RHYTIDECTOMY (FACE AND NECK)
From 40 on, cosmetics with anti-aging properties, aesthetic procedures (intense pulsed light, fractional laser, hyaluronic acid, botulinum toxin and radiofrequency) and antioxidant products are great allies in the fight against aging.
From age 50 on, hormone replacement (helps recover a good part of the skin’s vigor), vitamin supplements (reduce the oxidative effect caused by sun exposure), creams (that promote cell renewal), and some non-invasive treatments (infrared and medium and deep peelings) can smooth out the effects of time.
WHAT IT IS AND HOW IT IS DONE
When a certain age is reached, the facial muscles lose their tone and rigidity, causing some sagging of the facial skin and resulting in an aged appearance. Any contraction of the facial muscles causes wrinkles and creases, even a smile. As the years go by, this happens even for those who have taken care of their skin regularly, have not had excessive sun exposure, have not abused alcohol and cigarettes, have experienced little stress and emotional fatigue, and have not been exposed too much to pollution.
Also known as Facelift, Rhytidectomy is an aesthetic plastic surgery that can diminish the visible signs of aging of the face and neck by treating the flaccidity of the skin and deep tissues and positioning the facial structures.
To identify the type of Rhytidectomy most indicated for your case, it is fundamental to go through our evaluation. We make a specific planning for each face, because the results can vary according to age, weight, gender, skin type, among other factors. Basically, we remove the excessive fat, reposition the musculature, and remove the excess skin from the face and neck with the intention of leaving the face naturally younger and with a rested appearance.
There are several incision techniques that can be used in Rhytidectomy. Sometimes we want to correct only slight sagging and small wrinkles in the neck area or reduce jowls. Other times we want to raise the eyebrows and reduce wrinkles in the upper and outer part of the eye. We can treat wrinkles on the forehead or increase the height of the forehead, or treat the face as a whole, but without intervening in the neck region. There are cases where we correct imperfections in the cheek area and the nasolabial fold (known as the “Chinese mustache”) and there are cases where we revitalize the face and neck as a whole.
Often we start the scalp incisions in the temporal region, continue around the ear, and finish at the bottom of the scalp. We can sculpt and/or redistribute the fat on the face, jowls, and neck, and even remove the excess muscles that cause wrinkles in the forehead area. Commonly, we reposition the underlying tissue in the deeper layers of the face and lift the muscles. If necessary, we make a second incision below the chin to improve the aging appearance in the neck.
In an alternative technique, we use smaller incisions in the temporal region, continuing around the ear and possibly inside the lower eyelids or under the upper lip. In another, we start in front of the earlobe, moving behind it, ending at the bottom of the scalp.
Rhytidectomy can be done in association with other procedures in the same surgical act, such as the Blepharoplasty and Facial Lipograft (see Liposculpture).
When we finish the procedure, we close the incisions with sutures or skin patches. A bandage may be placed gently around the face to minimize swelling and bruising. A drain may be temporarily placed under the skin to drain any excess blood and fluid that may accumulate.
It is a totally personalized surgery, planned to be beneficial to each face. In case of a complete surgery involving the face, jowls and neck, or other associated surgery, it can take 4 to 6 hours. The procedure starts under local anesthesia with sedation or general anesthesia, depending on what we have planned, on the indication of the anesthesiologist and what is best for the patient.
INDICATION
Life expectancy has been increasing lately, and it is increasingly common for people to pass their 60s, 70s, and even 80s and still have an active social life – despite some physical limits -, a clear mind, and lots of interesting activities to do! It is natural that the search for beauty continues for these people, and they do it for themselves and for their own well-being.
Rhytidectomy is a surgical and aesthetic procedure indicated for women and men, preferably from 40 years of age, who are bothered by the natural consequences of aging. It can present better results in patients who are physically healthy, have good facial skin elasticity, don’t smoke and have realistic expectations of the surgical result.
It is necessary to keep in mind that Rhytidectomy does not conceive perfection, does not change your appearance, and does not interrupt the body’s evolutionary process… but, it visually delays the aging process and optimizes all the natural characteristics of the face. In some cases, there is a need for retouching or complements, after a certain period of time.
This facial rejuvenation surgery is capable of correcting problems such as loss of muscle tone, the presence of deep creases located under the lower eyelids, drooping cheeks and deep wrinkles between the cheeks and the nose (nasolabial fold or “Chinese mustache”), skin and structural flaccidity in the jaw and neck contour, and fat accumulation in the chin area, among others.
PREOPERATIVE
It is essential to consult the SCHEDULED THE SURGERY? page which has a series of questions to talk about during the consultations, to help you with your doubts and where you will find recommendations for the day of the procedure.
Depending on the extent of the Rhytidectomy – and if it has associated surgery -, fasting should be of 10 or 12 hours. We let you know what it should be.
If necessary, we make an appointment at the doctor’s office the day before the surgery for hair preparation. The hair is cut only in the areas where we plan the incisions.
Male patients should shave on the day of the surgery.
POSTOPERATIVE
After the surgery, according to the needs of each case, the patient is released after 12 to 36 hours of hospitalization, always taking into account the patient’s comfort and safety. The pain is not usually very bothersome, but you will probably feel it for a few weeks while the swelling starts to go down, depending on each person and the extent of the surgery. Cold water compresses over the eyes can be helpful to decrease the time of swelling and provide some comfort.
The first two days must be of absolute rest, fundamental for the cicatrization and for the elimination of liquids (seroma) through the drain (if necessary). Do not wear blouses with collars for the first two weeks, thus avoiding traction of the earlobe when removing them.
It may take several months for the swelling to go down and up to 6 months for the incision lines to look normal. Asymmetries and small irregularities in the face are absolutely normal during the recovery period, because the right half of the face is different from the left half, including the way it reacts to the surgery. Thus, one side may have more swelling than the other, or one side may absorb the swelling faster than the other.
Opt for lighter food on the 1st day (fruit, soup, gelatin, fiber, liquids, etc.). As of the 2nd day of the procedure, you can eat practically anything, but food with a minimum of salt in order not to increase swelling, and mainly protein-based (meat, milk, eggs) and vitamin-based (fruit). Alcoholic beverages, smoking, saunas, and steam baths must be avoided during the entire recovery period.
Sleep with your stomach up, with your torso elevated by pillows and cushions. Do not lie on your side or face down. Schedule lymphatic drainage sessions starting on the 5th postoperative day, until about 30 days. We recommend the schedule. Besides eliminating the accumulation of liquid from the body, this treatment activates the immune system, helps reduce pain and discomfort, relieves bruising and swelling, and is effective in preventing and treating fibrosis and scar adhesions.
Avoid wetting the scalp dressings for at least 24 hours. We give you a schedule for changing the dressing and removing the drain and stitches, which is done in the doctor’s office in stages. Wear sunglasses when in bright sunlight and wind. Avoid make-up for at least 1 week. Exfoliants and depigmenting products will only be allowed after evaluation. During this period, wash your face gently with neutral, creamy soap. Hair dye, after 30 days. In the case of female patients, a scarf in the hair can make you feel more at ease.
Itching, burning or insensibility may eventually occur over the scars. This is temporary and tends to disappear. After 6 months, the planned result starts to appear. A healthy lifestyle also helps prolong the results obtained with the surgery, giving a rejuvenated and youthful appearance.
After 1 week it is already possible to return moderately to daily activities, but without physical effort and try to limit sudden and large movements. Light exercises (such as walking and stretching) after the 15th day are allowed, as well as driving. More intense physical activities and contact sports after evaluation. Avoid as much as possible exposure of the scars to the sun for at least 3 months; after that, always use sunscreen with a minimum of 30 SPF (sun protection factor).
If the scarring does not result in keloid or hypertrophic scarring, the tendency is that it may become clear and of good quality until it reaches its definitive appearance in two years. In the meantime, cosmetic resources such as make-up and hairstyles disguise recent scars.