Endoscopic Facelift

The facelift, technically known as a rhytidectomy, is a procedure designed to diminish signs of aging in the face and neck. This is accomplished by lifting and tightening the relaxed muscles and then removing fatty tissue and loose baggy skin from the face and the neck area.

Dr. Maloney and Dr. Agarwal customize every facelift to maximize the patient's unique facial features, needs, and goals. Most often a quadraplanar (4 level) facelift is recommended - but in some patients, a tri (3 level) or bi (2 level) planar facelift is all that is required to give the desired look. Custom built facelifts (when combined with the endoscopic technique) permit the vertical repositioning of target areas to achieve the most natural "lift" to the face. This customizing concept is especially important for men whose needs and goals are different from women.

As you would expect, the facelift of a younger person may appear less dramatic. The desired look is one that is refreshed, rested, and youthful. The earlier in the aging process that a facelift is performed the more enduring are the results.

As you would expect, the facelift of an older person would produce more dramatic results, especially if there had been significant wrinkling and sagging.

A few words about the endoscopic facelift procedure....
Endoscopic procedures allow the surgeon access to hard-to-reach areas that traditional face-lifting couldn't reach. These difficult-to-reach areas are in the central third of the face, including frown lines between the brows, the folds adjacent to the nose and the lines around the mouth.

Tiny incisions are made in the skin's creases above and behind the ear. Using fiber-optics and a video camera, the relaxed skin and soft tissue in the face and neck can be lifted to its proper position with exacting precision. For example, a pair of trousers with a worn elastic waist band may appear tired and baggy. By replacing just the stretched elastic, the worn trousers can regain their original fit without removing fabric. With this concept in mind, video-endoscopic facelift procedures have been developed. The baggy and tired muscles of the face are surgically tightened and lifted to regain natural and pleasing facial contours while preserving skin, hairline and skin sensitivity. Because this procedure preserves the fabric of the skin, it is suitable for patients in their late 30's, 40's, and 50's.

A rhytidectomy involves 'lifting' the face, neck, and temple areas. However, the most pleasing results are created in combination with eye-lid surgery, forehead lifts, and laser resurfacing.

Video

Dr. Richard Maloney discusses the endoscopic facelift procedure on WINK

Dr. Richard Maloney discusses the endoscopic facelift procedure on NBC

How do I know if I am a candidate for an endoscopic facelift?
An individual consultation with one of our Board Certified Facial Plastic Surgeons, Dr. Maloney or Dr. Agarwal, is the best way to determine which procedure is best suited to meet your goals. During this consultation, the surgeon will examine you, and computer imaging will be utilized to demonstrate proposed changes to you.

I am 39 years old, am I too young for an endoscopic facelift?
No. The beauty of this procedure is that the face is strengthened in multiple layers during an endoscopic facelift. The flexibility of this procedure (biplanar, triplanar, or quadraplanar) allows it to be custom designed to suit the needs of a 39 year old, or a 69 year old.

How long is the recovery process?
Generally speaking, it takes two weeks for most of the swelling and any bruising to resolve. This can vary from individual to individual. When an endoscopic midface lift is performed, there is some cheek swelling that persists for about 3 weeks post-operatively.

How long do the results last?
A facelift will make you look younger than your chronologic age. However, you will continue to age after the procedure. The best way to think about this is setting the clock back on the aging calendar. For example, if you are currently 65 years old, and after a facelift you look 55 years old, then 10 years from now you will look 65, not 75 years old. You will always look younger than you would if you had not had the facelift.

Are there any drains after the procedure?
Our Board Certified Facial Plastic Surgeons, Dr. Maloney or Dr. Agarwal, will make this decision after your consultation. Most commonly, ultra-thin drains are used for two days post-operatively in order to reduce bruising and swelling. If drains are used, these are removed easily in the office.

In certain cases, especially during an UpLift Facelift, drains are not used.

Do I need someone to take care of me after my endoscopic facelift?
You will need someone to help you for at least one or two days post-operatively. If a supportive friend or family member is not available, then home nursing can be arranged through our office.

What kind of anesthesia is utilized during an endoscopic facelift?
Twilight sedation is used most commonly. During this type of anesthesia, you will breathe on your own, but you will not remember anything. It is a quick acting type of anesthesia that also wears off quickly. Because you are breathing spontaneously, an endotracheal tube is usually not used.

Am I going to bruise after a facelift?
There is some amount of bruising after a facelift. This varies from individual to individual. Because the endoscopic facelift technique requires good visualization during the surgery, bleeding is kept to a minimal. As a result, bruising is minimized.

Are there stitches and when are they removed?
Our facial plastic surgeons use fine, delicate sutures to close all incisions. The majority of these are dissolvable. The remaining sutures are removed about 7-9 days post-operatively.

Where is the procedure performed?
All procedures are performed at our state-of-the-art ambulatory surgery center, Doctors Outpatient Surgery Center (DOSC). DOSC is fully certified by the Accreditation Association for Ambulatory Health Care (AAAHC).

When I can workout after an endoscopic facelift?
You will be able to resume walking exercises about 10 days post-operatively. You will be able to start running and weight training after two weeks, and advance from there.

When can I play golf after my endoscopic facelift?
Generally speaking, you can begin putting and chipping at two weeks. You can resume your full swing at three weeks.

When can I swim after an endoscopic facelift?
Assuming there is no laser resurfacing performed simultaneously with the endoscopic facelift, you can submerge your head 3 to 4 days post-operatively.

When can I color my hair?
Ideally, we recommend coloring your hair a couple of days before your endoscopic facelift. You can color it again 3 weeks post-operatively.

When can I shave?
Men who have facelifts can use an electric razor gently two days post-operatively. Care must be taken to avoid all sutures. Shaving with a blade can be undertaken three weeks post-operatively.

Is an endoscopic facelift painful?
Most patients complain of a tight sensation, temporary numbness, and slight discomfort. Pain is uncommon after facial surgery.

When can I drive?
After an endoscopic facelift, you will be able to drive your own car about one week post-operatively, provided that you are not still taking narcotic pain medicine.

When can I return to work after an endoscopic facelift?
You will feel quite good after an endoscopic facelift. When to return to work depends on the type of work you do, whether you care if your colleagues know you have had something done, etc. Certainly, you should not embark upon any strenuous physical work for at least 2 weeks post-operatively.

How long do I need to be in town after a facelift and when can I fly again?
At the Aesthetic Surgery Center, we have many national and international patients who fly to Naples for their facial plastic surgery. We ask that you remain in town for a full 14 days after a facelift. After that, you are free to fly.

How long will the scars be noticeable after an endoscopic facelift?
Many of the incisions for an endoscopic facelift are hidden in the hair bearing scalp, or in the mouth. These are difficult to detect as they heal. The scars around the ears are well hidden, but are slightly red and noticeable upon close inspection for one month post-operatively. Beyond that, they fade and blend in beautifully.

If I am a smoker, can I have a facelift?
Smoking has been shown in numerous scientific publications to dramatically affect the healing of facial skin and soft tissues post-operatively. At the minimum, you should stop smoking completely 2 weeks prior and for 2 weeks after a facelift. If you absolutely cannot stop smoking, hyberbaric oxygen may be utilized before and after the facelift to reduce but not eliminate the chances of wound healing problems. The endoscopic technique can be adjusted so that the skin layer is not disturbed, thereby preserving its blood supply while your surgeon works on deeper layers.

Do I have to stop any medications before my facial surgery?
Our nurses at the Aesthetic Surgery Center will provide you with a comprehensive list of medications (both prescription and non- prescription) that are known to increase bleeding and affect wound healing after surgery. These should be stopped about 10 days pre-operatively.