What Is A Facelift? What Is A Rhytidectomy?

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A facelift is a surgical procedure that is typically used to give a more youthful appearance to the face. Technically, it is also called a rhytidectomy. This type of cosmetic surgery reshapes the lower one-third of the face by removing excess facial skin. Some facelift procedures also include the tightening of underlying tissues. To achieve the best result, it is often combined with other additional procedures addressing the forehead, cheeks, brows and eyes. According to statistics, facelifts are increasingly popular among both men and women.
The first facelift was performed in Berlin in 1901 by surgeon Eugen Holländer.

According to Medilexicon’s medical dictionary, a rhytidectomy is:

“Literally, excision of wrinkles. Usually used to designate rejuvenative surgery of the cheeks and neck performed by tightening the facial supporting structures and excising excess skin; face-lift.”

The facelift procedure

The traditional facelift. An incision is made in front of the ear extending up into the hair or hairline. The incision stretches downward in front of the ear, comes under the ear and then upward behind the ear. It then ends in the hair or hairline behind the ear. If necessary, the deeper tissues of the face can be tightened. The excess skin is removed.
The incisions are then closed with sutures and staples. In some cases a drain is placed under the skin behind the ear to drain off any excess blood and fluids. This drainage tube is removed a day or two after the procedure. Then bandages are applied.

Dr Amir Karam Performing Nose Surgery 01

Surgeons performing a facelift

New surgical techniques There are new methods for performing facelifts. New surgical options are constantly being developed.These advances aim at improving cosmetic procedures:

  • Lasers: A face-lift procedure called laser neck and jaw liposculpture and resurfacing, uses lasers. This can be done through a one-inch incision under the chin using only a local anesthetic.
  • Endoscopy: Endoscopic techniques are now used to do face lifts and brow lifts. This method allows for smaller incisions. As a result, there are fewer traumas to tissues, and a faster recovery time. Facial structures are raised, and there is no need to cut away folds of skin. However, this type of procedure also depends on the patient.
  • Liposuction: This method is used to remove focal deposits of fat in the face. It is usually used in the area between the chin and neck. Liposuction can be combined with a face lift or performed separately.

Face lift surgery can last from two to five hours. It can be performed in an outpatient facility with local anesthetics and sedatives to relax the patient. However, in some cases surgery can be performed under general anesthesia and the patient may stay in the hospital overnight.
Facelifts are effectively combined with eyelid surgery and other facial procedures. The result of a facelift is a smoother, more youthful appearance. The procedure removes and tightens sagging skin. The droop of the cheeks around the jaw line is reduced. The corners of the mouth are lifted and the creases between the cheeks and lips are diminished. The results usually last between five to ten years.

The incisions in front of and behind the ear are usually not noticeable. For a satisfactory and pleasing result, the adequate techniques are required in each individual case. In men, achieving a natural appearance following surgery can be more challenging because men have hair in front of their ears (sideburns). The sideburns can be pulled backwards and upwards.
This may result in an odd look. In both men and women, one of the obvious signs of having had a facelift is a distorted earlobe. If skin is removed in excess, the face can assume a pulled-back or startled appearance.
Additional procedures to supplement the facelift may be necessary for optimal results, including neck lift, eyelid surgery, liposuction, fat injection, removal of cheek fat, forehead lift, brow lift, chemical or laser peel, and cheek or chin implants.


What are the complications of facelift surgery?

Complications of facelift surgery are infrequent – cosmetic procedures are generally safe. However, any surgery comes with some risk. The risks and complications of facelift surgery include:

  • Bleeding
  • Bruising
  • Complications of anesthesia
  • Damage to the facial nerves controlling muscles (usually temporary)
  • Hematoma (inflammation, pain, swelling and redness)
  • Infection
  • Loss of hair although uncommon (around the incision site)
  • Numbness (can improve within days or weeks)
  • Scarring
  • Skin necrosis (tissue death)
  • Unevenness between two sides of the face
  • Widening or thickening of scar


Recommendations for facelift surgery

Most patients are very pleased with the results of their facelifts. The following points should be discussed and considered before going forward with a facelift procedure:

  • Undergoing a facelift surgery is not recommended for anyone with serious medical problems.
  • The individual who is considering undergoing the procedure should be in good general health.
  • The risk of postoperative complications is increased in cigarette smokers.
  • There is a higher risk of complications for patients with high blood pressure and diabetes.
  • The patient should have reasonable expectations. Surgery will not detain the overall aging process.
  • Patient should be psychologically stable.
  • For best results, patient should have good skin elasticity and bone structure.
  • Patients should abstain from taking aspirin or other blood thinners for at least one week prior to surgery.

Prior to surgery, the plastic surgeon will review the patient’s medical history. There will be analysis and evaluation of blood pressure, blood clotting, medications, cigarette smoking, drug use, allergies, scarring, and skin condition. Moreover, the plastic surgeon will discuss with the patient what the surgery will involve, where it will take place, the type of anesthesia used, the recovery, and potential complications that may develop.
The surgeon and patient should discuss thoroughly what the goals and expectations of the surgery are, according to the skin type and bone structure.


Pain and discomfort are usually minimal and medication can be given to relieve tenderness. Most patients do experience a slight discomfort after a facelift. Bruising and swelling can persist for a few days. Recovery time is usually one week but activities can begin the day after the procedure. Sutures are removed about five to ten days after surgery.
Incisions and bandages must be kept dry and the patient should follow the specific instructions about bathing and washing. Vigorous activity should be avoided for some time. Following doctor’s directives is crucial and will speed the healing process, allowing for the best possible result. Full recovery takes about two to three weeks while bruises heal and swelling diminishes. Some numbness and muscle stiffness is normal for some time.
Scars can take nearly a year to fade and tone down.
Most patients are very satisfied with the results of their facelift. They feel that they have recovered a more youthful appearance. Both men and women enjoy their rejuvenated look. The results of a facelift can last approximately 10 years.
Genetics and lifestyle factors play a role in aging and the appearance of skin. A healthy lifestyle, including not smoking or drinking alcohol, limiting stress, sun exposure and contact with pollutants can help extend the beneficial effects of the facelift surgery.

Written By: Christian Nordqvist
Copyright: Medical News Today
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