As we age, all of our tissues begin to wrinkle, loosen and sag, as we pay the price for our exposure to the ravages of the environment and the relentless force of gravity. A facelift, or rhytidectomy, smoothes the loose skin, jowls, and deep folds and creases of the face and neck, tightens and repositions the underlying tissues to restore the more youthful shape and location of the facial volume, and removes the sometimes excess fat as well as the redundant skin. As with all of his surgeries, Dr. Gold tailors his approach to meet the individual needs of each patient, and performs all of the variations of rhytidectomy, including the short scar technique, “mini-lifts”, “S-lifts”, “focused, segmental lifts”, midface lifts, cervical lifts, “corset platysmaplasty” and “complete” rhytidectomy, with Bi-Planar, Extended SMAS and Platysmal approaches as necessary, with many variations in the location and orientation of the incisions to achieve the best result for a particular patient.
Although there may be many variations, the incisions for a “complete” rhytidectomy usually start in the temporal scalp, extend in front of the upper part of the ear, pass within the ear and then out where the earlobe joins the cheek, and extend upward in the crease behind the ear for a variable distance, often crossing into the scalp behind the ear and into the back of the scalp. Commonly a small incision is made beneath the chin as well, in order to permit greater access for reshaping the fat and muscle of the chin and neck. The skin is lifted from the face and neck through these incisions, the soft tissue (muscle and fat) is lifted separately, repositioned and recontoured as necessary as it is returned to and fixed in a more “youthful” position, and the skin is then redraped and resected according to the individual needs of the patient.
Dr. Gold generally does not use drains in his rhytidectomy procedures in women, but usually does in men because of the thickness and vascularity of their skin, and uses a number of additional techniques to help reduce swelling and bruising and speed your return to social and business activities.
Although complete resolution of swelling may take three to six months, you will be usually be able to return to work or social activities comfortably and with relatively minimal noticeable swelling with make-up covering any possible residual bruising in two to three weeks or less.