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Plastic Surgery - The face & eyes
Table of Contents
  • FACELIFT
  • EYES

    • FACELIFT

    Facelift or rhytidectomy is an attempt to use surgical means to correct the changes that occur in the natural process of aging. Facial skin can sag because of weight loss, the lifelong effects of gravity, the effects of smoking, or other reasons. With a successful facelift, the tightening of the facial skin and supporting tissues can 'turn back the clock' from 5-10 years.

    The ideal candidate for facelift is at a body weight that is normal or slightly under that which is normal for their height. They also have strong facial bony features (chin, cheekbones, etc.). The best patients are non-smokers and do not have a long history of sun exposure or skin cancers. Patients who smoke, are obese, and who do not have prominent facial bones may receive some benefit from facelift procedures, but they will not have the quality of outcome seen in the ideal patient. The plastic surgeon should discuss the expectations with regard to possible outcome in some detail. Patients with unrealistic expectations are not good candidates for cosmetic surgery, including facelift. Although a successful facelift can temporarily set the clock back, no cosmetic procedure can permanently forestall all the effects of aging.

    ANAESTHESIA

    A facelift is always done as an inpatient surgical procedure. Although most patients prefer to have a general anesthetic, many facelifts are carried out under local anesthesia with sedatives providing a 'twilight sleep'. This allows the patient to recover quickly post op.

    OPERATION

    In general terms, a facelift requires an incision which curves from within the hair of the forehead down in front of each ear and back into the hairline on the back of the head. The skin is undermined and tightened and some of the supporting tissues deep to the skin may also be tightened. Liposuction is sometimes done if there is excess fatty tissue under the skin. Occasionally, if there are visible cords in the neck, another small incision may be necessary under the point of the chin so the surgeon can repair the neck muscles and restore a youthful look to the neck and jawline. There are a number of variations on this general theme. Ask questions if you feel you don't understand what he or she intends to do.

    POSTOPERATIVE COURSE

    Bruising and swelling is common after a facelift and the time it takes for this to resolve is different for each patient. Half the sutures are removed at 7 days after surgery and supporting dressings may be worn for several days after the sutures are removed. It is extremely important that the newly rejuvenated skin be protected from sun damage after surgery. A broad-brimmed hat and SPF 15 or stronger sunscreen is essential.

    COMPLICATIONS

    All surgical procedures can have complications. Infection, bleeding, and damage to important structures such as nerves in the operating area may occur. Each patient assumes a different degree of risk with every surgical procedure and these should be explained by your surgeon and understood by you before you proceed with any procedure. No surgeon can guarantee a complication-free outcome for any procedure. Your best solution to this is to find a surgeon with experience in the procedure you want and who is able to handle complications if they arise.

    EYES

    Patients interested in eyelid surgery may have noticed drooping or sagging of the skin around the eyes. These changes can result in a tired or forelorn look, and many patients complain that others notice "bags under my eyes" or "ask if I'm tired even though I feel great". Some patients complain of an angry look or scowl due to heavy skin creases in the forehead or between the eyes. In other patients, peripheral vision may actually be blocked by the excess skin drooping over their eyes. This may interfere with certain activities such as driving. The surgical correction of these age related changes around the eyes have been some of the most common procedures that qualified plastic surgeons have performed. The continued popularity of blepharoplasty (eyelid surgery) attests to the high rate of patient satisfaction with these procedures.

    Below is an overview of what you might expect during the pre-operative consultation, the procedure itself, and the post-operative recovery. As with any discussion of specific plastic surgical procedures, this overview serves as a general guide and specific details and approaches will vary according to your situation and should be discussed carefully and thoroughly with your surgeon.

    The initial consultation is the most important step in your consideration of surgery. It is your chance to ask questions and evaluate the qualifications and personality of your surgeon. On the other hand, it is the surgeons chance to evaluate your goals and expectations. You should leave with your questions answered and feeling confident of your surgeon's abilities and manner before proceeding with any plans for surgery.

    Your surgeon will want to know why you are considering the operation. Is it because you want to look rejuvenated? Are you having changes in your vision? Are you having major life changes such as divorce, job change, or spouse's death? Your surgeon will also want to know about your general health, medications, and any specific problems such as dryness of the eyes, changes in vision, eye pain, or other eye related symptoms. Remember... ask questions now!

    THE OPERATION

    By far the most common plastic surgical procedure of the eyes is blepharoplasty. The goal is to remove sagging skin and fat from the upper and/or lower eyelids. The procedure is done on an inpatient basis (you go home the next day), and can be done under a local anesthetic with sedation.

    For the upper lids, the surgeon makes the incision right in the upper lid skin crease above your eyelashes, so it is very well hidden. Excess skin is removed. Then the excess fat is removed as needed. The incision is sewn together with very small suture and usually heals quickly with a very good scar.

    The same occurs for the lower lids. Here the surgeon can make an incision either right under the eyelashes. Again, fat is removed as needed.

    Potential complications of blepharoplasty are a poor scar (rare), asymmetries in the lid appearance, bleeding, and infection. More serious problems are unusual but do occur such as dry eyes, a drooping of the lower eyelid, and even blindness. Remember, blepharoplasty is an effective rejuvenating procedure with high satisfaction rates among patients. But it is surgery, and the only minor surgery is surgery being done on someone else. Consider the benefits AND the risks before undergoing any surgical procedure.

    Sutures will be removed in a few days.

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