FACELIFT

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A facelift is a surgical procedure to rejuvenate the middle and lower thirds of the face. It can be combined with a neck lift. A facelift addresses many of the changes seen in an aging face. 

What are the changes treated with a facelift? 
These include changes such as:

1. Wrinkles and deep creases under the lower eyelids
2. Prominent nasolabial folds (folds beside the nose, extending towards the corner of mouth)
3. Jowls
4. Sagging of the cheek and jawline
5. Fatty deposits under the chin (with a neck-lift)

How is a facelift different from a resurfacing procedure? 
A resurfacing procedure treats the changes seen in the skin. LASERS and peels are examples of commonly performed resurfacing procedures. Because they tackle the skin, the aging changes which occur at a deeper plane at the level of fat and muscles are not addressed with resurfacing. A facelift involves surgical repositioning of the skin and the deeper layers made of fat and muscles. It treats the aging changes seen in these structures. 

Who is a good candidate for a facelift?
These include individuals who are:

1. Nonsmokers
2. In good health without any significant co-morbid illness
3. Have reasonable expectations about the procedure

How is a facelift performed? 
It is performed under local anesthesia with sedation or general anesthesia. In a traditional facelift, incisions are placed behind the hairline, skirt the anterior and lower part of the ear and enter the hairline behind the ear. Some of the variations like short scar facelift include incisions which are confined to the front of the ear. The surgeon works guided by the natural planes existing in the face. The lax structures are re-positioned such that it results in better harmony and balance. Drains are usually placed temporarily to help in removal of any collection at the operated site. The incisions are closed with the help of sutures which are removed at 4 days to 2 weeks. A facelift is a short stay procedure. Dressings are changed during follow-up reviews. 

What are the variations of the facelift?
These includes:

1. Traditional facelift: This involves incision extending from within the temporal hairline to the natural crease in front of the ear and ends in the hairline behind by going around the lower part of the ear. This procedure rejuvenates the middle and lower third of the face. it also gives access to the neck for a neck-lift. 
2. Short scar facelift: In this variation the scar starts at the hairline and remains confined to the natural crease in front of the ear. It does not go around the lower part of the ear. This is a shorter procedure and is useful for individuals who do not have any significant changes in the neck. 

What is fat grafting?
Fat grafting is the transfer of fat cells to the areas affected by volume loss. This helps restore the volume atrophy and give a more youthful look. Fat is harvested from the lower abdomen and thighs. Fat grafting can be combined with a facelift to improve outcomes.

What is the recovery following a facelift? 
A facelift is a short stay procedure and patients can return home after an overnight stay. The dressings, drains, and sutures are removed during follow-up visits. It is common to have swelling at the operated site in the immediate post-operative period. Most swelling is gone by 3 weeks. Pain and discomfort can usually be managed easily with oral pain medications. Patients can return to light work around two weeks. Exercise can be resumed after a month. 

What are the risks associated with facelift procedure? 
They include the following:

1. Anesthesia complications
2. Infection 
3. Collection of blood or fluids at the operated site
4. Wound healing problems
5. Injury to facial nerve resulting in weakness
6. Poor scarring
7. Unfavorable results

However, with proper attention to detail and technique such incidents are uncommon in patients who are in good health. Wound-related complications tend to occur more commonly in smokers. 

What are the changes a facelift cannot achieve? 
This includes aging changes in the forehead. A browlift is useful for aesthetic rejuvenation of the forehead. A facelift cannot prevent the progress of aging in the treated areas and elsewhere.

What are the benefits of a facelift procedure? 
This includes: 

1. A more youthful looking and rested appearance
2. Improvement in self-confidence

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Incision (shown in red) lies inside the hairline and along the natural skin creases. Facelift rejuvenates the middle and lower third of face.

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Before (frontal)

After (frontal)

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Before (right lateral)

After (right lateral)

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