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 jawline grows slack and jowly; folds and fat deposits appear around the neck. A facelift 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 your surgeon Dr. Oksar about anything you don`t understand. The best candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their 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 your surgeon. 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.
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. 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 a week or 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. A facelift may be performed in a surgeon`s office-based facility, an outpatient surgery center, or a hospital. It`s usually done on an outpatient basis, but some surgeons may hospitalize patients for a day when using general anesthesia. Certain conditions such as diabetes or high blood pressure should be monitored after surgery, and may also require a short inpatient stay. Most facelifts are performed under local anesthesia, combined with a sedative to make you drowsy. You`ll be awake but relaxed, and your face will be insensitive to pain. (However, you may feel some tugging or occasional discomfort.) Some surgeons prefer a general anesthesia. In that case, you`ll sleep through the operation.
A facelift usually takes several hours-or somewhat longer if you`re having more than one procedure done. For extensive procedures, some surgeons may schedule two separate sessions. Every surgeon approaches the procedure in his or her own way. Some complete one side of the face at a time, and others move back and forth between the sides. The exact placement of incisions and the sequence of events depends on your facial structure and your surgeon`s technique. 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. 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. 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 may also wrap your head loosely in bandages to minimize bruising and swelling.
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 five days. Your scalp may take longer to heal, and the stitches or metal clips in your hairline could be left in a few days longer.
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. Keep in mind that everybody heals at a different rate, so it is important to listen to the recommendations and directions of your plastic surgeon and to ask questions during the several follow-up visits you will have during your recuperation.
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. 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. In a month or so following your neck lift procedure, you will look in the mirror and enjoy the results of your tighter, more toned and more attractive appearance.
Other than possible complications from the anaesthetic, which are very rare in healthy people who are in the hands of a specialist anaesthesiologist, the two significant potential complications of this operation are: 1. Damage to the facial nerve, which supplies the muscles of facial expression. In the hands of a well-trained and experienced specialist Plastic Surgeon, nerve damage is very rare and when it does occur is usually temporary in nature. 2. Skin loss in front of or behind the ears resulting from damage to the blood supply of the skin. Skin loss due to errors of surgical technique is very unusual and, when it does occur, is almost always due to the patient smoking in the perioperative period. The surgery by its very nature temporarily decreases the blood supply to the skin and smoking during this period is almost guaranteed to lead to death of portions of the skin in front of or behind the ears. You should not undertake any strenuous exercise for at least two weeks following facelift surgery. Your blood pressure rises during heavy exercise and it is possible to induce secondary (late) bleeding if you start exercising too soon.
Liposuction is a procedure that can help sculpt the body by removing unwanted fat from specific areas, including the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks and neck. During the past decade, liposuction, which is also known as lipoplasty or suction lipectomy, has benefited from several new refinements. Today, a number of new techniques, including ultrasound-assisted lipoplasty (UAL), the tumescent technique, and the super-wet technique, are helping many plastic surgeons to provide selected patients with more precise results and quicker recovery times. Although no type of liposuction is a substitute for dieting and exercise, liposuction can remove stubborn areas of fat that don`t respond to traditional weight-loss methods. If you are considering liposuction, this information will give you a basic understanding of the procedure when it can help, how it is performed and how you might look and feel after surgery. It wont answer all of your questions, since much depends on your individual circumstances. Please ask your doctor if there is anything about the procedure you don`t understand.
Are you a good candidate for liposuction ?
To be a good candidate for liposuction, you must have realistic expectations about what the procedure can do for you. It s important to understand that liposuction can enhance your appearance and self confidence, but it won t necessarily change your looks to match your ideal or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy, psychologically stable and realistic in your expectations. Your age is not a major consideration; however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin.
Liposuction carries greater risk for individuals with medical problems such as diabetes, significant heart or lung disease, poor blood circulation, or those who have recently had surgery near the area to be contoured.
Planning Your Surgery
In your initial consultation, your surgeon will evaluate your health, determine where your fat deposits lie and assess the condition of your skin. Your surgeon will explain the body-contouring methods that may be most appropriate for you. For example, if you believe you want liposuction in the abdominal area, you may learn that an abdominoplasty or tummy tuck may more effectively meet your goals; or that a combination of traditional liposuction and UAL would be the best choice for you.Be frank in discussing your expectations with your surgeon. He or she should be equally frank with you, describing the procedure in detail and explaining its risks and limitations.
Getting the Answers You Need
Individuals considering liposuction often feel a bit overwhelmed by the number of options and techniques being promoted today. However, your plastic surgeon can help. In deciding which is the right treatment approach for you, your doctor will consider effectiveness, safety, cost and appropriateness for your needs. This is called surgical judgment, a skill that is developed through surgical training and experience. Your doctor also uses this judgement to prevent complications; to handle unexpected occurrences during surgery; and to treat complications when they occur.
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 vitamins, iron tablets and certain medications. If you develop a cold or an infection of any kind, especially a skin infection, your surgery may have to be postponed.
Though it is rarely necessary, your doctor may recommend that you have blood drawn ahead of time in case it is needed during surgery.
Also, while you are making preparations, be sure to arrange for someone to drive you home after the procedure and, if needed, to help you at home for a day or two.
Where Your Surgery will be Performed ?
Liposuction may be performed in a surgeon s office-based facility, in an outpatient surgery center, or in a hospital. Smaller-volume liposuction is usually done on an outpatient basis for reasons of cost and convenience. However, if a large volume of fat will be removed, or if the liposuction is being performed in conjunction with other procedures, a stay in a hospital or overnight nursing facility may be required.
Anesthesia for Liposuction
Various types of anesthesia can be used for liposuction procedures. Together, you and your surgeon will select the type of anesthesia that provides the most safe and effective level of comfort for your surgery.
If only a small amount of fat and a limited number of body sites are involved, liposuction can be performed under local anesthesia, which numbs only the affected areas. However, if you prefer, the local is usually used along with intravenous sedation to keep you more relaxed during the procedure. Regional anesthesia can be a good choice for more extensive procedures. One type of regional anesthesia is the epidural block, the same type of anesthesia commonly used in childbirth.
However, some patients prefer general anesthesia, particularly if a large volume of fat is being removed. If this is the case, a nurse anesthetist or anesthesiologist will be called in to make sure you are completely asleep during the procedure.
The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anesthesia and the technique used.
There are several liposuction techniques that can be used to improve the ease of the procedure and to enhance outcome.
Liposuction is a procedure in which localized deposits of fat are removed to recontour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed then pulled through the fat layer, breaking up the fat cells and suctioning them out. The suction action is provided by a vacuum pump or a large syringe, depending on the surgeon`s preference. If many sites are being treated, your surgeon will then move on to the next area, working to keep the incisions as inconspicuous as possible.
Fluid is lost along with the fat, and it`s crucial that this fluid be replaced during the procedure to prevent shock. For this reason, patients need to be carefully monitored and receive intravenous fluids during and immediately after surgery.
The basic technique of liposuction, as described above, is used in all patients undergoing this procedure. However, as the procedure has been developed and refined, several variations have been introduced.
Fluid Injection, a technique in which a medicated solution is injected into fatty areas before the fat is removed, is commonly used by plastic surgeons today. The fluid a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels) helps the fat be removed more easily, reduces blood loss and provides anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery.
The amount of fluid that is injected varies depending on the preference of the surgeon.
Large volumes of fluid sometimes as much as three times the amount of fat to be removed are injected in the tumescent technique. Tumescent liposuction, typically performed on patients who need only a local anesthetic, usually takes significantly longer than traditional liposuction (sometimes as long as four to five hours). However, because the injected fluid contains an adequate amount of anesthetic, additional anesthesia may not be necessary. The name of this technique refers to the swollen and firm or tumesced state of the fatty tissues when they are filled with solution.
The super-wet technique is similar to the tumescent technique, except that lesser amounts of fluid are used. Usually the amount of fluid injected is equal to the amount of fat to be removed. This technique often requires IV sedation or general anesthesia and typically takes one to two hours of surgery time.
Ultrasound-Assisted Lipoplasty (UAL). This technique requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat, the energy explodes the walls of the fat cells, liquefying the fat. The fat is then removed with the traditional liposuction technique.
UAL has been shown to improve the ease and effectiveness of liposuction in fibrous areas of the body, such as the upper back or the enlarged male breast. It is also commonly used in secondary procedures, when enhanced precision is needed. In general, UAL takes longer to perform than traditional liposuction.
All Surgery Carries Some Uncertainty and Risk
Liposuction is normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is adequately trained.
As a minimum, your surgeon should have basic (core) accredited surgical training with special training in body contouring. Also, even though many body-contouring procedures are performed outside the hospital setting, be certain that your surgeon has been granted privileges to perform liposuction at an accredited hospital.
Your doctor must have advanced surgical skills to perform procedures that involve the removal of a large amount of fat (more than five liters or 5,000 ccs); ask your doctor about his or her other patients who have had similar procedures and what their results were. Also, more extensive liposuction procedures require attentive after-care. Find out how your surgeon plans to monitor your condition closely after the procedure.
However, it s important to keep in mind that even though a well-trained surgeon and a state-of-the art facility can improve your chance of having a good result, there are no guarantees. Though they are rare, complications can and do occur. Risks increase if a greater number of areas are treated at the same time, or if the operative sites are larger in size. Removal of a large amount of fat and fluid may require longer operating times than may be required for smaller operations.
The combination of these factors can create greater hazards for infection; delays in healing; the formation of fat clots or blood clots, which may migrate to the lungs and cause death; excessive fluid loss, which can lead to shock or fluid accumulation that must be drained; friction burns or other damage to the skin or nerves or perforation injury to the vital organs; and unfavorable drug reactions.
There are also points to consider with the newer techniques. For example, in UAL, the heat from the ultrasound device used to liquefy the fat cells may cause injury to the skin or deeper tissues. Also, you should be aware that even though UAL has been performed successfully on several thousand people worldwide, the long-term effects of ultrasound energy on the body are not yet known.
In the tumescent and super-wet techniques, the anesthetic fluid that is injected may cause lidocaine toxicity (if the solution s lidocaine content is too high), or the collection of fluid in the lungs (if too much fluid is administered).
The scars from liposuction are small and strategically placed to be hidden from view. However, imperfections in the final appearance are not uncommon after lipoplasty. The skin surface may be irregular, asymmetric or even baggy, especially in the older patient. Numbness and pigmentation changes may occur. Sometimes, additional surgery may be recommended.
After Your Surgery
After surgery, you will likely experience some fluid drainage from the incisions. Occasionally, a small drainage tube may be inserted beneath the skin for a couple of days to prevent fluid build-up. To control swelling and to help your skin better fit its new contours, you may be fitted with a snug elastic garment to wear over the treated area for a few weeks. Your doctor may also prescribe antibiotics to prevent infection.
Don t expect to look or feel great right after surgery. Even though the newer techniques are believed to reduce some post-operative discomforts, you may still experience some pain, burning, swelling, bleeding and temporary numbness. Pain can be controlled with medications prescribed by your surgeon, though you may still feel stiff and sore for a few days.
It is normal to feel a bit anxious or depressed in the days or weeks following surgery. However, this feeling will subside as you begin to look and feel better.
Your New Look
You will see a noticeable difference in the shape of your body quite soon after surgery. However, improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible.
If your expectations are realistic, you will probably be very pleased with the results of your surgery. You may find that you are more comfortable in a wide variety of clothes and more at ease with your body. And, by eating a healthy diet and getting regular exercise, you can help to maintain your new shape.
*The Information Presented On This Website Is Intended To Be Used For Informational Use Only; It Is Not Intended To Be A Substitute For Professional Advice. If You Are Planning On Having A Procedure Performed Or If There Is Anything You Don`t Understand Or Have Questions About Your Procedure, Time, Price, Blood Work, Additional Cost For Operating Room, Anesthesia Work, Post Surgery Recovery, Combination Of The Different Procedures Please Consult To Our Physician Who Will Be Happy During Your Consultation To Go Over In Details All Your Questions.