A facelift, technically known as a rhytidectomy (literally, surgical removal of wrinkles), is a type of cosmetic surgery procedure used to give a more youthful appearance and removing signs of aging on your face.  It usually involves the removal of excess facial skin, with or without the tightening of underlying tissues, and the redraping of the skin on the patient's face and neck

Facelifts are helpful for eliminating loose skin folds in the neck and laxity of tissues in the cheeks. A facelift requires skin incisions; however, the incisions in front of and behind the ear are usually inconspicuous

- a surgical procedure to improve visible signs of aging in the face and neck
- it is a procedure to tighten the skin and muscles of the face and neck

What to expect during consultation?
- The success and safety of your facelift depends very much on the truthfulness of the patient during the consultation.
- Special inquiry is made regarding medications, allergies, medical problems, previous surgeries and smoking and drinking habits.
- The surgeon will:

• Evaluate the patient’s general health status
• Discuss the options available and recommend a treatment plan
• Discuss the outcomes and any risks or complications about the procedure
• Discuss the procedure itself, its benefits and limitations
• Examine and measure the face
• Take photographs

Preparation for surgery
- Prior to the procedure, the patient will be asked to:

• Get lab testing
• Get medical evaluation
• Take certain or discontinue certain medications
  • Discontinue Aspirin for at least 2 weeks

• Stop cigarette smoking for at least 2 weeks

- Pre-operative instructions include:

• What to do the night before and morning of surgery
  • Shower and wash the hair the night before surgery and on the morning of surgery
  • Avoid eating and drinking after midnight prior to surgery
• Type of anesthesia during the facelift
• Post-operative care and follow-up

Description of the procedure

Step 1 – Anesthesia
- The choices include intravenous sedation and general anesthesia

Step 2 – The Incision

Depending on the on the degree of change the patient would like to see, the facelift choices include:

- Classic Facelift

• Incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp
• Once the incisions are made, undermining is perfomed. The extent depends on the degree of aging.
• Skin is redraped over the uplifted contours and excess skin is trimmed.

- MACS Lift

• Minimal Access Cranial Suspension Lift
• Incision is along the sideburn and temporal hairline
• Soft tissue under the cheeks are being lifted and contoured

Step 3 – Closing the incisions

Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear.

Step 4 – Results

The visible improvements of a facelift appear as swelling and bruising subside.

Potential risks and complications
- The surgeon will discuss the details of all risks and possible complications of the surgery.
- The risks include:

• Unfavorable scarring
• Bleeding (hematoma)
• Infection
• Poor wound healing
• Anesthesia risks
• Correctable hair loss at the incisions
• Facial nerve injury with weakness
• Facial asymmetry
• Skin loss
• Numbness or other changes in skin sensation
• Fatty tissue found deep in the skin might die (fat necrosis)
• Fluid accumulation
• Pain, which may persist
• Skin contour irregularities
• Skin discoloration, sensitivity or swelling
• Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
• Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location, unacceptable visible deformities at the ends of the incisions (It may be necessary to perform additional surgery to improve your results)
• Deep vein thrombosis, cardiac and pulmonary complications
• Possibility of revisional surgery

What to expect post-operatively
- Post-operative care:

• Patients are instructed to rest with the head elevated for several days
• Blood pressure is monitored closely and controlled strictly
• Drains will be removed on the first post-operative day
• Pain medications and oral antibiotics will be given

-    Maximal swelling is expected for the first 7 to 10 days
-    Bruising is evident