Rhytidectomy; Cheek, Chin, and Neck

Name of the Procedure:

• Common Name: Facelift
• Technical/Medical Term: Rhytidectomy

Summary

A rhytidectomy, commonly known as a facelift, is a surgical procedure that aims to improve visible signs of aging in the face, particularly in the cheek, chin, and neck areas. This procedure involves removing excess skin, tightening underlying tissues, and repositioning the skin to create a more youthful appearance.

Purpose

• Medical Conditions Addressed: Aging signs, sagging skin, deep creases or wrinkles, jowls, and excess fat deposits in the face and neck.
• Goals/Expected Outcomes: To create a more youthful and refreshed facial appearance by reducing sagging skin and wrinkles, and improving the overall facial contour.

Indications

• Specific Symptoms/Conditions: Loose or sagging skin in the cheeks, chin, and neck area, deep creases below the lower eyelids, deep nasolabial folds, and sagging jawline.
• Patient Criteria: Generally, healthy non-smokers with realistic expectations and no medical conditions that impair healing.

Preparation

• Pre-procedure Instructions: Avoid smoking, certain medications, and herbal supplements that can increase bleeding. Adherence to fasting guidelines if general anesthesia is used.
• Diagnostic Tests/Assessments: Physical examination, blood tests, and possibly imaging studies to assess facial structures.

Procedure Description

1. Anesthesia: Either general anesthesia or local anesthesia with sedation.
2. Incision Making: Incisions typically start in the hairline near the temples, continue around the ear, and end in the lower scalp. For neck lifts, an additional incision under the chin may be necessary.
3. Tissue Repositioning: The underlying tissues are lifted and repositioned, and excess skin is removed.
4. Skin Redraping: The skin is then redraped over the newly repositioned contours.
5. Closing Incisions: Incisions are closed with sutures or skin adhesives.
   • Tools Used: Scalpels, surgical scissors, forceps, sutures, and sometimes surgical glue.

Duration

• Typically takes 2 to 5 hours, depending on the extent of the procedure.

Setting

• Performed in a hospital, outpatient surgical center, or a specialized clinic.

Personnel

• Healthcare Professionals: A team including a plastic surgeon, surgical nurses, anesthesiologist, and possibly a surgical assistant.

Risks and Complications

• Common Risks: Swelling, bruising, and temporary numbness.
• Rare Risks: Infection, bleeding, hematoma, scarring, nerve injury, and asymmetry. Management involves prompt medical intervention and sometimes corrective surgery.

Benefits

• Expected Benefits: Noticeable improvement in facial and neck contours, reduction in wrinkles and sagging, resulting in a younger and more refreshed appearance.
• Realization Period: Benefits can be observed immediately post-recovery, with full effects visible after swelling and bruising subside, usually within a few months.

Recovery

• Post-Procedure Care: Keep head elevated, avoid strenuous activities, follow wound care instructions, and take prescribed medications.
• Recovery Time: Initial recovery can take 2 weeks, with complete recovery and final results visible in several months. Follow-up appointments are needed to monitor healing.

Alternatives

• Non-Surgical: Botox, fillers, laser treatments, and ultrasound therapy.
• Pros and Cons: Non-surgical options have shorter recovery times but may provide less dramatic and temporary results compared to a facelift.

Patient Experience

• During Procedure: Patients under general anesthesia will be unconscious; those with local anesthesia and sedation will be awake but relaxed.
• Post-Procedure: Patients might feel tightness, discomfort, or pain managed with medications. Swelling and bruising are common but subside over time, and most patients can return to normal activities within a few weeks.