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Facelift (Rhytidectomy) in Dallas

Over time, gravity and sun exposure take their toll on the face and neck. Deep creases that run from each side of the nose to the corners of the mouth appear; the jawline slackens; and the neck develops loose folds and fat deposits. Rhytidectomy (facelift) counteracts these signs of aging by tightening muscle, removing fat, and trimming excess skin.

Rhytidectomy improves the look of the lower and middle areas of the face, and the neck. It is most effective for correcting the following:

• Mid-face sagging
• Deep creases under the eyes
• Nasolabial folds
• Jowls
• Sagging fat
• Loose skin and fat under the chin and jaw

Although rhytidectomy removes or reduces signs of aging, over time, they will gradually reappear. Rhytidectomy does not improve the look of the brow, eyelids and nose, and some parts of the mid-face. A patient who wants to improve those areas might combine rhytidectomy with a brow lift or eyelid surgery, and/or with injectable soft-tissue fillers, facial implants and skin resurfacing.

Candidates for Rhytidectomy

The best candidates for rhytidectomy want to correct one or more of the signs of aging indicated above; have some facial sagging, but still have elasticity in their skin; are generally healthy; do not smoke; and have realistic expectations about what rhytidectomy can do.

It is very important that the surgeon ascertains whether the patient is only interested in rhytidectomy because of pressure from someone else.

Types of Rhytidectomy

Rhytidectomy is typically performed as an outpatient procedure in an office-based facility, surgery center or hospital. Patients may have a choice of IV sedation or general anesthesia. The procedure takes about 2 hours. The way a facelift is performed depends on the surgeon, the patient‘s facial structure, and the extent of correction desired.

Traditional Rhytidectomy

A traditional rhytidectomy is a “full” facelift that rejuvenates the face, jowls and neck, and includes sculpting and redistributing of fat; lifting and repositioning of muscle and deeper tissues; and trimming and re-draping of skin. The incision begins at the temples and travels down to the front of the ear, around the earlobe and behind the ear to the lower scalp at the hairline. Sometimes, another incision is made under the chin.

Limited-Incision Rhytidectomy

A limited-incision rhytidectomy improves the area around the eyes and mouth by reducing nasolabial folds and other deep creases. Short incisions are made at the temples and around the ear, and possibly in the lower eyelids and/or under the upper lip.

In both methods, incisions are closed with stitches or tissue glue. Scars are hidden in the hairline and natural contours of the face.

Recovery from Rhytidectomy

After rhytidectomy, the surgeon wraps the incisions in bandages, and may insert drainage tubes; if so, they are taken out the next day. If surgical clips are holding some incisions closed, they are removed, along with any stitches, 1 week after the procedure.

Post-rhytidectomy, swelling, numbness, bruising and a feeling of tightness or tension in the face and neck may be felt. The face may look uneven or distorted, and facial muscles may feel stiff. Most of these side effects resolve within 3 to 6 weeks, and sensation typically returns to normal within a few months. Scars become less red, raised, lumpy and itchy over time.

Many patients return to work by the third week. Camouflage cosmetics can be used to minimize the appearance of bruising.

Results of Rhytidectomy

Results of rhytidectomy are not permanent, and some patients choose to undergo another in 5 or 10 years. In some sense, however, effects are permanent; years later, the face continues to look better than if rhytidectomy had not been performed.

Risks Associated with Rhytidectomy

Possible complications of rhytidectomy include bleeding, infection, bruising, swelling or discoloration, allergic reaction to the anesthesia, skin blistering (usually only in smokers), nerve injury, and temporary or permanent loss of sensation in the face.

Additional Resources

• MedlinePlus
• National Institutes of Health
• Centers for Disease Control and Prevention
• Eunice Kennedy Shriver National Institute of Child Health and Human Development
• S. Department of Health & Human Services
• S. National Library of Medicine
• WebMD

Dallas Facelift Surgeon Dr. Law

As time passes, deep creases, fine lines and wrinkles develop in the face. In addition, fat deposits and loose skin cause changes in the neck. Although these changes in the neck and face are part of the natural aging process, an experienced facial plastic surgeon can reduce the visibility of these characteristics with a facelift (aka a rhytidectomy). At Law Plastic Surgery in Dallas, Dr. Huay-Zong Law performs facelifts to help men and women turn back the hands of time. During a rhytidectomy, Dr. Law tightens the facial muscles, removes excess fat and trims away any extra skin.

Why Would Someone Choose to Have a Facelift in Dallas?

People who feel self-conscious about their appearance due to loose skin, misplaced facial fat and deep creases in their face and neck may choose to have a rhytidectomy to address these issues.

Facial characteristics people want Dr. Huay-Zong Law to address during a facelift in Dallas include:

• Sagging facial skin.
• Fallen facial fat.
• Deep folds that begin at the base of the nose and continue downward to the corresponding corner of the mouth (i.e., nasolabial folds).
• Excess fat and lax skin on the neck. The lax skin can make a section of the neck resemble a turkey waddle. Moreover, the lax skin and excess fat can create a double chin.
• Sagging skin on each side of the jawline (i.e., jowls).
• Deep creases beneath the eyes.

During a rhytidectomy, Dr. Law cannot reverse sun damage (e.g., dark patches) or address fine lines and wrinkles. That said, there are other procedures available that Dr. Huay-Zong Law can use to address these issues. Many of which can be added to the patient’s facelift surgical session.

What Makes Someone a Good Candidate for a Facelift in Dallas?

An individual with an adequate amount of skin elasticity who is interested in addressing the signs of aging in the face and neck that a rhytidectomy targets may be a good candidate for a full or mini facelift. In addition, the individual must be having a rhytidectomy for himself or herself, not as a means to please someone else.

What Causes the Signs of Aging?

Environmental factors and lifestyle choices can both contribute to the signs of aging.

Lifestyle choices and environmental factors contributing to the signs of aging include:

Sun exposure

Sun exposure — Especially when an individual neglects to use a water-resistant, broad-spectrum sunscreen that has a sun protection factor (SPF) of at least 30 to protect the skin from UV rays.

Gravity

Gravity — A reduction in the body’s production of collagen and elastin leads to a loss of skin elasticity. As the skin becomes less firm, the pull of gravity can cause the eyelids and brows to fall, jowls to develop, a double chin, as well as longer ear lobes.

Free radicals

Free radicals — Free radicals are a by-product of the metabolic processes of cells in the body. Exposure to certain environmental pollutants triggers the body to produce free radicals, which negatively affect collagen production. In addition, free radicals break down the skin cells, resulting in the rapid aging of skin. With age, the body has difficulty fighting the damage these free radicals cause.

Environmental pollutants that cause free radical production include:

• Smog.
• Dust.
• Cigarette smoke.
• Pesticides.
• Chemicals used for cleaning.
• Both UVA and UVB rays.

Stress

Stress — When an individual is under a great deal of stress, the collagen and elastin in the skin begins breaking down. Furthermore, skin cell turnover becomes erratic, causing the skin to appear dull.

Genetics

Genetics — A family history of premature aging can cause an individual to develop the signs of aging sooner rather than later. These individuals may be good candidates for a facelift.

Thinning skin

Thinning skin — As a natural part of the aging process, the outer layer of skin (i.e., the epidermis) becomes thinner. This thinning results from exposure to UV light, skin cell shrinkage, damage to the small capillaries that are located near the skin’s surface and a reduction in the amount of fat beneath the skin. In addition, a woman’s skin may thin due to a decrease in her estrogen levels, which usually occurs following menopause.

The loss or descension of facial fat

The loss or descension of facial fat — Changes in facial fat can cause areas of the face to appear sunken in. These areas may include the cheeks and the area beneath the eyes.

Smoking, or using other products that contain nicotine

Smoking, or using other products that contain nicotine — Because nicotine is a vasoconstrictor, smoking causes numerous unwanted changes in the face. As a vasoconstrictor, nicotine causes the blood vessels to contract. These contracting vessels disrupt blood flow. This disruption may be responsible for some of the premature aging that smoker’s develop in the face.

Changes attributed to smoking include:

• Pronounced lines between the brows (i.e., glabellar lines, 11s).
• An unhealthy looking grayish skin tone.
• The development of crow’s feet next to the outside corners of each eye.
• Fullness beneath the eyes.
• Thin lips.
• Vertical wrinkles surrounding the mouth (i.e., smoker’s lines).

Repeated facial movements

Repeated facial movements — Daily facial movements can cause wrinkles and lines to develop (e.g., scrunching up the forehead). A decrease in skin elasticity causes facial lines and wrinkles to become more visible. This loss of elasticity usually begins once an individual reaches 30 or 40 years of age.

Will a Rhytidectomy in Dallas Change an Individual’s Overall Facial Appearance?

No, when performed by an experienced facial plastic surgeon, a rhytidectomy only rejuvenates the patient’s face; his or her unique facial characteristics remain.

Is There Anything That Could Make Someone Ineligible for a Facelift?

Yes, there are factors that could make someone a poor candidate for a rhytidectomy in Dallas.

Factors that can affect an individual’s eligibility for a rhytidectomy include:

• Being emotionally unstable.
• Having body dysmorphic disorder.
• Being a smoker.
• Currently dealing with a life-changing situation (e.g., a divorce).
• An inability to tolerate being deeply sedated or receiving general anesthesia.
• Having an active autoimmune disease or vasculitis that is directly related to the skin on the neck or face (e.g., scleroderma).
• The inability to obtain medical clearance for surgery from his or her general practitioner.
• Currently undergoing chemotherapy treatments or taking chemotherapeutic medication.
• Having very deep grooves that run from the base of the nose to the corners of the mouth.
• Previously having a full course of radiation to the skin on the neck near the ear.
• Pronounced folds and cheek mounds.
• Having an obtuse cervicomental angle resulting from a low hyoid bone. The hyoid bone serves as an attachment structure for the muscles in the oral cavity and the tongue.
• Being substantially overweight. An obese individual may not be a good candidate for a facelift because excess weight stretches the skin. In addition, obesity frequently causes a variety of skin conditions including skin tags, varicose veins, stretch marks, dark patches and psoriasis (dry, red patches of skin that itch). Although psoriasis can develop anywhere on the body, this condition frequently develops near the hairline or on the scalp.

Can a Pregnant Woman Have a Rhytidectomy?

To ensure the safety of the unborn child, pregnant women should avoid having any elective surgical procedures during pregnancy. On the day of surgery, females of childbearing age will receive a urine pregnancy test to ensure they are not pregnant before their rhytidectomy begins. Women who have undergone a full hysterectomy will not need to have this test.

The Initial Consultation for a Facelift with Dr. Huay-Zong Law in Dallas

Upon arrival, patients fill out registration information. To ensure their safety, patients must disclose all of their medical conditions (e.g., hypertension, cardiac disease) to Dr. Law. Furthermore, patients with allergies to medications, known products used during surgery or latex need to let Dr. Huay-Zong Law know about these sensitivities right away.

Dr. Law needs to know which medications, herbal supplements and vitamins the individual takes. Some of these products cause bleeding, therefore the patient may need to discontinue taking these products for a short period of time or discuss having the dosage amount reduced. In addition, patients should be prepared to have a physical exam, a psychological evaluation, and to provide Dr. Huay-Zong Law with a detailed medical history for the two years leading up to their consultation.

If Dr. Law believes that a facelift can accomplish the changes the patient desires, he recommends this procedure. When a patient decides to go forward with a rhytidectomy, Dr. Huay-Zong Law begins preparing for surgery.

Dr. Law or a member of his staff may take pictures of the patient’s face. He or the staff member takes these photos from different angles. Dr. Huay-Zong Law uses these photos as he creates the patient’s personalized rhytidectomy plan.

Dr. Law may take a variety of measurements. These facial and neck measurements help him as he creates the patient’s customized surgical plan.

Preparing for a Facelift in Dallas with Dr. Huay-Zong Law

Most patients spend about two weeks resting following a rhytidectomy. To make recovery as easy as possible, patients should either make themselves meals and freeze them or purchase pre-made meals to eat during recovery.

Patients who have animals to care for may want to ask someone they trust to care for them (at his or her home) while they recover.

Those with small children should ask someone that they trust implicitly to either stay at the home to care for the children or take the children to his or her home for several days. Although this break may only be for a few days, it does allow the patient to rest well during the earliest stages of recovery.

Following sedation, individuals are not permitted to drive for at least 24 hours; therefore, patients need to ask a close friend or family member to come with them on the day of their facelift in Dallas. In addition, Dr. Law prefers that his patients have someone remain with them on the night of surgery as well as the next night.

Medications to avoid for at least seven days before and seven days after surgery include ibuprofen (e.g., Motrin), aspirin, naproxen (e.g., Aleve) and blood thinners (e.g., Coumadin). Before stopping or reducing the dose of a prescription or recommended medication, patients need to speak with Dr. Huay-Zong Law or their prescribing physician.

Herbal supplements to avoid for a week before and week after surgery include Ginkgo Biloba, Kava and St. John’s Wort. Patients taking herbal supplements need to speak with Dr. Law to make sure the supplements they take are safe directly before and right after surgery.

Vitamins patients need to discontinue taking before surgery include vitamin E, vitamin K and vitamin A. Patients taking other vitamins on a daily basis need to ask Dr. Huay-Zong Law if the vitamins they take are safe to use before and after surgery.

Patients who need to take a pain reliever during the week leading up to their facelift can take acetaminophen (e.g., Tylenol).

Stop Using Products That Contain Nicotine for at Least Two Weeks Before and Two Weeks After a Rhytidectomy

Products that contain nicotine include traditional cigarettes, e-cigarettes, chewing tobacco, pipe tobacco and cigars. Since nicotine is a vasoconstrictor, it inhibits the body’s ability to heal itself. This inability to heal can lead to an infection, open wounds or necrosis (i.e., tissue death).

Do Not Drink Alcohol Two Days Before and Two Days After a Facelift in Dallas

Alcohol promotes inflammation. Swelling can increase an individual’s pain level; therefore, patients need to avoid alcoholic beverages for at least two days before and two days after their rhytidectomy.

Patients May Need to Have Presurgical Testing

For safety’s sake, Dr. Law may request that a patient have presurgical testing. In addition, he may request that the patient receive a medical clearance for surgery from his or her general practitioner.

Potential Presurgical Tests

Dr. Huay-Zong Law or the patient’s general practitioner may order a variety of tests for the patient to complete before surgery or before receiving medical clearance to have a facelift in Dallas.

A patient may need to have a routine physical and one or more of the following tests before he or she can schedule surgery:

• A complete blood count (CBC).
• A blood test to determine how fast an individual’s blood clots.
• A urinalysis
• A blood urea nitrogen (BUN) and creatinine test.
• A blood test to check electrolyte levels.
• An electrocardiogram (EKG or ECG).

What Happens If Presurgical Testing Uncovers An Untreated or Serious Medical Problem?

If a patient’s preoperative screening indicates that he or she has an untreated or serious medical problem, Dr. Huay-Zong Law may postpone the facelift or cancel the procedure altogether.

The Night Before Surgery: What Patients Need to Know

Patients usually need to discontinue eating and drinking at midnight. However, Dr. Law or a staff member verifies the length of time a patient needs to fast before surgery. It is imperative that patients do not eat during the hours leading up to their rhytidectomy. Nonetheless, if a patient does eat, informing Dr. Huay-Zong Law is vital to ensuring his or her safety. Eating or drinking too close to the time of anesthetization can cause an individual to choke on the contents in his or her stomach.

The Day of Surgery

On the day of surgery, patients need to arrive at least 15 minutes before their scheduled appointment with their driver. Patients who neglect to bring a driver will have to reschedule. To protect his patients, Dr. Law does not permit the use of public transportation or for-hire transportation services (e.g., Uber) following procedures that require the patient to be sedated in any way.

Dr. Huay-Zong Law Performs Two Types of Facelifts: The Limited-Incision Rhytidectomy and the Traditional Rhytidectomy

A facelift takes about two hours. Patients who choose to add on procedures will stay in surgery longer.

A patient may receive general anesthesia or IV sedation. General anesthesia causes the patient to fall into a deep sleep, whereas IV sedation (aka twilight anesthesia) causes the patient to fall into a lighter sleep.

The rhytidectomy procedure Dr. Law chooses for a patient is based on his or her facial structure and the extent of correction the patient desires.

A Limited-Incision Rhytidectomy (aka Mini Facelift)

With a mini rhytidectomy, Dr. Huay-Zong Law improves the area surrounding the mouth by reducing any deep creases that are present, including the nasolabial folds. In addition, he refreshes the area around the eyes.

This procedure involves Dr. Law creating very short incisions at the patient’s temples, these incisions continue around the ear. Depending on the patient’s desires, he may also create an incision beneath the upper lip and within the lower eyelids.

A Traditional Facelift (a Full Rhytidectomy)

During a full rhytidectomy in Dallas, Dr. Huay-Zong Law rejuvenates the patient’s face and neck. He addresses the jowls, sculpts and redistributes the facial fat, lifts and repositions the deeper tissues, as well as the muscles. Dr. Law trims away excess skin and then re-drapes it over the face.

For a traditional rhytidectomy, Dr. Huay-Zong Law begins the incision at the temple. The incision continues downward to the front of the patient’s ear and then around the earlobe to the back of the ear and across the hairline at the lower scalp. Sometimes Dr. Law creates another very small incision beneath the chin.

Closing the Incisions Following a Mini Facelift and a Full Facelift in Dallas

After a limited-incision or traditional rhytidectomy, Dr. Huay-Zong Law closes the incisions using tissue glue or stitches. He wraps bandages around the incisions. Some patients receive small drainage tubes to help reduce inflammation by providing a place for excess fluid to drain. These tubes are removed the following day. Since patients are not permitted to drive for 24 hours following sedation, they will need someone to drive them to this appointment.

Recovering After a Rhytidectomy in Dallas

A week after surgery, patients return to the office in Dallas to have any surgical clips or stitches removed.

Patients should expect some discomfort following their rhytidectomy. This discomfort may include a pulling sensation in the neck and face, inflammation, bruising and numbness.
Initially, the patient’s face may appear uneven, and the facial muscles may feel very rigid. The majority of these side effects do resolve within three to six weeks. Neck and facial sensations usually return to normal a few months after surgery.

Most of Dr. Law’s rhytidectomy patients return to work within three weeks of surgery. Patients who are concerned about residual bruising can use cosmetics to minimize their visibility.

Any resulting scars remain well hidden within the patient’s hairline and the natural contours of his or her face. As long as these incisions are protected from UV light with a sunscreen that has an SPF of at least 30, as time passes, these scars will become flatter, less red and lighter in color.

The Results of a Dallas Facelift Are Long Lasting

A rhytidectomy offers patients lasting results; however, the natural aging process does continue, which will eventually affect the results. Despite the continuation of the natural aging process, the patient still looks more youthful than he or she would have without the rhytidectomy. To maintain a more youthful appearance, many patients return to Law Plastic Surgery 5 or 10 years after their first rhytidectomy to have another one.

Additional Procedures Patients Can Have During Their Facelift

Following a facelift, patients have features that appear more youthful; nonetheless, there are signs of aging a rhytidectomy does not address. To address these issues (e.g., loss of volume, fine lines and wrinkles, drooping eyelids, a heavy brow), many patients choose to add other procedures to their surgical session.

Some of these add-on procedures include:

• Upper and lower eyelid surgery.
• A brow lift.
• Facial implants.
• Facial filler injections.
• BOTOX injections.
• Skin-Resurfacing procedures.

Risks and Potential Complications Associated with a Facelift

All surgical procedures and treatments have potential side effects, as well as the possibility of the patient experiencing a complication. A rhytidectomy is no different.

Potential complications include:

• An allergic reaction to the medicines or products used during surgery.
• Skin blistering (typically only an issue for patients who smoke).
• Open wounds.
• Infection.
• Necrosis.
• Sensation loss in the face (can be temporary or remain permanently).
• Nerve injury.
• Breathing issues.
• Blood clots (usually only a concern for patients receiving general anesthesia).
• Chronic pain.
• Visible scarring.
• Uneven facial contours.
• Fluid accumulation beneath the skin (i.e., seroma).
• Blood accumulation beneath the skin (i.e., hematoma).
• Skin discoloration.

Since Dr. Law is a highly experienced, board-certified facial plastic surgeon, the likelihood of his patient experiencing a complication or poor results is extremely low.

How Much is a Facelift in Dallas with Dr. Huay-Zong Law?

Since Dr. Law takes the time to create each of his patients their own, unique surgical treatment plan, the only way he can determine how much a procedure costs is by evaluating the individual during a consultation.

If you reside in, or will be visiting the Dallas area and have been considering cosmetic surgery, make an appointment with Dr. Huay-Zong Law by calling (972) 331-1900. Dr. Law’s experience, artistic vision and skill have made him one of the top facial plastic surgeons in Dallas. During your facelift consultation, Dr. Huay-Zong Law can determine if a rhytidectomy can provide you with the facial enhancements and rejuvenation that you desire. Law Plastic Surgery’s Dallas office is located at 777 Forest Lane, C-528.

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