As people age, the effects of gravity, exposure to the sun, smoking, and the daily stress of life can be seen in their faces. The typical signs of aging begin with the deep creases that form between the nose and mouth. “Crows feet” around the eyes and creases across the forehead become evident. “Laugh lines” and “marionette” lines become visible on the lower face. The jaw line becomes poorly defined and jowls form. Folds and fats deposits appear around the neck.
Nothing can completely stop the process of aging. A facelift (technically known as rhytidectomy) can’t stop this aging process, but can “set back the clock,” and improving the most visible signs of aging. This is accomplished by removing excess skin and fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift (brow lift), eyelid surgery (blepharoplasty), and chin augmentation.
If you’re considering a facelift, this page will give you a basic understanding of the procedure: when it can help, how it’s performed, and what results you can expect. Dr. Zemmel will be pleased to answer all of your detailed questions during your consultation.
The Best Candidates For A Facelift
The ideal candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well defined. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties. A facelift can make you look younger, fresher, and rejuvenated. It may enhance your self-confidence in the process. But it can’t give you a totally different face, nor can it restore the health and vitality of your youth.
Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Zemmel.
Planning Your Surgery
No two faces are alike and therefore no two facelifts procedures are the same. Facelifts are very individualized procedures. In your initial consultation Dr. Zemmel will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery.
Your surgeon should check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. Be sure to tell Dr. Zemmel if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.
If you decide to have a facelift, Dr. Zemmel will explain his technique and the anesthesia he will use, the type of facility where the surgery will be performed, and the risks and costs involved.
Don’t hesitate to ask any questions you may have, especially those regarding your expectations and concerns about the results.
Preparing For Your Surgery
Dr. Zemmel will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Following these instructions will help your surgery go more smoothly. If you smoke, it’s especially important to stop at least 4 weeks before and after surgery. Smoking reduces blood flow to the skin, and can interfere with the healing of your incision areas.
If your hair is very short, you might want to let it grow out before surgery, so that it’s long enough to hide the scars while they heal.
You should arrange for someone to drive you home after your surgery, and to help you out for a day or two if needed.
Where Your Surgery Will Be Performed
Dr. Zemmel performs facial rejuvenation surgery in his operation room. The facility is a “quad-A” certified operating room that meets the highest standards of safety for an outpatient facility.
Patients recover at the office and then spend the night at home. Dr. Zemmel always calls each patient personally night to ensure his patient’s safety and conform.
Types Of Anesthesia
Dr. Zemmel performs facelifts under local anesthesia with deep sedation. You will not feel any pain and you will asleep the entire operation.
The Surgery
Blepharoplasty usually takes one to two hours, depending on the extent of the surgery. If you are having a brow lift with upper and lower lids done, Dr. Zemmel will perform the brow lift first, then the upper lid procedure, followed by the lower lid procedure. The brow lift often changes the amount of skin removal of the upper lids and therefore must be performed first.
In a typical procedure, Dr. Zemmel makes incisions following the natural lines of your eyelids; in the creases of your upper lids, and just below the lashes in the lower lids. The incisions may extend into the crow’s feet or laugh lines at the outer corners of your eyes. Working through these incisions, Dr. Zemmel separates the skin from underlying fatty tissue and muscle, removes excess fat, and often trims sagging skin and muscle. The incisions are then closed with very fine sutures.
If you have a pocket of fat beneath your lower eyelids but don’t need to have any skin removed, Dr. Zemmel may perform a transconjunctival blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. It is usually performed on younger patients with thicker, more elastic skin.
After Your Surgery
After surgery, Dr. Zemmel will lubricate your eyes with ointment and will apply a cold compresses. Your eyelids may feel tight and sore as the anesthesia wears off, but you will have excellent pain medicine to control the discomfort. Dr. Zemmel will give you a prescription before surgery so you may get it filled and have it ready. If you feel any severe pain, call Dr. Zemmel immediately.
Dr. Zemmel will instruct you to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising. Bruising varies from person to person: it reaches its peak during the first week, and generally lasts 2 weeks. You’ll be shown how to clean your eyes, which may be gummy for a few days. Dr. Zemmel will recommend lubricant eye drops, since your eyelids may feel dry at first and your eyes may burn or itch. For the first few weeks you may also experience excessive tearing, sensitivity to light, and temporary changes in your eyesight, such as blurring or double vision.
Dr. Zemmel will follow your progress very closely for the 2 weeks. The stitches will be removed 5 days after surgery. Once they’re out, the swelling and discoloration around your eyes will gradually subside, and you’ll start to look and feel much better.
Getting Back To Normal
You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first.
Dr. Zemmel will give more specific guidelines for gradually resuming your normal activities. They’re likely to include these suggestions: Avoid strenuous activity, including sex and heavy housework, for at least two weeks (walking and mild stretching are fine); avoid alcohol, steam baths, and saunas for several months. Above all, get plenty of rest and allow your body to spend its energy on healing.
At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff and you’ll probably be self-conscious about your scars. Some bruising may persist for two or three weeks, and you may tire easily. It’s not surprising that some patients are disappointed and depressed at first.
By the third week, you’ll look and feel much better. Most patients are back at work about ten days to two weeks after surgery. If you need it, special camouflage makeup can mask most bruising that remains.
Your New Look
The chances are excellent that you’ll be happy with your facelift-especially if you realize that the results may not be immediately apparent. Even after the swelling and bruises are gone, the hair around your temples may be thin and your skin may feel dry and rough for several months.
You will have some scars from your facelift, but will be well hidden by your hair or in the natural creases of your face and ears. In any case, they’ll fade within time and should be scarcely visible.
Having a facelift doesn’t stop the clock. Your face will continue to age with time, and you may want to repeat the procedure one or more times-perhaps five or ten years down the line. But in another sense, the effects of even one facelift are lasting; years later, you’ll continue to look better than if you’d never had a facelift at all.