Face Lift

Over time, gravity and sun exposure take their toll on the face and neck. Deep creases that run from each side of the nose to the corners of the mouth appear; the jawline slackens; and the neck develops loose folds and fat deposits. Rhytidectomy (facelift) counteracts these signs of aging by tightening muscle, removing fat, and trimming excess skin.

Rhytidectomy improves the look of the lower and middle areas of the face, and the neck. It is most effective for correcting the following:

• Mid-face sagging
• Deep creases under the eyes
• Nasolabial folds
• Jowls
• Sagging fat
• Loose skin and fat under the chin and jaw

Although rhytidectomy removes or reduces signs of aging, over time, they will gradually reappear. Rhytidectomy does not improve the look of the brow, eyelids and nose, and some parts of the mid-face. A patient who wants to improve those areas might combine rhytidectomy with a brow lift or eyelid surgery, and/or with injectable soft-tissue fillers, facial implants and skin resurfacing.

Candidates for Rhytidectomy

The best candidates for rhytidectomy want to correct one or more of the signs of aging indicated above; have some facial sagging, but still have elasticity in their skin; are generally healthy; do not smoke; and have realistic expectations about what rhytidectomy can do.

It is very important that the surgeon ascertains whether the patient is only interested in rhytidectomy because of pressure from someone else.

Types of Rhytidectomy

Rhytidectomy is typically performed as an outpatient procedure in an office-based facility, surgery center or hospital. Patients may have a choice of IV sedation or general anesthesia. The procedure takes about 2 hours. The way a facelift is performed depends on the surgeon, the patient‘s facial structure, and the extent of correction desired.

It is important for a patient to have realistic expectations before undergoing cosmetic blepharoplasty. Although the procedure can enhance appearance and improve self-confidence, it does not radically alter the face.

Candidates for Blepharoplasty

The best candidates for blepharoplasty are those who are in good overall health, do not smoke, do not have any serious eye conditions, and have healthy facial tissue and muscle.

People with eye disease, including glaucoma or retinal detachment, thyroid disorders, diabetes, cardiovascular disease or high blood pressure are not good candidates for blepharoplasty.

The Blepharoplasty Procedure

Blepharoplasty is typically performed as an outpatient procedure requiring local anesthesia and sedation. General anesthesia may be used for anxious patients. Patients can choose to have this procedure on their upper or lower eyelids, or both. The procedure can take anywhere from 45 minutes to 2 hours, depending on whether both the upper and lower eyelids are operated on.

If the upper eyelid is being operated on, an incision is typically made along its natural crease. Once the incision is made, fat deposits are repositioned or removed, muscles and tissue are tightened, and excess skin is removed. For the lower eyelid, an incision is usually made just below the lash line so that excess skin can be removed.

After the procedure, the incisions are closed with sutures, tissue glue or surgical tape, and usually loosely covered with gauze so the area can heal.

Recovery After Blepharoplasty

After blepharoplasty, patients may be advised to apply lubricating drops/ointment and cold compresses to aid in healing and minimize side effects. Most patients return to work within a few days to a week, but should avoid exercise and strenuous activities for at least 2 weeks. Stitches are usually removed after 3 or 4 days. Most swelling and other side effects typically subside within 2 weeks. Contact lenses and eye makeup may not be worn for 2 weeks after surgery. Patients are typically advised to wear dark sunglasses outside or in bright light for 2 weeks to protect their eyes from sun and wind.

Risks of Blepharoplasty

Although there may be swelling and bruising around the surgical site, they will subside on their own, and the eyelids will improve in appearance for up to a year. Uncommon side effects include infection, reaction to anesthesia, and double or blurred vision. Eyes may be irritated and dry due to a temporary change in tear distribution. Side effects such as uneven healing and permanent scarring are rare but, if they occur, may require surgical correction. The scars from blepharoplasty are well-concealed, and usually fade with time until they are virtually undetectable. Although the eyelids are still subject to aging, blepharoplasty produces long-lasting results.

Additional Resources

• MedlinePlus
• National Institutes of Health
• Centers for Disease Control and Prevention
• Eunice Kennedy Shriver National Institute of Child Health and Human Development
• U.S. Department of Health & Human Services
• WebMD