IN THIS ISSUE Be Informed, be Realistic, be a Happier Patient Recent National Survey Reveals an Increase in Facelift Surgery... is it for You? Ask the Surgeon / Health Tip / What's New Aging is Inevitable; but Premature Aging can be Fought

What is a facelift?
A facelift is a surgical procedure that improves the appearance of the aging face by removing accumulated fat, re-supporting muscles that have stretched, and removing excess skin. The lower third of the face is targeted for refinement; therefore, a facelift does not eliminate forehead wrinkles, bags under the eyes, or crow's feet. There are different techniques that may be used such as deep plane facelift, s-lift, j-lift, and midface lift.

--Deep plane facelift: This involves elevating facial muscles and fat that lie below the superficial musculoaponeurotic system, or SMAS layer, and securing the fat pads of the cheek and midface back to their natural position.

--S-lift: This technique fixates the soft tissue to the cheek bones, providing stability and fullness to the area. Its name is derived from the shape of the excision that is used near the ear.

--J-lift: Derived from the area it addresses, the jowls, entails repositioning the muscles groups underneath the surface and thereby lifting the jowl to its natural best site.

--Midface lift: The fat pads of the cheeks are repositioned up and over the cheekbones where they belong. This redraping improves the nasalfurrows and restores a more youthful appearance.

Is it for me?
You are only as old as you feel, right? A facelift offers a way for your appearance to reflect your youthful inner spirit. If you want a facelift in order to feel better about yourself and are looking for improvement and not perfection, then a facelift may be a viable option.

The earliest apparent change is the elimination of the angle formed by the neck and the lower jaw. Overall aging to the face may be a combination of loose skin, laxity of underlying muscles, and an accumulation of fat.

How is surgery performed?
The exact steps of your procedure will be determined by the approach that is taken to meet your needs. Generally, incisions will be made on the hairline at the temples, following the natural line in front of the ear, curving behind the earlobe into the creases behind the ear, and into or along the lower scalp, or inside the ear. The skin will be separated from the fat and muscle below. The muscle is re-supported with stitches. Fat may be trimmed or suctioned from around the neck and chin to improve

the contour. The skin is redraped and tightened to a natural point, and then the excess skin is removed. Stitches, sutures, or metal clips may be used to secure the skin and to close the incisions. Additional incisions may be made under the chin to address loose deposits of hanging tissue.

GRAPH (click to image enlarge): Average Number of Patients Receiving Each Procedure

What is the recovery process?
Following the procedure, your head may be wrapped in bandages to minimize bruising and swelling. You can expect some swelling and bruising of the face and eyelids, which usually diminishes within 10 days. Dressings are removed the day after surgery. Initially, there may be a feeling of numbness and tension in the operative area. You will be given guidelines to follow during recovery such as keeping your head elevated, refraining from strenuous activities, avoiding sun exposure, and eating a balanced diet. There is little pain following a facelift, although, pain medication is prescribed to alleviate any discomfort.

Generally, incisions will be made on the hairline at the temples, following the natural line in front of the ear, curving behind the earlobe into the creases behind the ear, and into or along the lower scalp, or inside the ear. (Illustration courtesy of The Face Book, published by the American Academy of Facial Plastic and Reconstructive Surgery.)

The procedure will require four to six weeks for the skin to completely heal. Makeup may be applied over the skin of the face up to the edge of the scars approximately seven to 14 days following surgery. Most patients return to normal activities within 14 days after surgery. Remember, healing is a gradual process; it may be several weeks before you will begin to see the new you.