Face lift, mid and lower face lift

A facelift is also known as a rhytidectomy.

Time and gravity can alter our facial symmetry to distort our looks and make us appear older. As aging skin loses its tone and elasticity, more wrinkles, creases and sagging skin appear.

Of all the cosmetic surgical procedures that Dr. Chartchai does, the facelift is possibly the one procedure his patients want most yet are most anxious about.

For Dr. Chartchai a natural, refreshed look is preferable to the old-fashioned "windswept" or
"wind tunnel" look of a too-tightly pulled lift.

As a result, Dr. Chartchai's patients are extremely pleased with the outcomes of their facial plastic surgery. When they see their new "look" post-surgery, they see firmer, toned, and refreshed faces that have been subtly "adjusted" with as little noticeable scarring as possible. This is extremely important especially for older men who have very little hair with which to hide any scars that might show.

Women and men in their mid 40s to mid 50s, at a time when the signs of aging begin to show in the face, may be the best candidates for partial facelifts. When they reach the mid 50s to mid 60s, they are more likely candidates for full facelifts.

As facial cosmetic surgery is "superficial", with only a minimal amount of blood loss, no entry into body cavities, and no strict confinement to bed rest after surgery, almost everyone who doesn't have serious health problems can have facial surgery.

What do you want to change?
When you are dissatisfied about your facial appearance and structure, you poke here and there, pull your skin up behind your ears or into your hairline. Dr. Chartchai will also do this during his examination of you to help you determine what you most dislike, what you want improved, and how to do this for you with the most naturally looking results. This may be a full facelift, a partial facelift, or other surgery that will correct your nose, your drooping or baggy eyelids, or a too-weak or too-strong jaw.

There are 4 main areas of the face where the sagging effects of aging are most apparent, in the forehead, in the temporal and cheek area, in the lower jaw, and in the neck. With aging, facial fat either descends or goes away, or a combination of both, and muscle tissue may lose mass and laxity.

Depending on the extent of this movement or reduction of fat and tissue and the sagging of your skin, Dr. Chartchai will consider what will give you the best and most natural looking outcome from your surgery. He will determine during the consultation whether a full facelift is best, or whether the results you want can be achieved by doing a partial facelift.

• Mid-face lift
  Also called a temporal lift or cheek lift
  In the temple region, droopy skin particularly of the upper eyelids can be so significant it can interfere with a person's vision. Most people accept the crow's feet that appear when they smile as long as they are minimal.
  A mid-face lift will elevate some of this descended temple fat as well as smooth out your wrinkles. Wrinkles that appear with smiling will not be eliminated but will be less severe. A combination of brow lift [link to brow lift] and/or lower blepharoplasty [link to eyelid surgery] may be necessary to treat significant crow's feet.
  In the cheeks, as facial fat and muscle tissue disappears or decreases, it bunches up just above the nasal-labial crease giving the typical appearance of a fallen face. During a facelift, or the mid-face lift, Dr. Chartchai will choose the best of several techniques to reposition the underlying tissue upward.
  
• Lower face lift
  A fleshy, sagging neckline may be due to jowling and fatty deposits below the chin or excess drooping of skin. Dr. Chartchai may determine that simply removing the excess, or a bit of liposuction may be all that's necessary. Or he may advise that a neck lift [link to neck lift] is the procedure best able to fix your problems. In order to tighten prominent bands or cords in the neck and restore a younger, chiseled look to your neck and chin line, surgery will be required.
  
• The underlying facial skeleton has a significant effect on facial appearance as well as eyelid position. Bone modification can be performed by cheek implants or a chin implant to create a stronger or more balanced jaw, or by careful shaving of the jaw bone to ease an overly sharply defined jaw. For some people, nose surgery will create a more balanced appearance to the face.

Procedure
The face is divided into 3 parts for surgical diagnosis: forehead, temporal region and cheeks, and neck. If you are having a full facelift, incisions are made in the hairline and in the creases in front of the earlobe and at the back of the ear. Dr. Chartchai will place incisions inside the ear if possible, and in all ways work to minimize visible scarring.

The surgery, using local or general anesthesia, can take 2-5 hours to perform depending on the extent of the work involved.

Recovery time
To minimize swelling, you will be given cold packs for the first day while you keep your head elevated. Drains may be used to take away excess fluids and to promote healing.

Swelling will subside in 2-3 weeks to nearly normal and in 3-6 months it should be gone. Total healing takes about a year. You will need about 2 weeks away from work for this procedure. About 3 weeks after surgery, you may resume normal activities. Avoid sun exposure for several months post surgery.

Possible complications
There may be some bleeding in the first 24 hours which may take a few weeks to dissipate. Minimal bruising, a common complication, will take many weeks to finally dissipate. For most of this time, concealing makeup will be sufficient to cover all evidence of bruising.

During surgery, one or more of the nerves that control facial muscles may be injured; if they are bruised, the symptoms should subside in 3-12 months. Sensory nerves in the area of the ear may be cut and some numbness may occur there.

Some collected bleeding may occur in the first 24 hours. During surgery, the motor facial nerves may be injured, but this should be extremely minimal in an experienced professional hand.

After a combination facelift and neck lift, it takes up to 3 weeks to look near normal, 3-6 months for all swelling to subside, and a year until the face and neck are completely healed. Vigorous activity and work should be avoided for the first 2 weeks. Exposure to the sun should be limited for the first few months.