Rhytidectomy
Encyclopedia
A facelift, technically known as a rhytidectomy (literally, surgical removal of wrinkles), is a type of cosmetic surgery procedure used to give a more youthful appearance. It 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
.
According to the most recent 2008 statistics from the American Society for Aesthetic Plastic Surgery, facelifts were the sixth most popular aesthetic surgery performed after liposuction
, breast augmentation, blepharoplasty
(eyelid surgery), abdominoplasty
(tummy tuck), breast reduction
, and rhinoplasty
.
, 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.
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Facelifts are helpful for eliminating loose skin fold
s in the neck and laxity of tissues in the cheeks. The areas not well corrected by a facelift include the nasolabial fold
s and perioral mounds marionette lines
which are more suitably treated with Botox or liposculpture, respectively.
A facelift requires skin incisions; however, the incisions in front of and behind the ear are usually inconspicuous. Hair loss in the portions of the incision within the hair-bearing scalp can rarely occur. In men, the sideburns can be pulled backwards and upwards, resulting in an unnatural appearance if appropriate techniques are not employed to address this issue. Achieving a natural appearance following surgery in men can be more challenging due to their hair-bearing preauricular skin. In both men and women, one of the signs of having had a facelift can be an earlobe which is pulled forwards and/or distorted. If too much skin is removed, or a more vertical vector not employed, the face can assume a pulled-back, "windswept" appearance. This appearance can also be due to changes in bone structure that generally happen with age.
Facelifts are effectively combined with eyelid surgery (blepharoplasty) and other facial procedures and are typically performed under general anesthesia or deep twilight sleep
.
Contraindications to facelift surgery include severe concomitant medical problems. While not absolute contraindications, the risk of postoperative complications is increased in cigarette smokers and patients with hypertension and diabetes. Patients are typically asked to abstain from taking aspirin or other blood thinners for at least one week prior to surgery.
.
Additional Notes on Costs in Europe, :
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
on the patient
Patient
A patient is any recipient of healthcare services. The patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider....
's face
Face
The face is a central sense organ complex, for those animals that have one, normally on the ventral surface of the head, and can, depending on the definition in the human case, include the hair, forehead, eyebrow, eyelashes, eyes, nose, ears, cheeks, mouth, lips, philtrum, temple, teeth, skin, and...
and neck
Neck
The neck is the part of the body, on many terrestrial or secondarily aquatic vertebrates, that distinguishes the head from the torso or trunk. The adjective signifying "of the neck" is cervical .-Boner anatomy: The cervical spine:The cervical portion of the human spine comprises seven boney...
.
According to the most recent 2008 statistics from the American Society for Aesthetic Plastic Surgery, facelifts were the sixth most popular aesthetic surgery performed after liposuction
Liposuction
Liposuction, also known as lipoplasty , liposculpture suction lipectomy or simply lipo is a cosmetic surgery operation that removes fat from many different sites on the human body...
, breast augmentation, blepharoplasty
Blepharoplasty
Blepharoplasty is surgical modification of the eyelid. Excess tissue such as skin and fat are removed or repositioned, and surrounding muscles and tendons may be reinforced. It can be both a functional and cosmetic surgery.-Indications:...
(eyelid surgery), abdominoplasty
Abdominoplasty
Abdominoplasty or "tummy tuck" is a cosmetic surgery procedure used to make the abdomen more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall...
(tummy tuck), breast reduction
Breast reduction
Reduction mammoplasty is the plastic surgery procedure for correcting over-sized breasts...
, and rhinoplasty
Rhinoplasty
Rhinoplasty , also nose job, is a plastic surgery procedure for correcting and reconstructing the form, restoring the functions, and aesthetically enhancing the nose, by resolving nasal trauma , congenital defect, respiratory impediment, and a failed primary rhinoplasty...
.
Procedure
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 (SMASSMAS
SMAS is an acronym for Superficial Muscular Aponeurotic System. It refers to an area of musculature of the face. This muscular system is manipulated during facial cosmetic surgery, especially rhytidectomy. The SMAS extends from the Platysma to the Galea Aponeurotica and is continuous with...
, 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.
Considerations
Skin fold
Skin folds are areas of skin where it folds. Many skin folds are distinct, heritable anatomical features, and may be used for identification of animal species, while others are non-specific and may be produced either by individual development of an organism or by arbitrary application of force to...
s in the neck and laxity of tissues in the cheeks. The areas not well corrected by a facelift include the nasolabial fold
Nasolabial fold
The nasolabial folds, commonly known as "smile lines" or "laugh lines," are facial features. They are the two skin folds that run from each side of the nose to the corners of the mouth. They separate the cheeks from the upper lip...
s and perioral mounds marionette lines
Marionette lines
Marionette lines are long vertical lines that laterally circumscribe the chin. They are important landmarks for the general impression of the face. Deep ones might give the face an expression of being dissatisfied, grim or even scornful. Marionette lines are an ideal target for Botox treatment,...
which are more suitably treated with Botox or liposculpture, respectively.
A facelift requires skin incisions; however, the incisions in front of and behind the ear are usually inconspicuous. Hair loss in the portions of the incision within the hair-bearing scalp can rarely occur. In men, the sideburns can be pulled backwards and upwards, resulting in an unnatural appearance if appropriate techniques are not employed to address this issue. Achieving a natural appearance following surgery in men can be more challenging due to their hair-bearing preauricular skin. In both men and women, one of the signs of having had a facelift can be an earlobe which is pulled forwards and/or distorted. If too much skin is removed, or a more vertical vector not employed, the face can assume a pulled-back, "windswept" appearance. This appearance can also be due to changes in bone structure that generally happen with age.
Facelifts are effectively combined with eyelid surgery (blepharoplasty) and other facial procedures and are typically performed under general anesthesia or deep twilight sleep
Twilight sleep
Twilight sleep is an amnesic condition characterized by insensibility to pain without loss of consciousness, induced by an injection of morphine and scopolamine, especially to relieve the pain of childbirth...
.
Contraindications
The most common complication can be 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.Contraindications to facelift surgery include severe concomitant medical problems. While not absolute contraindications, the risk of postoperative complications is increased in cigarette smokers and patients with hypertension and diabetes. Patients are typically asked to abstain from taking aspirin or other blood thinners for at least one week prior to surgery.
Developments
New surgical options are always being developed. One such option is the use of barbed sutureBarbed suture
A barbed suture is a type of knotless surgical suture that has barbs on its surface. While suturing tissue, these barbs penetrate inside the tissue and lock them in place, eliminating the need for knots to tie the suture. Conventional sutures rely on a surgeon's ability to to tie secure knots,...
.
Costs
Cost varies by country where surgery is performed, :- CanadaCanadaCanada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
- US$7,000-15,000 - PakistanPakistanPakistan , officially the Islamic Republic of Pakistan is a sovereign state in South Asia. It has a coastline along the Arabian Sea and the Gulf of Oman in the south and is bordered by Afghanistan and Iran in the west, India in the east and China in the far northeast. In the north, Tajikistan...
- US$5,500 - Malaysia - US$6,400
- PanamaPanamaPanama , officially the Republic of Panama , is the southernmost country of Central America. Situated on the isthmus connecting North and South America, it is bordered by Costa Rica to the northwest, Colombia to the southeast, the Caribbean Sea to the north and the Pacific Ocean to the south. The...
- US$2,500 - RussiaRussiaRussia or , officially known as both Russia and the Russian Federation , is a country in northern Eurasia. It is a federal semi-presidential republic, comprising 83 federal subjects...
- US$10,000 - SingaporeSingaporeSingapore , officially the Republic of Singapore, is a Southeast Asian city-state off the southern tip of the Malay Peninsula, north of the equator. An island country made up of 63 islands, it is separated from Malaysia by the Straits of Johor to its north and from Indonesia's Riau Islands by the...
- US$7,500 - South KoreaSouth KoreaThe Republic of Korea , , is a sovereign state in East Asia, located on the southern portion of the Korean Peninsula. It is neighbored by the People's Republic of China to the west, Japan to the east, North Korea to the north, and the East China Sea and Republic of China to the south...
- US$6,650 - IndiaIndiaIndia , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...
- US$4,800 - TaiwanTaiwanTaiwan , also known, especially in the past, as Formosa , is the largest island of the same-named island group of East Asia in the western Pacific Ocean and located off the southeastern coast of mainland China. The island forms over 99% of the current territory of the Republic of China following...
- US$8,500 - ThailandThailandThailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...
- US$5,000 - United StatesUnited StatesThe United States of America is a federal constitutional republic comprising fifty states and a federal district...
- US$7,000-$15,000
Additional Notes on Costs in Europe, :
- BelgiumBelgiumBelgium , officially the Kingdom of Belgium, is a federal state in Western Europe. It is a founding member of the European Union and hosts the EU's headquarters, and those of several other major international organisations such as NATO.Belgium is also a member of, or affiliated to, many...
- GBP £1,650 and up - ItalyItalyItaly , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...
- GBP £5,000 - United KingdomUnited KingdomThe United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
- £4,000 - £9,000
See also
- Cosmetic surgery
- Micro-current treatment ("non-surgical" facelift)
- Lifestyle LiftLifestyle LiftLifestyle Lift is a cosmetic surgery practice based in Troy, Michigan, United States. The company's name in all caps is also a trademarked brand name used to market a particular type of facial surgery....
- MACSMACSMinimal-access cranial suspension is a form of facial surgery or rhytidectomy used to reduce wrinkles and lift sagging facial tissue and originally developed in Belgium. Facial tissues are accessed via an incision before the ear. Sutures are then used to lift the underlying tissue...
- Maxillofacial surgeryOral and maxillofacial surgeryOral and maxillofacial surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. It is an internationally recognized surgical specialty...
- OtolaryngologyOtolaryngologyOtolaryngology or ENT is the branch of medicine and surgery that specializes in the diagnosis and treatment of ear, nose, throat, and head and neck disorders....
- Plastic surgeryPlastic surgeryPlastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand...
- SMASSMASSMAS is an acronym for Superficial Muscular Aponeurotic System. It refers to an area of musculature of the face. This muscular system is manipulated during facial cosmetic surgery, especially rhytidectomy. The SMAS extends from the Platysma to the Galea Aponeurotica and is continuous with...