Plastic Surgery Indianapolis
 
 
David Sterling Slatton, MD
Indianapolis Plastic Surgeon
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Facelift Indianapolis, Indiana

Facelift Procedures, also known as Rhytidectomy in Indianapolis, IN

Face Lift SurgeryYour face is your most visible feature and conveys how and what you feel.  With facial aging, even though we feel youthful and vigorous, your facial appearance may appear tired and unhappy even though you are energetic and excited about life.  When the face ages, the skin becomes less elastic, tissues sag, and wrinkles appear.  With the aging face, the jaw line becomes less defined and jowls develop.  The mid face looses volume and develops drooping cheeks.   The neck develops bands, wrinkles, unsightly fat deposits and in profile, the angle of the neck changes from acute to obtuse.

If you are displeased with these signs of facial aging, a facelift may be a good procedure for you.

The areas of the face that a facelift corrects are the jawline, neckline, and mid face cheek fat descent. The nasolobial folds are improved as well. 

What is a facelift?

Facelift surgery, also called a Rhytidectomy, is a procedure that improves the jaw

line, wrinkles of the face, facial fat descent and when indicated, the neck line.  There are many techniques available for facelift surgery.  Since no two people are exactly alike, the technique chosen for you is based on your areas of concern, your anatomy and what can be improved through surgical techniques.

Techniques of facelift procedures (rhytidectomy) include:

  • Full Face and Neck lift- addresses wrinkled face and neck skin, jowls, jaw line, and nasolabial folds and crow’s feet to a lesser extent.
  • Mid Face Lift-addresses aging in the cheek area along with the tear trough beneath the lower eyelids
  • Mini Face Lift-addresses minor skin wrinkling in the face where minimal facial aging has occurred along the jaw line and in the neck.

Description of Full Face Lift Surgery

Not only does facial aging occur at the level of the skin, it occurs within the deep layers of facial connective tissue and fat.  Therefore, it is rare that a little skin tightening will address all of the areas of facial aging with which one is concerned.   The approach is most commonly a dual layer one, where the skin is elevated off the deeper layers of facial fat and other structures and then the facial fat is repositioned by elevating it in a second plane.  The vectors (directions) of pulling and re draping of the skin and deep fat of the face to a more youthful position are different, so this dual plane approach is often used. 

The SMAS is a layer of fat and connective tissue beneath the facial skin layer that itself can be elevated off deeper facial structures and repositioned.  SMAS elevation and repositioning is a key element of correction of jowls and mid face facial fat descent.   In patients with minor midface descent and jowls, placing sutures within the SMAS alone to tighten it or surgically removing a strip of the SMAS and suturing the divided edges of tissue together are both effective means of addressing anatomic factors of deep facial aging.

Facial Skin layer elevation addresses wrinkles in the face due to aging and sun damage and also helps smooth crow’s feet. Excess skin is surgically removed in front or behind the temporal hairline, in front of and behind the ear and when the neck is treated, along the hairline behind the ear.

Incisions and the resulting scars for facelift surgery are strategically located along or behind the temporal hairline, in front of the ear, and behind the ear and along the hairline behind the ear.

The neck in every individual can be improved in the facelift procedure if signs of aging previously described exist.  The platysma is a thin muscle that underlies the skin of the neck from the chin down to the lowest portion of the neck and extends over the jaw line and becomes contiguous with the SMAS in the lower face.

Plastymal bands may contribute to facial aging by descending and falling off the underside of the chin and jaw, causing the neck and skin to appear loose and wrinkled, contributing to an aged appearance of the neck and cervical obliquity.  The bands of the platysma may move as one talks or makes facial expressions.  These bands are tightened during the neck lift portion of a facelift through an incision behind the chin crease.  Sutures are used to bring these bands together and this causes the platysma to hug the deeper muscles beneath the jaw and chin and in the front of the neck. The platysma is sometimes cut in the lowest aspect of the front of the neck in order to improve the angularity of the neckline.

Excess neck skin is removed from behind the ears after the plastysma is sutured. 

A Full Facelift procedure may be combined with a  Brow Lift (open or endoscopic), upper and lower eyelid cosmetic surgery (blepharoplasty), fat transfer (injections), Lip augmentation, chin implant placement, and laser resurfacing of the areas around the mouth (perioral region).

Mid face lifts involve elevation of the malar (cheek) fat pad.  This procedure requires an incision in the temporal and frontal hairline and a subperiosteal dissection.  The fat pad can be elevated to a higher, more youthful position with sutures that attach to it from the temporal muscle fascia.  Brow lifts and upper and lower eyelid surgery are often performed with a Mid Face Lift.

Mini face lift describes a procedure that involves an incision in front of the ear and within or in front of the temporal hair line.  The incision may curve partially or fully behind the ear.  The skin of the face is elevated in the cheek area and the underlying facial fat (SMAS layer) is sutured to tighten the deep facial fat.  The excess facial skin is trimmed, and the incision scars that result fall in the areas described for incision placement.

Good Candidates for facelift surgery are healthy women and men who feel that their facial appearance is not consistent with the vigor and youth they emotionally and physically feel.

Your consultation will include a discussion of your signs of facial aging, and goals and an evaluation by the doctor.   The options for facelift and facial rejuvenation will be discussed.  Non surgical or additional procedures will be discussed as well.

How to choose a facelift surgeon.  Always make certain your plastic surgeon is certified by the American Board of Plastic Surgery for your plastic surgery procedures.  Verify your surgeon by going to www.abplsurg.org.

Before your face lift surgery, you should have any medical conditions addressed and controlled, stop smoking, if you smoke, at least 4 weeks prior to surgery.  In preparation for facelift surgery, Medical conditions, if any are well controlled.   If you smoke, you must quit smoking at least 4 weeks prior to surgery.  Aspirin and all aspirin containing medications must be stopped 4 weeks prior to surgery. NSAIDs (Motrin, Alleve, naproxen, Ibuprofen) should be discontinued at least two weeks prior to surgery.  Tylenol (Acetaminophen) is ok to take up and immediately after surgery.   Hormone replacement therapy should be discontinued 2 weeks prior to surgery.

Preparing-once your surgery is scheduled you should prepare arranging for appropriate time off from work, and adequate time to recover. It is helpful to sleep propped up with two pillows, on your back, and with your head and neck in a neutral position for the week preceding the surgery so that you will become accustom to this position after surgery.

During the surgery, you will be under twilight anesthesia and under the care of a board certified MD anesthesiologist.  The surgery is performed at an outpatient AAAASF surgery center and you may be admitted for overnight observation. A family member, significant other or friend must accompany you home from the surgery center.

After Surgery a bandage is placed around your face to minimize swelling and bruising. A small drain is placed in the incision behind the ear to evacuate excess serum and blood. Oral pain medication is prescribed.  Ice packs can be placed on both cheeks under the dressing and are primarily used for comfort.  You will be seen by the doctor the day following surgery and at least once more within the first week of surgery. All sutures are removed about a week after surgery.

Recovery from facelift surgery takes 2-3 weeks before returning to work, although you can return to light normal activity within a week after your surgery.  You will be seen in our office for regular visits during this time period.  Return to light exercise is at 4 weeks.

Your Results will take some time to become visible to you.  Many patients see immediate results and some see results evolve more slowly as swelling subsides.  Makeup can be worn to camouflage bruising after about a week. It may take several months for all of the swelling to resolve and about 6 months for the incision scars to mature.  The results of a facelift can be long lasting

Cost of a face lift includes the surgeon’s, facility, and anesthesia fees. The cost increases commensurate with the total areas of liposuction performed at the same time as the lower body lift.

Financing for surgery can be obtained through several lenders.  Click here to go to our financing page

The benefits of facelift surgery are numerous and specific to the individual. 

Complications are uncommon. During your consultation and pre operative visits, we will discuss these as they pertain to you and facelift surgery. The risks of this surgery are minimized by having the surgery performed in a AAAHC accredited surgical facility and being in overall good health before having the surgery.