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 Elderly Health

January 2011
Putting On A Good Face
Facelift for the Elderly
Dr Parag Sahasrabudhe
 
Want the neighbourhood children to call you “Uncle” this year, instead of “Granpa”? Here’s how.

Facelift is a surgery in which the most visible effects of ageing are reduced. As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen on their faces. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck.

Why Get a Facelift?
A facelift can correct the most obvious effects of the aging process, by ticking a three point checklist, mainly.
  1. Remove excess fat
  2. Tighten underlying muscles
  3. Redrape 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.

Skin aging continues after this operation, even though the excess skin and wrinkles have been removed. On rare occasions, a minor secondary procedure may be advisable. One needs to keep in mind that the surgery only masks aging – it does not stop the aging process!

5 Success Factors
The most common question in regards to a face lift is, how long it will last? This is almost impossible to state, as there are many factors involved.
  1. The amount of skin removed.
  2. Age and general condition of the patient.
  3. Type of the skin as well as its condition and texture.
  4. Amount of previous sun and wind exposure.
  5. The skin’s healing ability.
Surgical Procedure
The facelift surgery takes approximately three hours - or longer, when combined with other procedures, such as eyelids, neck, etc. The operation is usually performed in the hospital and needs an average hospital stay of two days. This is what your surgeon will do.
  1. Incisions are made within the temple area: in front of the ear, behind the ear, under the chin, and back into the scalp over the mastoid areas.
  2. After the incisions are made, the skin is dissected off the underlying tissue and is pulled in the proper lines of tension and the excess removed.
  3. Sutures are placed in deeper structures to assist in maintaining stability.
  4. The incisions are then closed with surgical stitches.
After The Surgery

  • Some discolouration is common with any type of facial surgery, so that’s something to factor in, along with possible swelling of the face and eyelids, for some patients. This is usually most noticeable on the second and third days and diminishes in approximately twelve days. This also depends on your type of skin, age and healing ability.
  • The surgical scars are permanent. However, in most patients they are barely, discernable to normal observation after a reasonable period of time. But bear in mind that for some patients, the scars can be lumpy and noticeable.
  • Immediately after surgery, bandages may be placed above the head and face for three to four days. A scarf may be worn to cover the stitches until they are removed.
  • Make-up may be applied over the skin of the face up to the edge of the surgical scars approximately eight days following the surgery.
  • No hair dye or stripping should be carried out until your surgeon gives permission. Other hair trimming and hair styling procedures must be carried out only after approximately two weeks following surgery. Do not permit any beautician to pull on your hair or roughly massage your scalp. A hair dryer if used, it should be set up to medium to cool heat. This is of utmost importance if any areas of numbness, especially around the ears or temples, are noted.
  • Social activities should be limited for approximately two weeks. Strenuous exercise should be avoided for three or four weeks.
5 Possible Complications
When a facelift is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Complications that can occur include:
  1. Haematoma – the collection of blood under the skin that must be removed by the surgeon.
  2. Injury to the nerves that control facial muscles, usually temporary.
  3. Infection.
  4. Reactions to the anaesthesia.
  5. Poor healing of the skin is most likely to affect smokers. Smoking should be stopped to prevent untoward complications.
Dr. Parag Sahasrabudhe is Consultant Plastic Surgeon at Jehangir Hospitals, Pune


    
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