Face lift

Face lift surgery is a cosmetic procedure to improve the appearance of the face by redirecting some of the skin and muscle tissue of the face and neck tocounter sagging and looseness caused by gravity as the patient ages. Also known as facialplasty, rhytidoplasty, or cervicofacial rhytidectomy, the procedure won't erase all facial wrinkles, for example, wrinkles around the mouth and eyes may benefit little from face lift surgery. Other procedures, such as blepharoplasty, chemical peel, or dermabrasion, also may be necessary. Patients with other medical conditions should consult their primary physician beforeundergoing face lift surgery. Lung problems, heart disease, and certain other conditions can lead to a higher risk of complications. Patients who take medications that can alter the way their blood clots (including female hormones, aspirin, and some non-aspirin pain relievers) should stop these medicationsprior to surgery to lower the risk that a hematoma, a pocket of blood belowthe skin and the most frequent complication of face lift surgery, will form.

Face lift surgery can be performed on an outpatient basis with local anesthetics. Patients typically also receive an intravenous sedative that helps to lower their awareness of the procedure. There are many variations of face liftsurgery. Which one is used depends on the patient's facial structure, how much correction is needed, and the preferences of the surgeon. In a typical facelift surgery, the surgeon begins by making an incision within the hairline just above the ear. The incision continues down along the front edge of the ear, around the earlobe, and then up and behind the ear extending back into thehairline. The location of this incision is designed to hide any sign of theprocedure later. This is repeated on the other side of the face. The surgeonseparates the skin of the face from its underlying tissue, moving down to thecheek and into the neck area and below the chin. Fat deposits over the cheeks and in the neck may be removed surgically or with liposuction. The surgeonfrees up and tightens certain bands of muscle and tissue that extend up fromthe shoulder, below the chin, and up and behind the neck. If these muscles and tissue are not tightened, the looseness and sagging appearance of the skinwill return. The surgeon trims excess skin from the edges of the original incision, pulls the skin back, and staples or sutures it into place.

Before the procedure, patients meet with their surgeon to discuss the surgery, and clarify the results that can be achieved and the potential problems that can occur. Some physicians prescribe vitamin C and K in the belief that this promotes healing. Patients will also be advised to stop smoking and to avoid exposure to passive smoke before the procedure and afterward. Some surgeonsalso recommend antibiotics be taken beforehand to limit the risk of infection. Some also use a steroid injection before or after the procedure, to reduceswelling. After the surgery, a pressure bandage will be applied to the faceto reduce the risk of hematoma. The patient may spend a few hours resting ina recovery room to ensure no bleeding has occurred, then returns home. Some surgeons recommend that the patient lie down for the next 24 hours, consume aliquid diet, and avoid any movements that lead the neck to flex. Ice packs for the first few days can help to reduce swelling and lower the risk of hematoma. Patients continue taking an antibiotic until the first stitches come outabout 5 days after the procedure. The balance are removed 7-10 days later. Many patients return to work and limited activities within two weeks of the procedure. The major complication following face lift surgery is a hematoma, which might require the patient to return to have the stitches reopened to findthe source of the bleeding. Most hematomas form within 48 hours of surgery. The typical sign is pain or swelling affecting one side of the face but not the other. Another risk of face lift surgery is nerve damage which can affect the patient's ability to raise an eyebrow, distort his smile, or leave him with limited feeling in his earlobe. Most nerve injuries repair themselves within 2-6 months. Some swelling and bruising is normal following face lift surgery. Other complications of face lift surgery include infection, scarring, andhair loss near incision lines.

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