A facelift, technically known as a rhytidectomy (from Ancient Greek ῥυτίς (rhytis) “wrinkle” + ἐκτομή (ektome) “excision”, surgical removal of wrinkles), is a type of cosmetic surgery procedure used to give a more youthful facial appearance. There are multiple surgical techniques and exercise routines. Surgery usually involves the removal of excess facial skin, with or without the tightening of underlying tissues, and the redraping of the skin on the patient‘s face and neck. Exercise routines tone underlying facial muscles without surgery. Surgical facelifts are effectively combined with eyelid surgery (blepharoplasty) and other facial procedures and are typically performed under general anesthesia or deep twilight sleep.
According to the most recent 2011 statistics from the American Society for Aesthetic Plastic Surgery, facelifts were the sixth most popular aesthetic surgery performed after liposuction, breast augmentation, abdominoplasty (tummy tuck), blepharoplasty (eyelid surgery) and breast lift.
Many different procedures of rhytidectomy exist. The differences are mostly the type of incision, the invasiveness and the area of the face that is treated. Each surgeon practices multiple different types of facelift surgery. At a consultation the procedure with the best outcome is chosen for every patient. Expectations of the patient, the age, possible recovery time and areas to improve are some of the many factors taken in consideration before choosing a technique of rhytidectomy.
In the traditional facelift, an incision is made in front of the ear extending up into the hairline. The incision curves around the bottom of the ear and then behind it, usually ending near the hairline on the back of the neck. After the skin incision is made, the skin is separated from the deeper tissues with a scalpel or scissors (also called undermining) over the cheeks and neck. At this point, the deeper tissues (SMAS, the fascial suspension system of the face) can be tightened with sutures, with or without removing some of the excess deeper tissues. The skin is then redraped, and the amount of excess skin to be removed is determined by the surgeon’s judgement and experience. The excess skin is then removed, and the skin incisions are closed with sutures and staples.
The most common complication is bleeding which usually requires a return to the operating room. Less common, but potentially serious, complications may include damage to the facial nerves and necrosis of the skin flaps or infection. Although the facial plastic surgeon attempts to prevent and minimise the risk of complications, a rhytidectomy can have complications. As a risk to every operation, complications can be derived as a reaction to the anesthetics.