Procedures
MIDFACE LIFT
MIDFACE LIFT (natural look)
As people age, the effects of gravity, sun exposure, pollution, smoking and stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jaw line grows slack and jowly; folds and fat deposits appear around the neck.
A facelift (technically known as rhytidectomy) can’t stop this aging process. What it can do is “set back the clock,” thus improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and re-draping the skin of the face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, nose reshaping, laser resurfacing, etc.
The technique has evolved from simple tightening of the skin to tightening and re-positioning deeper structures like muscle and connective tissues whereby the skin “comes along the ride.” This “deep plane” or “composite” facelift is considered by many to be the best procedure to create a more natural look (not “windblown”) and it lasts longer. Again, our goal is to achieve a natural “you look great” appearance rather than “I see you had a facelift.”
CO2 laser resurfacing can be done simultaneously. It is the gold standard for improving wrinkle lines and compliments the tightening effect of the facelift.
The three important areas of the aging face are:
Neck folds and fatty deposits under the chin;
Jowls and loose skin along the jaw line;
Descent of the cheek pad which deepens the folds from the nose to the corners of the mouth.
Any or all of these may be present at any age. Candidates for these procedures can range from age twenty to my oldest patient, who was a healthy eighty-four year old.
Aging obviously does not stop in surgery but you’ll look younger by “turning back the clock” from then on. The length of time of these improvements last will depend on genetics, habits, and skin protection.
PLANNING YOUR SURGERY
Facelifts are very individualized procedures. In your initial consultation, Dr. Ciano will evaluate your face, including the skin and underlying bone, and discuss your goals for surgery.
Certain medical conditions could cause you problems during or after your surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. Be sure to tell Dr. Ciano if you smoke, if you are taking any drugs, or medications, especially aspirin or other drugs that affect clotting.
PREPARING FOR YOUR SURGERY
Dr. Ciano will give you specific instructions on how to prepare for surgery and to stop or avoid certain vitamins and medications. Carefully following these instructions will help surgery go smoothly. If you smoke, it’s especially helpful to stop at least a week or two before and after surgery, if possible. Smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas.
THE SURGERY
A facelift usually takes 3 hours under general anesthesia although it can be longer if you’re having more than one procedure done.
Incisions usually begin above the hairline at the temples; extend in a natural line hidden just inside the cartilage at the front of the ear, and continue behind the ear to the scalp. If the neck needs work, a small incision may also be made under the chin.
AFTER YOUR SURGERY
There usually isn’t significant discomfort after surgery. If there is, it can be lessened with the pain medication prescribed by Dr. Ciano. Severe or persistent pain or sudden swelling of your face should be reported to Dr. Ciano immediately. Some numbness of the skin is quite normal and it should disappear within a few weeks or months.
You will be instructed to keep your head elevated and decrease your activity level for a couple of days after surgery, to keep the swelling to a minimum.
Bandages will be removed after two days and showering is possible. Don’t be surprised at the pale, bruised and puffy face you see. Just keep in mind that in a few weeks you will be looking normal.
GETTING BACK TO NORMAL
You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. The risk of bleeding under the skin, requiring a return visit to the operating room to treat the hematoma (blood collection) is at the highest during the first week. Since there is little pain and boredom sets in, you must resist the temptation to be too active!
Dr. Ciano will give more specific guidelines for gradually resuming your normal activities. They’re likely to include these suggestions: avoid strenuous activity, including sex and heavy housework, for at least two weeks. Avoid steam baths and saunas for several months. Above all, get plenty of rest and allow your body to spend its energy on healing.
At the beginning, your features may be distorted from the swelling and your facial movements may be slightly stiff. Some bruising may persist for two or three weeks, and you may tire easily.
By the third week, you’ll look and feel much better. Most patients are back to work within ten days to two weeks after surgery. Any bruising that remains may be covered by special camouflage makeup.
