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Rhytidectomy,
the medical term for a facelift, is
more than just a simple tightening of the facial skin. Rather,
the procedure involves three distinct stages; tightening certain
facial muscles with permanent sutures, removing excess subcutaneous
fatty deposit and skin. Incisions are made in the hairline
and in folds and creases of the skin so visible signs of a
facelift are kept to a minimum. The operation is usually performed
under local anesthesia with conscious sedation. It is commonly
done in conjunction with eyelid tightening (blepharoplasty)
and browlift. Often, performing one procedure without the
others can accentuate the effects of aging on an unaltered
facial area. A patient with the eyes of a 35 year old and
the jowl and neck of a 50 year old can look quite unnatural.
All three procedures can be done individually on an outpatient
basis. Preoperative preparation and patient cooperation are
essential to good results. A physical evaluation is performed
beforehand and any medical conditions considered risk factors
identified. Those patients should be cleared by their personal
physicians before this or any elective surgery is considered.
Each patient is advised to avoid substances or agents that
could compromise normal clotting. Smoking is prohibited 4
weeks before surgery because of the effect on blood oxygen
levels and, hence, healing. The patient then receives a full
face and neck scrub the day of surgery, and most patients
receive preoperative medication. Local anesthetics and intravenous
sedatives are usually administered and monitoring devices
attached. Nerve blocks are performed in and around the areas
to be incised. The sedated patient will feel some pressure
and will be able to respond if asked to move a part of the
face, but will experience no pain. The time in surgery varies
from 2 1/2 to 5 hours depending on the number of ancillary
procedures to be performed and the special problems presented
by the patient. Prostsurgical dressing usually consists of
a simple turban dressing of loosely wrapped gauze applied
to the head to hold the patient's hair and protect the sutured
incisions. A standard 'facelift' dressing may also be applied,
depending on the needs of the patient and the preference of
the surgeon. Medication to control any discomfort will be
prescribed |
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