Face Lift

Face Lift (Rhytidectomy) San Francisco Bay Area

As people age the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jaw line grows slack and jowly; folds and fat deposits appear around the neck. A face lift (technically known as rhytidectomy) can’t stop this aging process. A face lift can “set back the clock,” improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and re-draping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.

The Best Candidates For A Face Lift

The best candidate for a face lift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but a facelift can be successfully performed on people in their seventies or eighties.

The Face Lift Procedure

A face lift usually takes several hours—or somewhat longer if you’re having more than one procedure. For extensive procedures two separate sessions may be scheduled. Dr. Rajagopal moves back and forth between the sides of the face. The exact placement of incisions and the sequence of events depends on your facial structure. Dr. Rajagopal will discuss this with you. Incisions for a face lift procedure usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin.

In general, Dr. Rajagopal separates the skin from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. Dr. Rajagopal then tightens the underlying muscle and tissue, pulls the skin back, and removes the excess. Stitches secure the layers of tissue and close the incisions; metal clips may be used on the scalp.

Following surgery, a small, thin tube is temporarily placed under the skin behind your ear to drain fluids that might collect there. Dr. Rajagopal will also wrap your head loosely in bandages to minimize bruising and swelling.

After The Face Lift Procedure

There isn’t usually significant discomfort after face lift surgery; if there is, it can be lessened with the pain medication prescribed. (Severe or persistent pain or a sudden swelling of your face should be reported to Dr. Rajagopal immediately.) Some numbness of the skin is quite normal; it will disappear in a few weeks or months.

Keep your head elevated and as still as possible for a couple of days after surgery, to keep the swelling down.

If you’ve had a drainage tube inserted, it will be removed one or two days after your face lift surgery. Bandages, when used, are usually removed after one to five days. Don’t be surprised at the pale, bruised, and puffy face you see. Just keep in mind that in a few weeks you’ll be looking normal.

Getting Back To Normal After Your Face Lift

You should be up and about in a day or two, but plan on taking it easy for the first week after your face lift surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first. Dr. Rajagopal will give you more specific guidelines for gradually resuming your normal activities.

They will likely to include these suggestions: Avoid strenuous activity, including sex and heavy housework, for at least two weeks (walking and mild stretching are fine); avoid alcohol, steam baths, and saunas for several months. Above all, get plenty of rest and allow your body to spend its energy on healing. At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff and you’ll probably be self-conscious about your scars.

Some bruising may persist for two or three weeks, and you may tire easily. It’s not surprising that some patients are disappointed and depressed at first. By the third week, you’ll look and feel much better. Most patients are back at work two weeks after face lift surgery. If you need it, special camouflage makeup can mask most bruising that remains.

What is a Mini Facelift / Mid Face Lift?

As a person ages, the effects of gravity and time cause a loss of elasticity and sagging of the skin, especially deepening of the smile lines and forming of marionette lines (vertical lines that can form on either side of the mouth). When these changes are still minimal (especially when the person is in the late 30’s, or late 40’s), a mini face lift can be performed to tighten and reposition the skin producing a more rested, refreshed look. After a mini face lift, patients will notice diminished smile lines and diminished of marionette lines.

Short Scar Face Lift (S-lift, MACS Lift or Minimal Incision Face Lift)

Facelifts have become more popular as the Baby Boomers are reaching the prime of their lives. Patients desire to look youthful, vibrant and natural. Gone are the days of the “tight” face and “pulled” look. A short scar facelift can help patients achieve very natural results with minimal incisions, light anesthesia and fast recovery.

What is a short scar facelift?

A MACS lift repositions the skin and tissues that are affected by aging. The primary difference between the MACS lift and the traditional facelift is that the scar is greatly minimized. The scar behind the ear and hairline is eliminated. With the scar eliminated women can wear their hair up in a pony tail or French twist and men can keep their haircut short.

Where is the scar in a Short Scar Face lift?

The incision starts at the temporal hairline and extends in the natural curves in the front of the ear and ends just below or behind the earlobes.

Who are the best candidates for the MACS lift?

It is generally for the younger patient usually under the age of 60.

What type of anesthesia is used?

Since the facelift has minor incisions it can be performed under local anesthesia combined with twilight anesthesia. Patient’s wake up immediately after surgery and recover more smoothly as compared to a general anesthesia.

How long is recovery?
It is approximately 10-12 days at which time patients can return to work and wear some makeup.

What is the difference between a Face Lift and a Mini Face Lift?

The incisions for a mini face lift are smaller compared to a traditional face lift. They begin in the hairline and extend along the natural line in front of the ear and stop just behind the earlobe. The mini face lift procedure is done more quickly (usually only about 3 hours), and the recovery time is also shorter (most patients are back to work in a week).

With a mini face lift, only the isolated areas of the mid section of the face (such as nasolabial folds) will be addressed. For many patients who feel that these isolated areas are the most significant, a mini face lift is a great solution. On the other hand, a full face lift will improve areas like the neck-chin angle, and restore tighter jawline definition. While a mini face lift rejuvenates the mid-face area (which is what the term “Mid Face lift” refers to), a full face lift may be suggested to patients with sagging or droopiness in the jowl area, or to tighten up the neck muscles.

What is a Weekend Face Lift?

The phrase “weekend face lift” is used in a variety of ways depending on the doctor. Some surgeons advertise a mini face lift as a “weekend face lift” because the recovery time is quick when compared to the traditional face lift procedure. Other procedures (cheek lift, vertical cheek lift, endoscopic forehead lift, or microsuction of the neck) have also all been described in similar ways by advertisers as a “weekend facelift”. There is another procedure that some doctors perform as a “weekend face lift” in which a laser is used on the inside surface of the face, along with liposuction. The American Society of Plastic Surgery does not recommend the use of lasers on the inside surface of the skin due to safety concerns.

Face Lift Journal: From one of our patients

I have been seeing Dr. Rajagopal for at least 8 years. I chose her for her compassion and honesty. She has told me when I don’t need something done even though I thought I did.

I am a 48 year old female who has had botox and restalyne to try to keep looking fresh. I did not want to look like I’d had anything done. This year my sagging jowls and neck were really bothering me and I discussed it with Dr. Rajagopal—she suggested a half-face lift and lower eye surgery.

I made the appointment when I knew I could take 3-4 days off. I have 3 children and my mother was there to help. I went in feeling a little nervous, but had such faith in Dr. Rajagopal that I knew I was in good hands.

I did not have general anesthesia, but didn’t’ feel a thing. I was groggy when I woke up, but didn’t feel any pain or anxiety. I left the office with a friend and rested for 3 days as per doctor’s orders. I could have done much more, but didn’t want to ruin the procedure. I had no pain at all, infact I never used the pain medication. I was swollen and bruised, but within 6 days I was out and about- with glasses and a hat. It has been 2 ½ weeks now, most of the swelling and bruising has gone. I just use make-up. Nobody has asked me whether I’ve had anything done, but everyone has told me I look great and I must have had a great summer!
I don’t regret a thing and am so glad that I did this. My self-esteem has improved –not that I was depressed, I just wanted to look younger without looking plastic.
The whole experience was good and I’m very happy with the results. I feel so lucky to have such a great doctor and would recommend her to anybody considering any procedure.

See also: Facelift cost on our cost & pricing page

If you have any questions regarding Face Lift Surgery, or wish to schedule a consultation with Dr. Rajagopal in the San Francisco Bay Area, California, please call the San Francisco Plastic Surgery Laser Center at 415-392-3333.

Usha Rajagopal, MD
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