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Many factors cause the skin to wrinkle and sag; i.e., exposure to the sun, genetics as well as the natural aging process. Children and young adults have smooth, round faces due to fatty tissue that is evenly distributed throughout the contours of the face. As you age the skin sags and fits more loosely. These folds become prominent, especially around the chin, the jaw line and along the neck.

 Dr. Matouk performs rhytidectomies, or facelifts, to enhance your appearance and correct these conditions. A facelift involves tightening of the facial and neck muscles as well as the removal of any excess skin. The procedure is often performed in conjunction with additional cosmetic surgeries such as blepharoplasty (eyelid surgery), forehead lift, chin augmentation, liposuction and/or rhinoplasty (nasal surgery). These procedures can be performed any time after signs of aging appear in order to attain a more youthful appearance.

There are many types of newly developed “mini” facelifts.  Some of these prosecdures are performed with only minor incisions in the back of the ear and some are actually performed with the use of surgical endoscopes (small telescopes that are inserted through small incisions).  Some other procedures use long sutures to support tissues from sagging.  While these procedures often have an accelerated healing due to the more limited extent of dissection, they also have different effects on the facial structures and Dr. Matouk will discuss with you the best procedures for your specific case.

Before Surgery

We will evaluate your medical history in order to determine your overall health. Dr. Matouk will discuss with you how your face can look and what you can expect from surgery. Our objective is to create a natural appearance that is pleasing to you. Photographs and computer imaging are performed to determine the amount of improvement after surgery.

We will provide you with preoperative instructions that may include the elimination of specific drugs containing aspirin several weeks before surgery to minimize excess bleeding. Antibiotics may also be prescribed to prevent infection. You may be instructed to shampoo your hair the night before surgery. A small amount of hair may be shaved around your ears and temples.

Surgery

A Rhytidectomy can be performed under IV Sedation or general anesthesia in our state-of-the-art surgical facility. These options will be discussed in detail with you. Premedication is administered for relaxation. Incisions are made inside the hairline at the temple, running in front of the ear then around the earlobe and behind the ear, ending in the hair of the scalp. The loose skin is separated from underlying tissue and is pulled up and back. Excess skin is removed. Sagging muscles and connective tissues are tightened. In some cases, fatty deposits are removed from beneath the chin and neck. Small sutures are used to close the incisions. The procedure may take up to five hours depending on whether any other procedures are performed at the same time.

Postoperative Care

Bandages are applied to the area of surgery and are removed within a few days. Pain is moderate and controlled with oral medications. Your sutures are removed within the first 5 to 10 days. In order to minimize scarring, the doctor may remove the sutures in stages. Scarring fades quickly. Swelling and discoloration decrease within two weeks. Tightness in your face will be present for several weeks and there may be slight changes in your hair pattern around the incision.

It is recommended that you avoid the sun for several weeks after surgery. Healing is gradual so you will not notice final results for up to 6 months. Improvement varies, depending on the your initial condition. In most cases, a single procedure achieves the desired results. Most patients who have had facelifts are pleased with their new, more youthful appearance.

What to expect

Discomfort phase-First few days

     
 
  • It is advisable to avoid vigorous chewing, excessive talking, and cigarettes during the first week following surgery. Liquids are encouraged during the first few days: a soft diet is strongly advised in the first week. Begin a month long diet of rich iron thereafter (dark green vegetables, etc.). When you move or stand, or change position, do so deliberately as a single unit.
  • You can expect to be tired and uncomfortable the first few days postoperatively due to the normal effects of the anesthesia and surgical procedure. We strongly recommend that you make arrangements for family or a friend to be with you for at least the first 24 hours. It is best to stay in during these first few days. Driving is permitted 48 hours after surgery, providing all sensations of light-headedness have passed.
  • Arrange for follow visits with Dr. Matouk the 1st, 3rd and 10th days postoperatively. We will remove the facial drains the day following the surgery. The facial support dressing is to be worn 24 hours a day and will be changed by the doctor at the scheduled follow-up visits.
  • Bathing rather than showers is advised after surgery, taking care to avoid wetting facial dressings. Showers can resume on the fifth post-operative day.
  • Ice packs should be used the first 24 hours at _ hour intervals. You should sleep and rest on your back with your head elevated at a 45 degree angle for the first 72 hours. Warm, moist packs may be applied starting on the third postoperative day to help alleviate bruising.
  • Any unexplained development of pain, facial swelling or fever should be reported to us immediately.
  • Some facial and neck swelling and bruising are normally present after facelifts, but the degree of each varies from patient to patient. Do not be concerned if you have more or less than other patients who have undergone the “same” operation. Generally, most patients appear quite sociably acceptable within 10-14 days after surgery.
  • You will need to cleanse the incisions gently three times a day with 50% hydrogen peroxide and 50% water using cotton or Q-tips. After each cleansing, lightly apply Bacitracin Ointment to the incision lines. This will help decrease the redness of the incisions and help to alleviate crusting. Do not get the ointment in your eyes.
  • You may gently shampoo your hair 48 hours after surgery but do not use conditioners or gels that remain on the hair for one week. Avoid any rubbing or combing trauma to the incisions in the hairline and around the ear. Do not blow dry for two weeks, and postpone any planned permanent waves or hair coloring for 6 weeks following surgery.
  • It is acceptable to do some light walking 72 hours after surgery. Jogging and light non-contact exercise should not be resumed until 3 weeks, and strenuous sports activity require 6 weeks of healing before being safely resumed.
  • If you wear eyeglasses, make an appointment with your optometrist to adjust your frames the day following surgery. It is important that the tips behind the ears not put excessive pressure on the incisions. Padding these areas with cotton will make it feel better but this also tightens the frame which results in an inappropriate fit and will alter the visual fields of a be/trifocal prescription.  The first postoperative week can be an emotional roller coaster. Some patients will experience feelings that range form “zombie” on the first day or two, to irritation, sadness, anger, impatience and even fear. Common quotes: “What have I done?”, “How come…”, “I wish it was a month from now.”, “You should have told me about…”. These emotions can be considered normal for many. Accepting the possibility of having these will help you deal with them should they occur. You have had a significant surgical procedure and it is too early for you or others judge the results of the surgery. If you need to be reassured, or you need questions answered, please call the office and speak with a member of the staff or doctor.
 
     

Swelling and Bruising phase-Day four through day fourteen

     
 
  • You may resume non-contact, non-exertional activities.
  • Ice compresses may be soothing, but they are not necessary. We do recommend warm compresses to assist in resolving the bruising. A moist face cloth and a heating pad work nicely, leaving it on for 20-30 minute intervals.
  • Your remaining sutures will be removed between days 12-14.
  • Your earlobes and portions of the face that have been lifted and repositioned will be slightly numb for several weeks; sensation will usually return as healing progresses. Do not wear heavy or tight earrings for 6 weeks. Avoid prolonged exposure to extremely cold temperatures. Excessive exposures to sun (including sun-tanning parlors) in the first 3 weeks after surgery may result in prolonged facial swelling and injury to the skin. Continue to avoid incision line contact, (no makeup and no scratching) and continue to cleanse the instructed earlier. You should always protect your skin with a strong sunscreen in order to decrease the inevitable aging effects of the sun on your skin. These sun-block skin care products are available in our office including a PABA free sun block for those patients that are sensitive or allergic to PABA.
  • Sunglasses may be worn to disguise bruising, and scarves can be worn in attractive ways to camouflage bruising of the neck. Many patients wear a hat the first few days since we don’t encourage hair sprays and other hair care products initially. Try to find a simple, casual look for a couple days that requires minimal work for you.
  • It is common to experience itching of the incisions. This can range from itching to a tight pulling feeling.
  • By day four, you may notice a change in the amount of swelling, and some bruising will probably be more evident. Emotionally you will be wishing it is a moth from now, and may have feelings of regret. This is often a stage when patients are giving close attention to scars and often have concerns as to how they will heal. Be kind to yourself! Plan some activities that you feel comfortable with that will help you celebrate as you heal and help make time go faster. Have a manicure, go to a play or movie, go away for a few days, or revamp your wardrobe.
 
     

Disappointment Phase-Day fourteen through day twenty-one

     
 
  • Adopt a “hands off” policy, gently washing the incision lines with herbal wash. Shampoo on a daily basis.
  • Continue to wear your facial pressure dressing whenever possible when you are at home and at night through the twenty-first day following surgery.
  • Your face and neck will continue to feel very numb and some residual swelling will be present. You can expect some minimal swelling for up to six months. Feelings of regret and melancholy are common after major surgery. You are entering the final remodeling phase of wound healing. Do remind yourself that you will look “bad” before you look marvelous!
 
     

Relief Phase-Third week to sixth week

     
 
  • You may resume normal activity, makeup and your normal hairdressing regimen providing Dr. Clemenza has not informed you otherwise.
  • You may have a feeling of tightness and numbness around the face and neck, a normal sequel to facelift surgery lasting two or three months. Arrange a follow-up visit at six weeks postop at which time early postoperative photographs will be taken.
 
     

By now most patients are excited about the results. Some patients talk freely about their surgery, while others choose to keep it confidential. Many patients experience subtle remarks from family and friends indicating they have a rested look or look like they have lost weight, or perhaps even a comment indicating their hairstyle may have been changed. A good surgical result is one that results in a rejuvenated look as opposed to an over corrected “china doll” look.

The doctor and his staff greatly appreciate that confidence you have shown in us by allowing us to assist you in improving your appearance and health. You may be assured of our very best efforts to achieve the most satisfactory surgical result possible for your particular individual anatomy and condition.