As we age, a number of facial features change. Our facial skin and facial muscles become loose and saggy.

Our foreheads descend. Eyelids develop loose skin and bags grow down and become longer and wider.

Noses continue to grow. The nose may develop a bump. Skin not only loosens but becomes more coarse and develops wrinkles. The neck droops, perhaps accentuating the appearance of an already deficient chin. In facial rejuvenative operations, some or all of these age-related deformities may be addressed.

Face Lift

The so-called "face lift" (medically known as rhytidectomy) involves incisions connected from the temple region, around the ears in natural creases and extending into or adjacent to the back of the hairline. The skin is lifted partially from the underlying tissues. Underlying tissues may be brought upwards and closed meticulously to ensure optimum healing. Most patients wear dressings only overnight. Sutures are removed between the fourth and tenth post-operative day.

Forehead Lift

With age, most peoples' brows tend to descend. They develop one or two vertical wrinkles in the lower forehead between the brows. A forehead lift will improve this condition by one of two methods. It can be done "open" (coronal incision) through an incision from temple to temple (a continuation of the face lift incision) either within or immediately in front of the hairline. It can also be done through several smaller incisions with the use of an endoscope, a telescope-periscope like instrument introduced under the tissues, providing a lens through which the surgeon sees the image on a television screen. Which way is better? It depends on the opinion and preference of the surgeon.

Eyelid Lift (Blepharoplasty)

The aging eyelid develops loose skin and fatty protrusions ("bags"). Incisions in the upper eyelid crease and in the lower lid immediately below the lashes or inside the lower lid, permit the plastic surgeon to remove the fatty bags. Excess upper lid skin can be removed. If the lower lid incision is made on the skin, excess skin can be removed. If the incision is made inside the lower lid, the skin can be shrunk by resurfacing (see below).

Nose Operation (Rhinoplasty)

The nose, enlarged by age, can be reduced through invisible, inside the nose incisions. The full tip can be reduced by removing excess tip cartilage. It can be raised, if it droops. The hump can be reduced by rasping. If the nose has become too wide, it can be narrowed by dividing and moving in the divided nose bones ("infracturing").

Chin Rebuilding (Augmentation Mentoplasty)

Through the under chin crease or immediately near it, a pocket can be created to allow insertion of an inert plastic implant to build out a receding chin and help improve a drooping neck.

Skin Resurfacing

The wrinkles that occur with age, particularly those that occur on the upper and lower lips of women, can be improved by resurfacing . There are three basic methods of resurfacing: 1) Chemical peel, 2) Dermabrasion ("sandpaper surgery") and 3) Laser Treatment. Plastic surgeons have different opinions about which method is better. Most believe that it is all right to resurface the lips which have not been lifted in a face lift, and will resurface the rest of the face two to three months after a face lift.

General

Following most of these operations, most patients are remarkably comfortable and can be up and walking in one or two days. Most patients can face the public within two weeks or less following these operations, whether they had one or several procedures. These operations can be done singly or all at one time There are two advantages to doing multiple procedures at one time: 1) The time for recovery, facing the public, and going back to work is about the same whether one or several procedures have been done, 2) most plastic surgeons charge less per procedure when they are all done together than if they are done one by one.

Depending on the length of time involved, these operations can be done under local (dental-type) anesthesia or general (fully asleep) anesthesia. Some of these operations are permanent or semi-permanent (nose, chin eyelids, forehead). A Face lift is not permanent. It just set's back but does not stop the aging clock. To maintain the results for as long as possible, it usually takes two or three lifts done at increasingly wider intervals to stay looking the same over many years.

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