Rhytidectomy or Facelift

Facelift surgery is usually divided into two parts, lower face and necklift, and forehead and eyebrow lift. The procedure improves facial appearance by diminishing excessive wrinkling and over-stretched skin folds. By tightening the facial and neck skin and muscles, wrinkles can be smoothed and sagging reduced.

Incisions are made in the hair and around the ear, and scars are hidden for the most part in the hair or creases in front or back of the ear.

An eyebrow and forehead lift concentrates on the upper face, reducing the wrinkles caused by loss of muscle tone. Smoothing "worry lines" across the forehead and lifting drooping eyebrows can help erase the appearance of sadness and aging. Incisions are hidden in the hairline.

There are several types of browlifts that can be performed, here are several of them:

Coronal browlift:

This type of browlift usually yields the best results for women with sagging forehead skin. it is not usually recommended for men, because the procedure tends to raise the hairline, but can be used by men with stable hairlines. An incision is made behind the hairline, excess ski is removed, and the underlying muscles are tightened. In women and men with high hairlines, the incision is placed just within the hairline and oriented in such a fashion that hair follicles, when they regrow, camouflage the scar. This variation, which maintains or lowers the height of the hairline, is sometimes done on men who are not expected to have hair loss.

Direct browlift:

The direct browlift often is recommended for men who are likely to have hair loss. Incisions are made just within or above each eyebrow, and the underlying muscle is tightened and sutured to hold the eyebrows in the new position. This procedure only elevates the eyebrows themselves and does little to reduce laxness or wrinkles in the forehead skin.

Indirect browlift:

The indirect browlift, a variation of the direct browlift, is used when there are wrinkles above the eyebrows. Incisions are placed in the natural creases above each eyebrow, excess skin is removed, and the brow muscles are tightened. This allows some wrinkles to be reduced and provides a bit more lift.

Midforehead lift:

The midforehead lift may be appropriate for men who have an abundance of forehead creases. A cross between direct browlift and the coronal browlift, the technique involves a single incision made directly across the forehead, using natural creases to camouflage the scar. The midforehead lift allows more tightening of the skin and muscles than the eyebrow lift and enables the surgeon to tighten loose skin between the brows as well as on the sides.

Endoscopic browlift:

This new technique may be helpful for younger patients with deep wrinkles in the brow area who don't want a full incision. Several half-inch incisions are made in the scalp, through which a tiny video camera and other specially designed instruments are introduced. These are used to lift the skin and tighten the muscles. Tiny screws, electrocautery, or lasers may be used to secure the forehead in its new position. Afterwards, the patient wears a tight headband for several days to hold the skin in place while it heals. Because the endoscopic browlift does not permit the removal excess skin, it is advisable only for patients with good skin tone and a minimum of sagging. The technique is not yet in widespread use.

In coming years, if facial skin begins to sag again, a "tuck up" procedure is basically the same as the original one, but the recovery period is shorter. Improvement can be dramatic. The original surgery sets the stage for the second operation, and can provide a chance to achieve a high degree of improvement over the initial appearance of the patient.