Facial/Neck Rejuvenation (Facelift)

The older you get, the older you look (unless you're the rare exception). Gravity, exposure to the sun, harsh winds, the daily stress and strain, lack of proper exercise, over-eating, and age itself all take their toll. Look in the mirror, or at a recent photo of yourself, and-especially if you're over 40 or 50-you may well see a jaw that's grown slack, more than one chin, a sagging neck, and/or unsightly creases between your nose and mouth.

Although no one can stop the aging process, Dr Kapoor provides several options for rejuvenation of the aging face. He is one of the few cosmetic surgeons in Southern California proficient in the SMAS-platysma bidirectional face list which gives a more natural, longer-lasting result than the standard skin only facelift. He can make you look younger and feel more confident about your appearance, by performing a facelift (also known as a rhytidectomy) to rejuvenate your face and neck. This popular procedure removes excess fat, tightens the muscles just below your skin, and reshapes the skin of your face and neck so it no longer sags.

A facelift can be done by itself or in conjunction with eyelid (blepharoplasty) and eyebrow surgery (brow lift or forehead lift).

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Q. Who are the best candidates?

A. They are the men and women whose skin is still somewhat elastic and who have a strong, well-defined bone structure, but their face and neck have started to sag. Most people who opt for a facelift are between 40 and 60 years of age, although many older men and women have facelifts, too. That's because it can make you look younger and more alive. It can uplift your spirits as well as your face. And it can cause you to smile instead of hide when a friend or relative wants to take your picture.

Q. What are the risks?

A. Complications are few and far between when a facelift is performed by a highly qualified cosmetic surgeon like Dr. Kapoor. However, they might occur due to the patient's physical condition, healing ability (e.g., smoking is detrimental to healing), uncontrolled high blood pressure, blood clotting problems, or other factors. Despite the utmost care during surgery, it's sometimes possible to temporarily injure the motor nerves controlling facial muscles. Infections are rare. The patient may react poorly to the anesthesia. Hematoma which is bleeding under the facial skin, is the most common complication, and occurs 3-5% of the time. Although millions of people have had successful facelifts, results cannot be guaranteed.

Q. What's the first step?

A. A consultation at Dr. Kapoor's office. You'll be asked what you'd like a facelift to accomplish, what parts of your face or neck you'd like improved, whether you're a smoker, and what medications, vitamins or recreational drugs you're taking (if any). During your visit, the doctor will evaluate your face and neck, including the skin and bone structure. If you've ever had any surgery or medical problems, or bad reactions to drugs or anesthesia, he'll want to know about it. Then he'll explain what can and can't be accomplished with a facelift, and what is realistic.

Q. Where will the surgery be performed?

A. Depending on what's to be done and how extensive it is, Dr. Kapoor will perform the surgery at a Beverly Hills surgical center or in one of the hospitals he's affiliated with in Los Angeles. It's usually done on an outpatient basis, although you may be hospitalized for a day or so if general anesthesia is administered, or if you have a medical condition (e.g., high blood pressure or diabetes) and must be closely monitored after the surgery.

Q. What happens during surgery?

A. A local anesthesia will be administered, along with a sedative to make you drowsy. You'll be awake, relaxed, and you won't feel any pain, although you may feel occasional discomfort and some tugging as your skin is lifted. However, if general anesthesia is administered, you'll be asleep during the entire procedure, waking up in the recovery room.

Depending on what's to be done, its extent, and any special circumstances, a typical facelift takes from three to five hours. For a facelift, the first incision is usually at the temple, above or at the hairline, and extended in a natural line-in front of the ear or inside the cartilage at the front of the ear. This incision continues behind the earlobe to the lower scalp. If you're having chin work, a small incision is made there, too. Next, the skin is carefully separated from the underlying muscle and fat. To improve the contour, fat may be trimmed or suctioned from the chin and neck area. Then the underlying muscle and deeper tissues (SMAS, Platysma) are tightened, the skin is put back in place, and any excess skin is cut away.

To secure the layers of tissue and to close the incisions, stitches are used, while metal clips may be used on the scalp. Bandages may also be loosely wrapped around your head, to minimize swelling and protect against bruising. Finally, to drain any blood that may collect there, a small narrow tube may be placed under the skin behind the ear.

Q. What happens after surgery?

A. After resting in the recovery room, have someone drive you home and, if possible, assist you there for a day or two. Usually, there will be minor discomfort, which can be controlled with the pain medication prescribed. If, however, you experience severe or continuous pain, or your face suddenly swells up, report it immediately. Minor numbness of the skin is to be expected, and should go away in a few weeks or months.

For a few days after your surgery, keep your head elevated and as still as possible. One or two days after surgery, if a drainage tube was inserted, your doctor should remove it. One to five days after surgery, any bandages can usually be removed. Your face will look pale, bruised and puffy, but in a few weeks you'll appear normal. After about seven to ten days, most of your stitches will be removed.

Q. Then what?

A. Take it easy for the first week after surgery. Move around your home after a day or two of bed rest, but be gentle when washing-or even just touching-your face and hair. At first, your skin will be tender and numb, and the slightest touch may be painful, but gradually it will recover. Your face will feel and look bruised for two to three weeks, you may feel tired most of the time, and you may even be depressed. To avoid a relapse, during the first two or three weeks you should avoid strenuous activity, sex, and heavy housework. For several weeks, avoid steam baths, saunas, and alcohol. Around the third week, things should improve. You'll start to look better and feel better, and you'll start to see the positive changes in your appearance.

If you work outside the home, you may feel well enough to return to work (if it's not strenuous) 10 to 14 days after surgery. Makeup can cover most of the remaining bruises. Yes, you'll have some scars, but they can usually be hidden by your hair (if long enough) or in the natural creases of your face and ears. In time, they'll fade and be almost invisible.

Undoubtedly, many of the people you see every day-in person, on movie and TV screens, or on magazine covers-have had facelifts. They look and feel years younger. Why not join the crowd?