|
|  | Plastic
Surgery | |
Facelift (rhytidectomy) With
ageing the elasticity and strength of the connective tissue and skin diminishes
making the skin loose and wrinkled. Some individual properties and habits, like
smoking, drink abuses and heavy sun exposure might accelerate this process of
ageing.
A face-lift changes the "coating" of the skin like
the tailor changes clothes to fit. Excesses are removed but the quality of the
"fabric" stays the same. The predisposing characteristics of the face
do not change, which means, a face-lift cannot make anyone beautiful unless they
were so before. A tired appearance, however, can change to a less tired look. Purposes
of the operation: The purpose is to eliminate skin redundancy, stretch muscles
and connective tissue and attenuate wrinkles. The quality of the skin can be improved
by means of skin-rejuvenating procedures rather than with a face-lift. As the
ageing process continues and as the causes of the deformity are multi fold, one
can never estimate the longevity of the beneficial effect of the face-lift. The
operation does on the other hand not accelerate the process of ageing. Technique:
With the endoscopic technique, "button-hole-surgery", different procedures
are available depending on the wanted achievements. Mid
face and neck The
endoscopic technique has not yet convincingly made it possible to stretch redundant
skin without causing visible scars. The traditional face-lift with a combination
of detachment and lifting of the soft tissues of the midface through incisions
in the mouth or other combinations is the only alternative for tightening the
skin of the face and neck. Technique:
The incisions runs from the temple into natural wrinkles in front of the ear,
sometimes turning into the ear-canal, rounding the earlobe going in the crease
behind the ear upwards and finally turned into the hair in the neck. The hair
is not shaved or cut. The skin is widely undermined over the face and neck and
cut, allowing a smooth, firm redraping after repositioning of the sagged tissues
in the deeper layers. In cases of fat accumulation, the fat is reduced by suctioning
and in many cases; a correction must be directed to visible muscle bands on the
neck through an incision under the chin. A firm dressing is applied and kept for
24 - 48 hours. Anaesthetic:
Conscious sedation and local tumescent anaesthesia, which is comparable to general
anaesthesia. Operating
time: 2-5 hours depending on the complexity of the procedure. What
happens afterwards? (All lifting procedures):
 | When
the anaesthetic effect subsides there will be a short period with pain for about
40-45 minutes. Otherwise the pains are minimal and only mild painkillers are needed.
The bandage can press around the ears. |
| The
face will swell and the swelling reaches its maximum on the 2nd or 3rd day. It
subsides gradually during 7-10 days. Bruises can take a little longer to disappear.
| | To
accelerate the absorption of the swelling, you should sleep on the back with an
elevated head (2-3 pillows) for 14 days. |
|
Sudden or intense movements with the head should be avoided during the first week. |
|
You should eat soft food during the first 3 days. |
| Car
driving is forbidden during the first week. |
| When
the bandage is removed after one or two days, the hair should be washed daily
with soft shampoo. | | The
first stitches are removed after 4-5 days and the rest after 8-10 days. |
|
You can usually return to normal social activities after 10-14 days. |
| You
can return to physical training after 4-6 weeks. |
| Hair
dyeing and permanent should be avoided during the first 4-6 weeks. |
| The
face feels tense for about 4-5 weeks (face-lift). |
|
The face is numb for about 4-8 weeks (face-lift). |
| The
hairline is pulled up backwards according to the tightening of the skin. |
| You
will be on the sick-list in average 10-14 days. |
| COMPLICATIONS
Referred unwanted biologic events can occur with a certain low frequency
and must be regarded as calculated risks. Other risks not mentioned can also occur.
As a patient this must be considered before a decision for plastic surgery is
set. Bleeding:
Postoperative bleeding can occur after every operation. If there is a significant
bleeding the wound has to be opened again. These risks increase by the intake
of painkillers or Vitamin E. These medications should be avoided during 2 weeks
prior to operation. Smaller bleedings cause bruising and minor scars in the subcutaneous
tissues, which will feel like lumps. These will gradually disappear. Infection:
All operations can cause infection, which will need antibiotic treatment. Nerve
Injury: The facial nerve and its branches run in the area but normally in a deeper
level. The nerve to the frontal region crosses the zygomatic arch close to the
periosteum, which will be elevated during an endoscopic lifting. The proximity
increases the risk for damage. Even a totally cut nerve can regain its functions
spontaneously after a couple of months. Skin
loss: If blood circulation is impaired (smoking, bleeding, infection, pressure)
the blood supply to the thin, loosened skin can be disturbed and cause local necrosis.
Scars:
Scars are normally very discrete. Even in persons with a tendency to get hypertrophic
scarring on other parts of the body, usually get discreet scarring in the face.
The scars behind the ears have a tendency to get somewhat elevated in the beginning.
All scars are red for 3-4 months and bleaches gradually. The scars should be protected
against sunlight and solarium for half a year. Hair
loss: Hair bearing skin that is elevated will usually have transient thinning
of the hair growth. The hairlines are pulled up, backwards according to the stretching
of the skin. This is unavoidable. Smoking:
Smoking depravities the blood circulation and has a negative impact on the wound
healing. Smoking should therefore be avoided at least 2 weeks prior to the planned
procedure and during the healing phase.
| This
text is edited and controlled by Dr. Per Gunnar Opitz, Opitz plastikkirurgiska
klinik i Malmö Sweden | |
