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RITIDECTOMY
Facial Lift
"Time is exorbitant; however, today, aging is an option. Our goal in lifting is not to change the patient's face, but to rejuvenate it in a natural way.
The facelift, ritidectomy or facelift, are the different names given to the intervention to treat the effects that the passage of time leaves on the face. It is one of the most frequent interventions of facial aesthetic surgery from the age of 40-50.
General Overview
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A facelift (ritidectomy) is a cosmetic surgical procedure to give the face a more youthful appearance. The procedure can reduce sagging or folds of skin in the cheekbones and jawline, and other changes in the shape of the face that occur with age.
During a facelift, a flap of skin is stretched on each side of the face, and surgical changes are made to the tissues beneath the skin to reshape the contour of the face more youthfully. Before the flap is sutured, the excess skin is removed.
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A neck lift (platysmaplasty) is often performed as part of a facelift to reduce fat deposits and sagging skin on the neck.
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A facelift will not diminish skin folds, wrinkles, or sun damage. Other cosmetic procedures may treat the appearance or quality of the skin.
Why it is performed?
As you age, the appearance and shape of your face undergoes alterations due to normal age-related changes. The skin becomes flaccid and less elastic, and fat deposits decrease in some parts of the face and increase in others. Age-related changes in the face that can be reduced with a facelift include the following:
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Drooping appearance of the cheekbones.
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Excess skin on the lower jaw line (cheeks).
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Deepening of the skin fold from the side of the nose to the corner of the mouth.
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Flaccid skin and excess fat in the neck (if the procedure includes a neck lift).
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A facelift is not a treatment for surface wrinkles, sun damage, folds around the nose and upper lip, or skin color irregularities.
Risks
A facelift can cause complications. Some can be managed with proper medical care, medications, or surgical correction. While permanent or long-term complications are rare, they can cause significant changes in appearance. Risks include the following:
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Hematoma. The accumulation of blood (hematoma) under the skin that causes swelling and pressure is the most frequent complication of a facelift. Hematoma formation, which usually occurs within 24 hours of surgery, is immediately treated with surgery to prevent damage to the skin and other tissues.
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Scarring. Face lift incision scars are permanent, although they are usually hidden by the hairline and the natural contours of the face and ears. Rarely, incisions can cause red, raised scars. Corticosteroid injections or other treatments may be used to improve the appearance of the scars.
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Nerve injury. Although rare, nerve injury may temporarily or permanently affect the nerves that control sensation or muscles. Temporary paralysis of a select muscle, resulting in uneven facial appearance or expression, or temporary loss of sensation, may last from a few months to a year. Surgical interventions may offer some improvements.
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Hair loss. You may experience temporary or permanent hair loss near the incision sites. Permanent hair loss can be treated with surgery to transplant skin with hair follicles.
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Loss of skin. Rarely, a facelift can disrupt the blood supply to the facial tissues. This can lead to skin loss (peeling). Scaling is treated with medication, proper wound care, and, if necessary, a procedure to minimize scarring.
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Like any other type of major surgery, a facelift has a risk of bleeding, infection, and adverse reactions to the anesthesia. Certain diseases or lifestyle habits can also increase the risk of complications. The following factors may pose a significant risk or cause unfavorable results, so your doctor may advise against a facelift.
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Supplements or anticoagulant medications. Medications or supplements that thin the blood can affect the blood's ability to clot and increase the risk of bruising after surgery. These medications include anticoagulants (Coumadin, Plavix, or others), aspirin, nonsteroidal anti-inflammatory drugs, ginseng, Ginkgo biloba, fish oil, and others.
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Diseases. If you have a disease that prevents your blood from clotting, you won't be able to have a facelift. Other conditions, such as poorly controlled diabetes or high blood pressure, increase the risk of poor wound healing, bruising and heart complications.
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Smoking. Smoking greatly increases the risk of poor wound healing, bruising, and skin loss after a facelift.
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Weight fluctuation. If you have a history of repeated cycles of weight gain and loss (factors that affect the shape of the face and the condition of the skin), the result of surgery may not be satisfactory or may be satisfactory only for a short time.
How to prepare yourself
Initially, you will talk to a surgeon about facial rhytidoplasty. The consultation will probably include:
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Medical history and physical examination. Be prepared to answer questions about past and current medical conditions, previous surgeries, previous plastic surgeries, complications caused by previous surgeries, smoking history, and drug or alcohol use. Your surgeon will perform a physical exam, may ask for recent records from your doctor, or may ask for a consultation with a specialist if there are concerns about your conditions for surgery.
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Medication review. Provides the name and dosage of all medications you take on a regular basis, including prescription drugs, over-the-counter medications, herbal medications, vitamins, and other dietary supplements.
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Facial exam. Your plastic surgeon will take pictures of your face from different angles and close-up pictures of some features. Your surgeon will also examine your bone structure, the shape of your face, fat distribution, and skin quality to determine the best options for face lift surgery.
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Expectations. The surgeon will ask you questions about your expectations about the results of the facelift. He or she will help you understand how a facelift will change your appearance and what is not covered by a facelift, such as fine wrinkles or a natural asymmetry of your face.
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Before a facelift:
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Follow the medication instructions. You will receive instructions on what medicines to stop taking and when to stop. For example, you may be asked to stop taking any supplements or anticoagulant medication at least two weeks before surgery. Talk to your doctor about what medicine is safe to take and whether you need to adjust the dose.
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Wash your face and hair. You will probably be asked to wash your face and hair with disinfectant soap the morning of surgery.
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Don't eat. You will be asked not to eat anything after midnight before surgery. You will be able to drink water and take medications that have been approved by the surgeon.
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Organize for help during recovery. If facial ritidoplasty is performed as an outpatient procedure, plan to have someone drive you home and stay with you the first night after surgery.
What to expect
Before the procedure
Sometimes, the procedure is performed with sedatives and local anesthesia, which numbs only a part of your body. In other cases, general anesthesia is recommended, leaving you unconscious.
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During the procedure
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In general, facial rhytidoplasty elevates the skin and tightens the underlying tissues and muscles. Fat in the face and neck may be sculpted, removed, or redistributed. The facial skin is then repositioned over the newly repositioned contours of the face, excess skin is removed, and the wound is stitched or taped closed.
The incisions made in the procedure depend on the techniques used and the patient's preferences. Some options are:
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A traditional incision in facial rhytidoplasty begins at the temples, at the hairline, continues down and around the front of the ears and ends behind the ears, at the bottom of the scalp. An incision may be made under the chin to improve the appearance of the neck.
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A limited incision, which is shorter and begins at the hairline just above the ear, continues around the front of the ear but does not extend to the underside of the scalp.
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The incision for the neck lift begins in front of the earlobe and continues around the ear to the bottom of the scalp. A small incision is also made under the chin.
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Performing facial ritidoplasty usually takes between two and four hours, but may take longer if other cosmetic procedures are performed at the same time.
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After the procedure
After a facelift, you can state the following:
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Mild to moderate pain
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Discharge from the incisions
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Swelling
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Hematomas
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Numbness
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Contact your doctor immediately if you have any of the following:
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Severe pain on one side of the face or neck within 24 hours after surgery
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Shortness of breath
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Chest pain
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Irregular heartbeat
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Incisions will probably be covered with bandages that apply gentle pressure to minimize swelling and bruising. A small tube may be placed under the skin behind one or both ears to drain excess blood or fluid.
The first few days after surgery:
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Rest with your head elevated.
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Take analgesics as recommended by your doctor.
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Put cold compresses on your face to relieve pain and reduce swelling.
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Follow-up consultations
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You will be scheduled for several follow-up visits during the two months following surgery. At these visits, the following will be done.​
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The day after your surgery, your surgeon will probably remove your drainage tube, apply antibiotic ointment to your incisions, and put new bandages on your face.
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Two or three days after the facelift, you can stop using bandages and start using an elastic face sling.
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About a week after surgery, the doctor will remove the stitches and evaluate the wound.
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Subsequent visits will be scheduled to monitor your progress.
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Personal care
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Personal care at home for the first three weeks will help you recover and reduce the risk of complications:
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Follow the wound care instructions as directed by your surgeon.
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Do not remove the scabs that form on the wound.
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Follow the instructions on when you can start using shampoo and soaps, and what classes to use.
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Wear clothes that are fastened at the front (instead of clothes that are worn over the head).
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Avoid pressure or excessive movement over or around incisions.
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Avoid wearing makeup.
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Avoid vigorous aerobic activity or sports.
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Avoid direct exposure of the incision to the sun for three weeks, and then use sunscreen with a sun protection factor of 30 or higher.
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Avoid perming and coloring or bleaching your hair.
Six weeks after the facelift, you'll be able to fix your hair to hide any signs left over from the incision. You can also choose to postpone attendance at important social events for a couple of months, when you'll probably feel like you're back to normal.
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Results
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A facelift can give your face and neck a more youthful appearance. The results of a facelift are not permanent. With age, facial skin may begin to sag again. In general, a facelift can last 10 years.
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