Mini Facelift, Facelift, Neck Lift
Mini facelifts are targeted facial rejuvenation procedures.
They are perfect for those with sagging or excess skin and
fat in the neck, under the chin, or along the jawline. Ideal
candidates for the minifacelift have good skin elasticity
and mild to moderate sagging of the lower half of the face.
Those patients with more advanced sagging or poor skin elasticity
may wish to consider a full lower facelift or face/neck lift.
To achieve balanced results, the minifacelift is commonly
performed together with chin implants,
eyelid surgery, or fat
transfer.
While the jawline and neck typically begin to sag and show
jowls, double chins, and bands in the front of the neck between
35 and 45 years of age, the appropriate time to intervene
depends on the amount of aging change there is to reverse.
Operating too early is unwise, as there will likely be no
visible improvements after the surgery, and operating too
late, after health problems develop or marked aging changes
have occurred, sometimes limits the results that are obtainable.
In general, nonsmoking patients ranging from 40-70, in good
health, tend to be the best candidates.
Dr. Nayak performs the majority of his lower facelifting
procedurs in his in-office AAAHC-accredited operating suite
under local anesthesia or mild sedation. For patients who
would like to be more deeply sedated or fully asleep, Dr.
Nayak prefers Frontenac Surgery and Spine Care Center or St.
John’s Mercy Hospital.
The Consultation
During your consultation for facelift or neck lift surgery,
Dr. Nayak will ask you what about your middle and lower face
bothers you, and may also ask you to talk about other, related
areas of your face, such as your skin tone, facial hollowing,
neck fullness, or cheek position. Dr. Nayak will likely ask
you to point out, very specifically, what you’d like
to see changed. Identifying exactly what needs to be addressed
is the cornerstone of good results!
Dr. Nayak will then review your medical history form, and
may ask for some additional information from you. Current
and past smoking habits, or the use of nicotine gum or patch
products, are especially important to mention to Dr. Nayak
during this part of the consultation as nicotine dramatically
reduces the chances of proper healing. Dr. Nayak will also
pay special attention to parts of your medical history that
need to be considered carefully when undertaking face lifting
surgery, such as uncontrolled high blood pressure, or any
medications or supplements you may take that thin the blood.
In general, all over-the-counter pain/fever reducers (except
Tylenol) are off-limits for 2 weeks before and after facelift
surgery, as are ginkgo biloba, St. John’s Wort, or high
doses of fish oil, flax seed oil, or vitamin E.
The Physical Examination
Dr. Nayak will then examine your face to determine exactly
what must be corrected to achieve optimum results. Almost
all patients require lifting along the jawline to address
jowls; alone, this is accomplished readily by a “mini
facelift”. Many patients also have excess fullness or
sagging under the jawline and in the front of the neck; this
may require extra attention – a “submentoplasty”.
Some patients have extensive aging changes or a tendency toward
unpleasant skin wrinkling; these patients may require a “full
lower facelift”. In addition, some may desire improvements
of the eyelids, brows, chin, or earlobe areas to achieve balanced
results. Dr. Nayak will take a few moments to discuss these
options with you to make sure they meet your personal esthetic
goals.
The Preoperative Visit
Once you have decided to undergo lower face or neck lifting
surgery, Dr. Nayak’s staff will help you schedule your
surgical date, and, about 2 weeks preceding that, a preoperative
visit. Expect to spend about 90 minutes in the office on the
day of your preoperative visit. During this visit, you will
be educated on before instructions, after instructions, and
prescriptions. Written copies of all of these will be given
to you at this visit, as well, and you will be able to fill
your prescriptions ahead of time. You will also be reminded
at this time to avoid for 2 weeks before and after surgery
any medications and supplements that thin the blood.
Also at the preoperative visit, your private preoperative
photographs will be taken, the surgical consent form will
be read to you, and you will have an opportunity to discuss
with Dr. Nayak any questions you still have remaining. Finally,
at the conclusion of this visit, the balance of your surgical,
facility, and anesthesia fees will be due.
The Surgical Visit
In general, you will be asked to arrive at 7:30 AM the morning
of your planned surgery. If you are having your surgery at
an outside facility, you may be asked to arrive earlier. You
should have nothing to eat or drink (not even water, candy,
or gum) after midnight the night before your procedure. If
Dr. Nayak prescribed antibiotics, oral sedatives, or if you
take blood pressure medication in the mornings, you may take
these with a small sip of clear water.
You will need an adult driver on the day of your surgery
to bring you and to take you home. Your companion may wait
in our comfortable reception area, watching TV, reading, and
enjoying coffee, soda, and snacks. Alternatively, if your
companion wishes to leave a cellular telephone number, we
can call him or her with updates and also at the conclusion
of the procedure.
Upon your arrival, Dr. Nayak’s staff will greet you
and review your medical history, looking for any new changes
since your initial consultation. Dr. Nayak and his staff will
also confirm that they and you are in agreement about which
procedures are to be performed, and those areas will be marked
with you sitting upright in a chair. If you are a woman under
50 and have not been surgically sterilized, a urine pregnancy
test may be performed. In any case, you will have one last
opportunity to have last-minute questions answered and use
the restroom, and will be escorted to our AAAHC-accredited
surgical suite.
Once there, you will be positioned comfortably on your back,
with pillows behind your knees and under your neck. Blankets
are also available if needed. You may also bring your own
iPod or CD’s, or listen to our choice of soothing music.
Painless blood pressure and oxygen monitors will be placed
on your arm and finger, and massaging air-filled stockings
will be placed on your legs and thighs to encourage excellent
circulation while you are lying down. Most patients truly
enjoy these stockings and find them very soothing.
Dr. Nayak and his staff will then perform one final “time-out”
aloud to ensure they are about to embark on the appropriate
procedure on the appropriate patient. Your lower face will
then be slowly, gently numbed with local anesthesia, and sterile
towels will be placed around your face and neck.
By this time, most patients feel very relaxed. Once numb,
the majority of patients actually fall asleep intermittently.
Those who do not remain relaxed but awake, and Dr. Nayak and
his staff get the welcome opportunity to talk with you during
the procedure.
Through hidden, mini facelift incisions that are one-third
to one-half as long as traditional facelift incisions, Dr.
Nayak will lift and tighten the underlying muscular layer
and secure it in place. Once the muscle lift has been accomplished,
excess skin is tailored, and the incisions are meticulously
closed.
Your Recovery – Day 1
At the conclusion of your procedure, Dr. Nayak will tell
your companion how everything went, and he or she will have
the opportunity to see you. You will be mildly bruised and
swollen at this point, but neither will be visible due to
a fluffy cotton dressing that will be wrapped around your
forehead, cheeks, and under your chin. Your face, mouth, nose,
and eyes will not be covered by the dressing. If you have
had eyelid surgery, a thin layer of Vaseline may have been
applied to the eyelid area.
You will be asked to spend 1 hour with us prior to being
discharged. Dr. Nayak will call you the evening of the procedure
to check on your progress, and you will also be given Dr.
Nayak’s personal cellular phone number in case questions
should arise after hours or on the weekends.
Your Recovery – Week 1
Most patients feel no pain whatsoever immediately after surgery.
Many patients find they nap intermittently the first afternoon.
Later in the evening, most patients report a feeling of tightness
or soreness along the ears and jawline.
Most patients take their prescribed pain medication for 24-36
hours after the procedure, and then switch to Tylenol –
all other over-the-counter pain preparations are off-limits.
Many patients take Tylenol alone right from the start, while
a few require the prescription pain medication for 3-4 days.
On the day after surgery, you will need a ride back to Dr.
Nayak’s office, where he will remove your dressing and
examine your face to make sure you are healing properly. You
should bring a scarf with you that day to wear home.
You will be able to shower and get all sutures wet the first
day after surgery, as soon as you have your dressing removed.
You should refrain from wide mouth opening, heavy exercise,
or prolonged periods of looking down for the first week or
two. You will also be asked to use intermittent cold compresses
and sleep with your head elevated for the first few days.
On the 6th or 7th day after surgery, you will return to the
office for a painless suture removal visit. If you have significant
bruising remaining at this point, it may be treated with a
laser to hasten its disappearance. If sutures were used behind
your ears, they will be left in place to dissolve spontaneously
over the next week or so.
By the 7th day, you may wear makeup, and almost everyone
is “presentable” to run errands or go back to
work. Especially easy bruisers, or patients over 65, may require
another 2-3 days for most of the bruising to resolve. By 2-3
weeks, most people are “undetectable”. If you
are not self conscious about being seen with bruising or sutures
in place, or work from home, expect to be back to work within
3-4 days!
Your Recovery – Long Term
Over the ensuing weeks and months, you will find your incision
lines, hidden around your hairline and ears, become less and
less noticeable. They are generally mildly pink for a few
weeks, but easily covered with regular makeup. By 3-4 months,
the pinkness is generally gone.
While duration of results depends on lifestyle, genetics,
and ongoing skin care and sun protection, lower facelifts
are quite durable. It is not uncommon for results to last
5-7 years or even longer before touchups are required.
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