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 facelift (technically known as rhytidectomy) can't stop this aging
process. What it can do is "set back the clock," improving the most
visible signs of aging by removing excess fat, tightening underlying
muscles, and redraping 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.
If you're considering a facelift, this brochure will give you a basic
understanding of the procedure when it can help, how it's performed,
and what results you can expect. It can't answer all of your
questions, since a lot depends on the individual patient and the
surgeon. Please ask Dr. Rieger about anything you don't understand.
The best candidates for a facelift
The best candidate for a facelift is a man or woman whose face and
neck have sagged, but whose skin still has some elasticity and
whose bone structure is strong and well-defined. Most patients are in
their late forties to sixties, but facelifts can be done successfully on
people in their seventies or eighties as well.
A facelift can make you look younger and fresher, and it may enhance
your self- confidence in the process. But it can't give you a totally
different look, nor can it restore the health and vitality of your
youth. Before you decide to have surgery, think carefully about your
expectations and discuss them with Dr. Rieger.

A facelift can improve the deep
cheek folds, jowls and loose, sagging
skin around the neck that come with age.
All surgery carries some uncertainty and risk
When a facelift is performed by a qualified plastic surgeon,
complications are infrequent and usually minor. Still, individuals
vary greatly in their anatomy, their physical reactions, and their
healing abilities, and the outcome is never completely predictable.
Complications that can occur include hematoma (a collection of blood
under the skin that must be removed by the surgeon), injury to the
nerves that control facial muscles (usually temporary), infection, and
reactions to the anesthesia. Poor healing of the skin is most likely
to affect smokers.
You can reduce your risks by closely following your surgeon's advice
both before and after surgery.
Planning your surgery
Facelifts are very individualized procedures. In your initial
consultation the surgeon will evaluate your face, including the skin
and underlying bone, and discuss your goals for the surgery.
Your surgeon should check for medical conditions that could cause
problems during or after surgery, such as uncontrolled high blood
pressure, blood clotting problems, or the tendency to form excessive
scars. Be sure to tell your surgeon if you smoke or are taking any
drugs or medications, especially aspirin or other drugs that affect
clotting.
If you decide to have a facelift, your surgeon will explain the
techniques and anesthesia he or she will use, the type of facility
where the surgery will be performed, and the risks and costs involved.
Don't hesitate to ask your doctor any questions you may have,
especially those regarding your expectations and concerns about the
results.
Preparing for your surgery
Your surgeon will give you specific instructions on how to prepare for
surgery, including guidelines on eating and drinking, smoking, and
taking or avoiding certain vitamins and medications. Carefully
following these instructions will help your surgery go more smoothly.
If you smoke, it's especially important to stop at least two
before and after surgery; smoking inhibits blood flow to the skin, and
can interfere with the healing of your incision areas.
If your hair is very short, you might want to let it grow out before
surgery, so that it's long enough to hide the scars while they heal.
Whether your facelift is being done on an outpatient or inpatient
basis, you should arrange for someone to drive you home after your
surgery, and to help you out for a day or two if needed.
Where your surgery will be performed
Dr. Rieger prefers to perform the operation in a state-of-the art
accredited outpatient surgery center. Dr. Rieger prefers to allow
patient a 23 hour stay in the surgery center. The center combines
state-of-the-art technology with an exceptional degree of
confidentiality, personalized attention, convenience and
affordability. These centers offer overnight accommodations with
round-the-clock nursing care.
Types of anesthesia
General anesthesia is usually selected, so you'll sleep through the
operation.
The surgery
A facelift usually takes several hours-or somewhat longer if you're
having more than one procedure done.

Incisions usually begin above the
hairline at the temples, follow the
natural line in front of the ear, curve
behind the earlobe into the crease
behind the ear, and into or along the
lower scalp.
Incisions 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.

Facial, neck tissue and muscle may
be separated; fat may be trimmed or
suctioned and underlying muscle
may be tightened.
In general, the surgeon 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. The surgeon then tightens the underlying
muscle and membrane, 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.

After deep tissues are tightened, the
excess skin is pulled up and back,
trimmed and surured into place.
Following surgery, a small, thin tube may be temporarily placed under
the skin behind your ear to drain any blood that might collect there.
The surgeon will wrap your head loosely in bandages to minimize
bruising and swelling.
After your surgery
There isn't usually significant discomfort after surgery; if there is,
it can be lessened with the pain medication prescribed by your
surgeon. (Severe or persistent pain or a sudden swelling of your face
should be reported to your surgeon immediately.) Some numbness of the
skin is quite normal; it will disappear in a few weeks or months.
Your doctor may tell you to 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 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.
Most of your stitches will be removed after about one week. Your
scalp may take longer to heal, and the stitches or metal clips in your
hairline could be left in for two weeks.

Most of the scars will be hidden
within you hair and in the normal
creases of your skin.
Getting back to normal
You should be up and about in a day or two, but plan on taking it easy
for the first week after 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.
Your surgeon will give more specific guidelines for gradually resuming
your normal activities. They're 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 about ten days to two weeks after surgery. If you need
it, special camouflage makeup can mask most bruising that remains.
Your new look
The chances are excellent that you'll be happy with your
facelift-especially if you realize that the results may not be
immediately apparent. Even after the swelling and bruises are gone,
the hair around your temples may be thin and your skin may feel dry
and rough for several months. Men may find they have to shave in new
places-behind the neck and ears-where areas of beard- growing skin
have been repositioned.
You'll have some scars from your facelift, but they're usually hidden
by your hair or in the natural creases of your face and ears. In any
case, they'll fade within time and should be scarcely visible.

After surgery, you'll present a
fresher, more youthful face to the
world.
Having a facelift doesn't stop the clock. Your face will continue to
age with time, and you may want to repeat the procedure one or more
times-perhaps five or ten years down the line. But in another sense,
the effects of even one facelift are lasting; years later, you'll
continue to look better than if you'd never had a facelift at all.
call 316-652-9333 for a consult about Facelift in Wichita,
Kansas.
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Brochure © 2003 American Society of Plastic Surgery