and his staff at Imagos Institute of
Plastic Surgery, Inc welcome your questions.
It is our sincerest wish that your surgical experience
at IMAGOS INSTITUTE OF PLASTIC SURGERY, INC. be a pleasant
and informative one. We recognize that all patients
will experience pre-operative anxiety and fear of elective
surgical procedures is normal. Our trained professional
staff and doctors are here to serve your needs and answer
your questions.
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