Rhytidectomy Cosmetic Surgery

The skin of the face and neck tends to loosen with age, gradually forming wrinkles around the eyelids, on the forehead, and on the sides of the mouth.  Pouches or “jowls” may develop along the jaw line and extra folds may form over the front part of the neck, forming a “double chin.” 

Rhytidectomy, which is commonly called a “facelift,” is the operation designed to diminish the changes of aging in the face and neck.  It involves lifting and removing the excess skin of the face, neck and temple.

Other procedures may be performed at the same time as a facelift to enhance the desired results.  For instance, a submental lipectomy or submental liposuction may be needed to remove excess fat under the chin; plastic surgery of the eyelids and forehead can reduce wrinkling in these areas; and a chemical peel may be required to eliminate fine lines not improved by the facelift.

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Whether the surgery is desired for functional or cosmetic reasons, your choice of a qualified facial plastic surgeon is of paramount importance. Many facial plastic surgeons are trained in both ear, nose, throat, and facial cosmetic surgery, which provides you, the patient, with the highest level of training and expertise. Your surgeon will examine the structure of your nose, both externally and internally, to evaluate what you can expect from rhinoplasty. Your surgeon will also discuss factors that may influence the outcome of the surgery, such as skin type, ethnic background, age, degree of deformity, and degree of function of nasal structures.

You can expect a thorough explanation of the surgeon's expectations and the risks involved in surgery. Following a joint decision by you and your surgeon to proceed with rhinoplasty, the surgeon will take photographs of you and discuss the options available. Your surgeon will explain how the nasal structures, including bone and cartilage, can be sculpted to reshape the nose and indicate how reshaping the chin, for example, could enhance the desired results.

After conducting a thorough medical history, your surgeon will offer information regarding anesthesia, the surgical facility to be used, and the costs for the procedure.

• How is the surgery performed?

  The incision for facelift operation begins in the temple hair above and in front of the ear. It extends down just in front of the ear, around the ear lobe, up behind the ear, and then backward into the hair of the scalp. Working from this incision, the skin is released out into to the temples, cheeks, and neck. The underlying muscle and connective tissues are repositioned and excess skin and fat are remove. Occasionally, a small incision is made under the chin to help with the correction. Then the skin edges are sutured. Scars from these incisions can be well hidden in the face surrounding the hairline.
  
  The facelift surgery normally takes between two and four hours. When it is completed, a bulky dressing is applied and the patient is escorted to a recovery area.

• What should you expect afer surgery?

  Even though most patients experience minimal pain after surgery, the surgeon will still prescribe medication. Some degree of swelling and bruising is unavoidable, and your surgeon 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 to two days. The surgeon will also instruct you t o keep your head elevated when lying down, to avoid as much activity as possible, and to report any undue discomfort.
  
  Recovery usually takes two to three weeks, though many patients go back to work in two weeks. 

• Will insurance cover Facelift surgery?

  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.

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