Facelift

The incisions from a facelift need to heal before you color your hair.  This process of healing for the incisions takes approximately 2-4 weeks, so the timing of coloring of your hair is somewhere between 2-4 weeks.  After your facelift, I shall follow your progress closely and, once the incisions have healed properly, I shall recommend the timing for coloring of the hair.

Posted by Rami K. Batniji, M.D., F.A.C.S.

A facelift procedure is performed to re-position jowls, facial skin, and neck tissues into a more youthful position. The incisions are designed to follow the natural creases of the ears, so that the incisions are well hidden. The "pull" that is needed to re-position these tissues is achieved from a deeper, stronger layer of tissue called the SMAS layer. There isn't much (if any) "pull" or tension on the skin, as skin tends to not tolerate tension very well over the long term. By using the SMAS layer, we can achieve a more natural result that is longer lasting. While a facelift can improve the appearance of the skin, sometimes a skin resurfacing (such as a fractionated laser resurfacing) further improves the appearance of the skin and is often performed in conjunction with a facelift.

A mini facelift is designed to address jowl formation, loss of jawline contour and neckline contour. It is appropriate for an individual who has these aforementioned concerns and is healthy and able to undergo this surgical procedure. Smokers have an increased risk for skin flap necrosis; therefore, people who actively smoke are probably not ideal candidates for this procedure.

A traditional facelift incorporated an incision that extended into the scalp hair and lifted the lateral brow. A mini facelift or lower facelift addresses jowl formation, lower facial skin laxity, neck skin laxity, neck muscle bands, and fullness of the neck caused by excess fatty tissue. Sometimes the skin also demonstrates sun-damage and changes in elasticity and collagen, thus rendering the skin looser and with more wrinkles. If this is the case, then I sometimes recommend a fractionated laser resurfacing to address the skin at the same time as a facelift. A facelift can reposition tissues (such as the jowls), but a laser resurfacing is a better option at addressing the elasticity issues of the skin. These procedures can be performed at the same time.

There are several non-surgical facelift alternatives available to the market. Some of these alternatives use heat in the form of lasers, ultrasound, or radiofrequency to create collagen reformation and thus tightening of the skin. The questions that remain to be answered with these modalities include: how long do they last and how many treatments are needed to create and maintain an appreciable result? Further studies need to be performed to answer these questions.

The folds you are referring to are the smile lines, also known as the melolabial folds and/or nasolabial folds. Facelift surgery usually does not remove these folds. The better option for treating these folds include injectable filler.

According to statistics recently released by the American Society of Plastic Surgeons, the number of men seeking out plastic surgery has increased by 2% last year. Facelifts increased by 14% and eyelid surgery (upper and/or lower blepharoplasty) increased by 6%. Non-surgical options, such as Botox, remain popular among males. Also, rhinoplasty, or nose reshaping, is still a commonly sought out plastic surgical procedure among males.

First, I don't place the tension of the facelift on the skin flap. Rather, I use the tougher, fibrous layer underneath the skin (known as the SMAS layer) to hold the tension. This allows for a more natural appearance. Second, the direction of the lift is important. Lifting in a superior and posterior direction provides a more natural appearance than lifting in a posterior direction.

In the Feb 2011 edition of the journal, Plastic and Reconstructive Surgery, an outcomes study demonstrated that most patients who undergo a facelift feel comfortable returning to work 2-3 weeks after the procedure. There are a variety of issues that may impact your swelling and bruising after surgery. For example, avoidance of aspirin and ibuprofen 10 days before surgery may decrease risk of bruising. As well, it is important to make sure your blood pressure is normal as high blood pressure increases the risk of bleeding and bruising. If bruising is present 10 days after the surgery, we can apply make-up to conceal this bruising.

Posted by Rami K. Batniji, M.D., F.A.C.S.

It sounds like you take excellent care of your health and you may be a good candidate for a facelift. That said, we would make arrangements for you to be seen by a Cardiologist for clearance prior to surgery. This clearance process includes blood testing and an EKG. Alternatively, we would recommend you have an evaluation by your Internist or Cardiologist prior to surgery.

Posted by Rami K. Batniji, M.D., F.A.C.S.