A facelift (also known as a rhytidectomy) is a facial rejuvenation procedure that typically includes a temporal lift (lateral brow lift), cheek lift (midface and jowl lift) and/or neck lift. In the same operation, the temporal lift may also be extended to a medial brow lift if the patient has more advanced brow drooping. Dr. Velargo frequently performs several procedures in the same operation for comprehensive rejuvenation and a shared recovery period.
While all lifts that he performs include addressing the deeper facial structures, he can perform “mini-lifts” where only one or two of the main rhytidectomy components are surgically addressed. Mini-lifts are a great option for patients who have moderate aging on the cheek and neck areas only.
Dr. Velargo also performs the Renaissance Lift™, which is an advanced technique that combines facelift surgery with nano-fat grafting and skin resurfacing to fully restore a youthful facial appearance.
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What Can a Rhytidectomy Accomplish?
A rhytidectomy is a powerful surgical technique for facial rejuvenation. This procedure can accomplish the following:
- Correct drooping brows to create a youthful, refreshed appearance
- Lift “sunken” cheeks and sagging skin in the midface
- Eliminate jowls to create a tighter jawline
- Trim loose skin in the neck and “turkey neck” deformities to create a slim neck silhouette
Since facelifts do not address the eye area, many patients have a blepharoplasty (eyelid lift) performed at the same time. Dr. Velargo will assess your face during your consultation to determine the best treatment plan to meet your needs.
Your Facelift Experience at our New Orleans Office
Rhytidectomy is an outpatient procedure, and Dr. Velargo will discuss options regarding anesthesia with you during the consultation. Your sense of comfort and medical history are the most important factors in making this decision. The surgery can be performed at our New Orleans office-based procedure room under oral sedation with laughing gas and local anesthesia only, or in an outpatient surgical facility with conscious sedation or general anesthesia.
Facelift surgery begins with incisions made either inside the hairline and/or behind the ear for optimal camouflage. Dr. Velargo takes great care to make the incisions as short as possible and in areas that naturally conceal the resultant scars.
After the incisions have been made, Dr. Velargo tightens and secures the underlying SMAS (superficial musculoaponeurotic system) and facial muscles and then removes any remaining loose, sagging skin. Dr. Velargo prefers to perform a modified deep plane facelift (going deep to the SMAS and then lifting this layer) as well as a deep plane neck lift (going deep to the platysma muscle and then lifting the neck tissues) for most cases. This specific technique produces long-lasting, natural-looking results that allow patients to look naturally refreshed rather than overcorrected.
Dr. Velargo can incorporate liposculpture (liposuction and direct fat excision) as needed into any facelift and necklift procedure.
In addition, Dr. Velargo can incorporate nano-fat grafting into any facelift procedure, particularly in cases where the skin quality, tone, and texture can be improved as well as in cases where there is moderate volume deficiency.
What Happens During a Face Lift?
While rhytidectomy is an outpatient procedure, Dr. Velargo will discuss options regarding anesthesia with you. Your sense of comfort and medical history are the most important factors in making this decision. The procedure can be performed in his office-based procedure room under oral sedation with local anesthesia only, or it can be performed in an outpatient surgical facility in the community with conscious sedation or general anesthesia.
Dr. Velargo’s training and experience includes a variety of facelifting methods that are customized for your needs, but he always tries to make the shortest possible incisions in hidden areas. Face lift incisions are often made inside the hairline and/or behind the ear for optimal camouflage.
In a facelift, Dr. Velargo tightens and secures the underlying SMAS (superficial musculoaponeurotic system) and facial muscles for strength and then removes any remaining loose, sagging skin. It is this technique that allows for face lift durability, as well as a natural-appearing result since it is not the skin that is being stretched for stability.
Additionally, the vector that Dr. Velargo secures the SMAS and re-drapes the skin and soft tissue of the face ensures that the patient will receive a natural-appearing face LIFT and not and a wind-blown-appearing face PULL.
Dr. Velargo incorporates liposculpture (liposuction and direct fat excision) into nearly every face and neck lift. He feels that a better jaw and neck line can be created by artistically sculpting these areas.
Renaissance Lift: A Powerful Facial Rejuvenation Combination
When rhytidectomy surgery and skin resurfacing are performed in the same surgical setting, Dr. Velargo is able to address all aspects of facial aging at the same time – sags and bulges, volume loss, and wrinkles. He refers to this procedure as the Renaissance Lift™ because it provides dramatic results and is essentially “the rebirth of you.”
Combining the best aspects of facelifting and facial rejuvenation observed throughout his training, Dr. Velargo developed and trademarked this unique procedure. Particular attention is paid to the neckline, where long-lasting results are obtained utilizing the “SMMS technique” published by Dr. Velargo et. al. in the Aesthetic Surgery Journal in 2013 or other advanced techniques that specifically address the platymsa muscle such as platysmaplasty, platysma transection, or a lateral platysma sling.
The Renaissance Lift also usually incorporates placement of nano-fat to the face. This is often accomplished by harvesting fat from the body (usually the lateral thigh) and then serially emulsifying the fat down to stem cells, growth factors, and collagen scaffolding. This creates better skin quality as well as adds a conservative amount of volume to areas of placement.
Because the Renaissance Lift™ comprehensively addresses all aspects of facial aging during the same surgical setting, there are tremendous benefits – one healing period, more natural and balanced results, and economic advantages as well. No one Renaissance Lift™ is performed in the same manner from one patient to another because Dr. Velargo embraces the unique attributes of each patient.
Dr. Velargo encourages you to schedule a consultation to find out if the Renaissance Lift™ is right for you. View Dr. Velargo’s photo gallery for before-and-after photos of prior patients who’ve undergone this cutting-edge procedure.
Your Complete Facelift Recovery Guide
First 2 Weeks After Surgery
You will feel some tightness when the anesthetic wears off after your facelift surgery. A head wrap will be placed following the procedure and is left in place until the next morning. Pain will be minimal, but the constrictive nature of the head wrap may be uncomfortable to some patients. However, most of our patients find this very tolerable.
Swelling, bruising, and soreness are to be expected after a rhytidectomy, but post-operative instructions and recommended medications will be given to ease any discomfort. It’s common to also experience temporary swelling, lumpiness, and discoloration. Though somewhat visually disconcerting, most people feel it is a negligible inconvenience to pay for the physical and psychological improvement they experience after a facelift.
The head wrap system that Dr. Velargo uses also has integrated ice packs specifically designed to contour to your face. Frequent application of these cool compresses for the first 72 hours helps to speed the healing process along. Dr. Velargo gives every facelift patient several days worth of Ocumend pads (contain 50 x the concentration of Arnica Montana than over the counter preparations as well as Ledum palustre), which drastically reduces the amount of bruising as well as the length of bruising following your procedure.
With some make-up, your hair worn down, a neck scarf (which Dr. Velargo will provide you with), and thick-rimmed sunglasses, you should be able to go out in public within a few days with minimal attention drawn to yourself. Most patients take 2 weeks off from work after a rhytidectomy.
Lumps and bumps may be present in the initial phases of healing. These usually go away with time, but we can often speed the healing process with local injections of steroids.
Incisions should be cared for around 4 times per day by cleansing the incision lines with hydrogen peroxide and applying bacitracin ointment. For dark-haired individuals, Dr. Velargo recommends cleansing the incisions with witch hazel to avoid bleaching the hair with hydrogen peroxide.
All sutures and staples are removed at one week except a tiny blue stitch at the corner of each earlobe. This stitch is kept in place for a total of 2 weeks to prevent accidental pulling of the earlobe in the initial healing phase.
You must avoid turning the head or stretching the neck for 2 weeks. When you turn, move the shoulders and head as one unit or as though you had a stiff neck. This is important to prevent stretching the healing incisions and causing the scars to widen, as well as to prevent putting tension on the deep sutures beneath the skin, which could cause them to loosen. Because of this risk, we advise patients to not drive for 2 weeks following surgery.
In order to minimize swelling, you are advised to sleep with the head of your bed elevated or in a recliner for 2-4 weeks post-op. The most common cause of post-op pain is not from the surgery itself, but from improper posture while sleeping on your back. The hips, back, and head should be in a straight line whenever you are lying down.
2 – 4 Weeks After Surgery
Parts of the face, neck, ears, and scalp might still feel weak or numb after the facelift operation. This is to be expected and is usually temporary. It may take several weeks or, and on rare occasions, months for this to subside. The top of the head may itch or exhibit numbness for 6-12 months.
The facial skin may feel tight for a while, and you may feel that it interferes with normal facial expressions. This should disappear within a few weeks when swelling subsides.
There may be thinning of the hair in areas adjacent to the suture lines at the temple or forehead/scalp and behind the ear. This usually occurs because the trauma of surgery “shocks” the hair follicles. It can sometimes be avoided by closely adhering to the instructions about shampooing and cleaning the suture lines, and the hair generally re-grows over time. The incisions are designed in such a manner that the hair in the temporal area and post-auricular area should grow right through the scars. Should a problem arise, we will advise you on any additional treatments.
After all stitches and/or clips have been removed, the scars will appear deep pink in color. There will be varying amounts of swelling in and around the scars themselves. With the passage of time, the pink should become white, the firmness of the scar should soften, and they should become less noticeable. It takes approximately one year for these changes to occur and for scars to fully mature.
As a rule, 80% of swelling is gone in 2 weeks, and 90% of swelling is generally gone by 2 months. So, do not evaluate the results of your surgery too soon. While you will look younger right away, facelifts continue to show subtle refinement for a significant period of time.