Rhytidectomy, commonly referred to as a facelift, is a cosmetic surgery procedure designed to tighten loose skin on the lower third of the face, the neck and the jaw line. The facelift procedure refreshes the natural facial symmetry unique to each individual while removing major folds and wrinkles on the face and neck that naturally occur with aging. The neck and jaw line regain a more youthful definition. The best results are seen in candidates with reasonable surgical expectations of looking rested, refined and naturally vibrant. Healthy men and women with sagging or laxity in the neck and jowl generally see great improvement.

Procedure Description

Dr. Hand performs the facelift procedure in our accredited Marin County outpatient surgical facility. Depending on the extent of the procedure, the procedure may be performed under local anesthesia with sedation or general anesthesia. Several variations of facelift are available dependent on the amount of correction needed. Most procedures are completed in two to four hours. The procedure that best addresses the anatomical issues and patient’s concerns will be decided at the consultation.

Mini-lift: This procedure is designed for the younger person that observes a general loosening of his or her face but has no major folds or wrinkles. The incision begins hidden in the hair above the ear and continues in the natural curve in front of the ear, finishing at the base of the ear or slightly behind it. Minimal swelling can be expected since no muscle correction is done. The scars fade quickly and will be difficult to visualize.

Facelift: This procedure is designed for the more mature face that not only has laxity of the skin but also muscle in the lower face that has relaxed. This patient may have “neck bands” and/or facial fat that has collected under the chin. Most often the neckline has lost its definition and youthful angles. The incisions begin much as in the minilift but extends behind the ear and up into the hairline. This facelift addresses all areas of the lower face and neck by tightening the underlying muscle, followed by trimming and redraping the facial skin. Frequently, another incision is made under the chin that allows Dr. Hand to tighten the muscles in the neck that have separated and usually cause banding and to remove fat deposits. A neck suspension is commonly done to improve neck definition.

Mid-facelift: This procedure is always performed by Dr. Hand on the patient that chooses lower lid blepharoplasty as a facial rejuvenation choice. Through the lower lid blepharoplasty incision, the malar fat pads are repositioned and the mid-face is lifted vertically to assist in softening the nasolabial lines (the lines between the nose and the lip).

Recuperation and Healing

A compressive dressing will be wrapped around the head immediately after surgery and will be changed to a looser dressing the next day by Dr. Hand. On the third postoperative day, the dressing may be removed and the patient should shower and gently wash the hair. Most patients will see swelling and bruising subside within 1 to 3 weeks depending on the amount of muscle correction. Generally, the more extensive the procedure, the longer swelling continues. Sutures in front of the ear are removed at 4 days after facelift. The sutures behind the ear will be removed at 10 days to 2 weeks after the procedure.

Most patients can begin light exercise after 10 days and regular exercise at 2 weeks after surgery. Depending on the amount of swelling and bruising, most patients can return to work in 1 to 2 weeks. Postoperative discomfort is easily controlled by oral medications.

Alternative Options

Dr. Hand will carefully evaluate all aspects of the face during consultation. He will present recommendations based on attaining the most aesthetically pleasing outcome. Often, the midface and eyes need to be addressed with surgical correction (blepharoplasty) and sometimes the eyebrow position needs to be elevated (forehead lift) to achieve the best result. Other procedures such as fillers or Botox that complement the facelift result may be done during the facelift procedure as well.