Swayed by the high esteem in which youthful minds and youthful bodies are held these days, many people are turning to cosmetic surgery to smooth their furrowed brows and lift their sagging jowls. Although face lifts were first performed in Europe and the United States at the turn of the century, the process remained cloaked in secrecy, deemed unrespectable because it catered to vanity and often fostered quackery. Today, this difficult and complex surgery is considered an art, for the surgeon must not only solve the problem of wrinkles but restore the face without changing its character in the process. In short, the procedure, technically known as a rhytidoplasty or rhytidectomy, is this: a surgeon incises and detaches the skin of the face and neck, lifts and tightens the skin, trims off the excess skin, and closes the incisions.
A face lift involves surgery that requires the patient to spend three or four days in a hospital—and to have a minimum of several thousand dollars set aside for surgical fees. Perhaps because of the infinite variety of faces, there is no rigid standardization of methods. Either local or general anesthesia may be administered, and the operation usually takes about two and a half to four hours.
The surgeon begins the incision in the area of the temples, in the hair-bearing scalp where the subsequent scar will be concealed. The incision runs down to the point where the ear is attached, continues just in front of the ear, then curves around the earlobe to the back of the ear. The incision then moves into a strip of scalp on the neck hairline which has been trimmed or shaved, the precise location depending on the hair style of the patient. (Resulting scars are ideally hidden by the hair.) Then the surgeon begins the incredibly delicate process of undermining, or separating the skin from the fat and muscle lying beneath it, being careful not to disturb nerves and blood vessels. In the hair area he must go particularly deep so as not to destroy the hair follicles. In general, he undermines the cheeks and the portion of the neck behind the ears, but the actual amount required naturally depends on the location of the sagging skin and the amount of “lifting” to be done. Next, he may or may not need to shift and tighten the tissues under the skin.
To actually “lift” the face, the surgeon pulls the loosened skin upward and backward, thus tightening the skin and smoothing away the patient’s unwanted signs of age. Great care must be taken not to pull the skin too tightly, or to remove too much skin, for the patient might be left with a drawn or frozen expression. The surgeon tailors the skin to fit the face, makes anchor sutures above and behind the ear, and trims excess skin. Finally, he sutures the incision and proceeds to work on the other side of the face. Operating on one side at a time makes it easier for the surgeon to make the two sides as symmetrical as possible—decidedly an important factor!
If the patient wishes to be rid of an especially large double chin, the surgeon performs a submental lipectomy: he makes a transverse incision under the chin and removes superfluous skin and fat.
After a face lift the patient’s head in encased in a massive bandage, which supports the tissues and helps prevent bleeding. Drains in the bandage may be necessary to draw seepage away from the wounds. After twenty-four to forty-eight hours the cocoon is removed and a new face revealed.
From: How Do They Do That? By Caroline Sutton