American Medical Association Family Medical Guide - American Medical Association [775]
After Surgery
A facelift produces little pain or discomfort. After you go home, keep your head elevated to minimize swelling. You can be up and about in a couple of days, but you should not return to work for 10 days to 2 weeks. It may be 2 to 6 weeks before you can engage in strenuous activity. Bruising, stiffness, and puffiness are normal during the first few weeks, and your face may feel tight. The stitches are taken out after about 5 days.
The most common risks of facelift surgery are bleeding, infection, and facial scarring. Some people also experience unwanted hairline changes or feel that the new appearance of their face lacks symmetry. Occasionally, some of the nerves that serve muscles in the face are injured during surgery, resulting in numbness or weakness, which is usually temporary.
Facelift
During a facelift, the surgeon makes incisions above the hairline (where they can be concealed) starting at the temples and extending down in front of and behind the ear to the lower scalp (top). The surgeon first separates the skin from the underlying fat and muscle (center). Then the surgeon tightens the muscles and deeper connective tissues, draws the skin back tight, and trims off the excess skin. The incisions are closed with stitches (bottom).
The firming effects of a facelift usually last from 5 to 10 years. Men may notice that they have to shave in new places, such as behind the ears, where beard-growing skin has been repositioned.
Facial Implants
Facial implants are used to reshape the face. Implants are commonly used in the chin, cheeks, lips, or jaw to remedy such features as a receding chin or sunken cheekbones, or to balance the proportions of the lower face. Facial implants come in a variety of sizes and shapes, and most are made of silicone. Once inserted, facial implants are usually permanent. Frequently, facial implantation is combined with other cosmetic surgery procedures to achieve better results.
The Procedure
Facial implantation is an outpatient procedure using either a local anesthetic or general anesthesia, depending on the implant. In any type of implant surgery, the surgeon makes a small incision near the desired location, forms a pocket between the skin and fat or muscle, inserts the implant, and then stitches the incision closed.
Chin implantation takes about 30 to 60 minutes. The incision is made either under the chin or inside the mouth at the base of the lower lip. To perform cheek implant surgery, the surgeon makes an incision either inside the lower eyelid or inside the upper lip. The surgery takes 1 to 1½ hours for both cheeks. In jaw implant surgery, which lasts 1 to 2 hours, the implant is inserted through an incision inside the lower lip. Lip implants, made of donor connective tissue or a synthetic gel, are injected or implanted directly into the lips.
After Surgery
Facial implant surgery produces temporary bruising and swelling. Activities such as eating and talking may be hampered for a brief period, depending on the site of the implant. The person may have to eat a liquid or soft food diet for several days. It may take months before the swelling goes down completely and the final facial configuration takes shape. While recovering, people who have implants need to take special care when brushing and flossing their teeth.
Risks accompanying implant surgery include bleeding, infection, an asymmetrical appearance, numbness, and implants that shift out of place. If complications develop, the implant may have to be removed.
Collagen Injections
Collagen injection is a popular nonsurgical technique for giving the face a fuller, more youthful appearance by replacing the collagen that the skin naturally loses with age. Most collagen used for cosmetic purposes is a natural substance derived from the purified structural protein of cows. A few weeks before the procedure, the doctor tests the person for a possible allergic reaction to the collagen. Plastic surgeons most often inject collagen to treat frown lines, crow’s feet, and the so-called