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Face Lift & Blepharoplasty

ArticleHuman Interest
Skin Care
Surgical Procedures
Contributed byKrish Tangella MD, MBAMay 07, 2018

Background Information:

What are the other Names for the Procedure?

  • Cosmetic Surgery of the Face
  • Rhytidectomy

What is Face Lift & Blepharoplasty surgical procedure?

  • A Face Lift is a surgical procedure that involves the removal of skin, fat, and tissue, from the face, in order to give a youthful appearance
  • The objective of this procedure is to tighten loose skin and remove wrinkles, sagging cheeks, or a double chin
  • Blepharoplasty is a procedure that involves the removal of excess fat and skin surrounding the eyelids, which can decrease the wrinkles and baggy appearance, from under the eyes

What part of the Body does the Procedure involve?

A Face Lift (and Blepharoplasty) procedure involves the skin and surrounding tissues of the face and eyelids.

Why is the Face Lift & Blepharoplasty surgical procedure Performed?

A Face Lift procedure is performed for the following reasons:

  • To decrease the signs of aging in the face
  • If there is a mid-face sagging (appearance)
  • Presence of deep wrinkles in the face
  • Presence of deep creases below the eyelids
  • A Blepharoplasty is performed for the following reasons:
  • Improve visual appearance and eyelid function
  • To rectify defects, deformities, disfiguration, of the eyelids
  • To modify eyelids
  • A Face Lift surgery is typically performed in conjunction with eyelid and brow lift surgery, to rejuvenate the appearance of the face.

What are some Alternative Choices for the Procedure?

Some of the alternative techniques used include:

  • Thread lift: In this technique, a threaded needle is used to lift the face
  • Thermage: This technique uses radiofrequency energy to heat the skin's collagen. Due to this the existing collagen gets tightened and it also stimulates the production of new collagen, which results in a smooth skin
  • Facial injectables, which include Botox, Dysport, and Xeomin, that paralyze wrinkle-producing muscles
  • Facial fillers, such as Juvederm and Restylane can add volume to sunken cheeks and minimize facial folds
  • Superficial skin care treatments, like laser skin resurfacing, micro dermabrasion, and laser hair removal
  • However, these techniques provide temporary results only and cannot address severe sagging of the face.

What are the Recent Advances in the Procedure?

  • The use of various novel techniques have been some of the recent advances
  • Stem cell facelift: It involves the removal of fat cells from other locations in the body, processing them and re-injecting them into the face, to generate new skin cells

What is the Cost of performing the Face Lift & Blepharoplasty surgical procedure?

The cost of Face Lift and Blepharoplasty procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused by the information regarding a Face Lift and Blepharoplasty procedure and on what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
  • They can also choose to approach another physician independently. Besides, if the procedure has many alternatives, the patient may take a second opinion to understand and choose the best one

What are some Helpful Resources?

Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006

Prior to Face Lift & Blepharoplasty surgical procedure:

How is the Face Lift & Blepharoplasty surgical procedure Performed?

  • An incision is made in front of the ear extending from the hairline above, curving around the bottom of the ear, and then up to the hairline on the back of the neck
  • The skin is separated from the deeper tissues
  • The excess deeper tissues and skin are excised
  • The deeper tissues are then tightened with sutures
  • Skin incision is closed with sutures

Where is the Procedure Performed?

A Face Lift and Blepharoplasty procedure is usually performed in an out-patient surgery center facility and normally the person can go home once the procedure is completed.

Who Performs the Procedure?

A Face Lift and Blepharoplasty procedure is performed by any of these medical personnel, with assistance from an anesthesiologist:

  • Plastic surgeon
  • Reconstructive surgeon

How long will the Procedure take?

The procedure usually takes several hours to perform. The individuals can go home the same day.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the surgical procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
  • A physician will request your consent for a Face Lift and Blepharoplasty procedure using an Informed Consent Form.

What is the Consent Process before the Procedure?

A physician will request your consent for the Face Lift and Blepharoplasty procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Face Lift & Blepharoplasty surgical procedure?

Before a Face Lift and Blepharoplasty procedure, the patient has to undergo certain tests such as:

  • Routine blood and urine analysis
  • The physician may suggest further tests depending on the health of the patient and their medical history.

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is a Face Lift and Blepharoplasty procedure?
  • Why is this procedure necessary?  How will it help?
  • How soon should I get it done?
  • What are the alternatives to the procedure?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed? 
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • What are the costs involved?

During the Face Lift & Blepharoplasty surgical procedure:

What kind of Anesthesia is given, during the Procedure?

The procedure is commonly performed under general anesthesia. But, it can also be done under deep sedation and local anesthesia.

How much Blood will you lose, during the Procedure?

Since Face Lift and Blepharoplasty is a less invasive procedure, the blood loss is generally minimal.

What are the possible Risks and Complications during the Face Lift & Blepharoplasty surgical procedure?

There are general factors that increase the risk of complications during the procedure, which include:

  • Obesity: Generally greater the degree of obesity, greater is the surgical risk
  • Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk 
  • Advancing age
  • Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
  • Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
  • Poorly functioning liver, as evidenced by increased blood liver function tests
  • Hypertension (increased blood pressure), especially if it is poorly controlled
  • Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
  • Poor lung function, as evidenced by abnormal lung function tests
  • History of bleeding disorders
  • Longstanding illness, such as autoimmune disorders, chronic infections
  • Poor immune system due to a variety of causes

The possible risks or complications that may arise during the surgery are:

  • Excessive bleeding
  • Formation of blood clots
  • Collection of blood under the skin, at the site of the procedure (hematoma)
  • Accidental injury to the facial nerves
  • Irregular scarring of facial muscles
  • Anesthetic complications
  • Accidental injury to the neighboring tissues

What Post-Operative Care is needed at the Healthcare Facility after the Face Lift & Blepharoplasty surgical procedure?

At the healthcare facility, generally there is no requirement for any post-procedure care, unless any complications arise.

After the Face Lift & Blepharoplasty surgical procedure:

What are the possible Risks and Complications after the Face Lift & Blepharoplasty surgical procedure?

The possible risks and complications that may arise after a Face Lift & Blepharoplasty procedure are:

  • Infection in the surgical wound
  • Paralysis of the face
  • Spasm in the face
  • Hair loss, adjacent to the ear
  • Numbness of the skin
  • Swelling of the face
  • Bruising of the face
  • Facial stiffness (usually temporary)

What is the Prognosis after the Surgery?

  • The effectiveness and the outcome of the procedure, depends on the surgeon’s skill and expertise
  • A Face Lift and Blepharoplasty procedure makes the face appear younger and healthier by tightening the skin, lifting the sagging tissues, and eliminating wrinkles
  • The technique may not be able to remove all wrinkles around the eyes and lips

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

  • Worsening pain and swelling around the surgical wound
  • Bleeding or fluid drainage from the surgical wound
  • The occurrence of any symptom that causes uneasiness, such as nausea and vomiting
  • Signs of infection
  • Fever
  • Dizziness
  • Muscle aches
  • Fever
  • Feeling sick
  • Changes in vision
  • Complications associated with prescription medications used for the treatment

What Post-Operative Care is needed at Home after Face Lift & Blepharoplasty surgical procedure?

At home, the following post-operative care is recommended, after a Face Lift and Blepharoplasty procedure:

  • Avoid all physical activities for up to 3 weeks after the surgery
  • Dressing changes must be done, as recommended by the physician
  • Resume showering, only after your physician’s advice
  • At night while sleeping, keep your head elevated using 2 pillows, in order to reduce swelling
  • Complete the course of prescribed medication (under advice of the physician)
  • Use ointment or topical medications, only if prescribed by your physician
  • Avoid taking nonprescription medications, such as aspirin. However, individuals may take acetaminophen, to relieve pain, if necessary
  • Resume driving 3-7 days after surgery, or follow the physician’s advise

How long does it normally take to fully recover, from the Procedure?

It takes about 4 to 6 weeks to fully recover from the procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The procedure usually does not involve the surgical removal of any tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient

Who will you receive a Bill from, after the Face Lift & Blepharoplasty surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The outpatient facility, physician’s office or hospital
  • An anesthesiologist (if anesthesia was administered)
  • An plastic surgeon or a reconstructive surgeon

The patient is advised to inquire and confirm the type of billing, before the Face Lift and Blepharoplasty procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

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