It is known under this term the procedure to remove the excess skin from the face and to correct the facial angles that may be altered by the effects of gravity and the process of natural aging, which cause the tissues to relax creating an excess lax skin, accentuating the folds of the face and losing the angles of facial expression, and whose aim is to give freshness to the person and look about 10 years younger.
It is important to know that rhytidoplasty does not stop the facial aging process, it only disguises it by eliminating excess skin, softening lines of expression (wrinkles) and recreating the right angles in the face.
Surgery can be done jointly with procedures such as facial lipoinjection, rhinoplasty or others, and technically can be divided into high rhytidectomy (which includes forehead, eyebrows and eyelids) and low rhytidectomy (which includes cheeks and neck), being able to perform surgery separately in two surgical times or completely in the whole face at the same time, and this will depend on the general needs and conditions of our patient.
Anyone who is well informed of the procedure, who benefits from it, and who knows their risks and enjoy good health can be considered a good candidate, without today an ideal age for it, since sometimes it can help enormously to very young people who for reasons of inheritance and lifestyles present faces with aged aspect, in such a way that it is not rare to do it even from the 35 years.
The procedure is usually performed under local anesthesia and sedation carried out by the anesthesiologist, for some rare the cases requires general anesthesia. The average duration of surgery is 3 to 5 hours depending on whether it is partial or complete.
In the case of high facial rejuvenation, scars are performed at or above the hair implantation line, either in coronal form or in the temporal region according to the indication, in special cases it is performed by minimum incisions in the scalp through which an endoscope (chamber) is inserted, being able to reposition the tissues and muscles of the forehead assisted by it, and in case it is required to use endotine, which is an internal device designed to control the fixation of the tissue at that level.
Moreover, in low rhytidectomy, incisions usually begin on the scalp at the level of the temporal region, then extend through the natural line just in front of the ear, border of the earlobe and reaching the posterior region of the auricle to finally conceal behind the line of hair implantation and through which a drainage is placed. Some cases require a small incision under the chin to work the neck.
Whatever the approach, the scars are practically invisible as they are hidden in the natural folds of the skin or the surrounding hair, and through them the removal of excess skin and fat, as well as also through internal sutures are tackled and reposition the facial muscles.
The patient is usually kept for 24 hours in hospital, or depending on whether it is only a high facial rejuvenation which could be handled as a short-term surgery, leaving the center once the residual effects of the anesthesia have passed, typically 3 -6 hours later.
The person should plan to stay in bed with the head elevated and as still as possible during the first days and then to rest relative. Always try to stay in semi-fowler’s position and avoid lowering the head, taking the prescribed drugs as directed. Eat according to tolerance and ingest abundant liquids.
We recommend the constant placement of cold dressings on the face to reduce inflammation and bruising, to make daily care on surgical wounds, to maintain proper dressing and drainage care, as the case may be, to avoid being exposed to the sun for approximately 8 weeks and suggest always use sunscreens for 3 months.
This period implies that the patient must maintain a bandage that will keep the face partially covered, to be removed along with the drainage between the 4th and 5th day after the procedure, at which time some sutures are removed. As needed, being re-evaluated 10 days after surgery to remove the rest of the sutures.
In the hands of a qualified surgeon it is unlikely that facial rejuvenation surgery will present complications, however any surgical procedure may present minimal risks and we should think of them as a possibility for how unpredictable these can be.
Complications may include hematomas, changes in the capillary implantation line, lesions of a nerve (usually temporary but may be permanent), alterations in scarring, infection, and even necrosis of the skin (especially in smokers).