Face lift

Face lift —— what you need to know
An experienced plastic surgeon’s viewpoint by

Dwight V. Galloway M.D.

Meloplasty, popularly known as a face lift, is a very well known operation in Los Angeles and California where I trained. That is how so many movie and TV personalities do not seem to age, even though you and your friends do. A good complete face lift is generally intended and expected to take about 10 years aging off your face and neck in the first few months after surgery, but then the skin relaxes and 7 to 8 years younger is a more realistic appearance. In recent years it has become apparent that the long incision behind the ear and scalp contribute very little to the result and add a great deal to the problems of the operation. The “short scar” technique is used by the vast majority of us now. This gives access to the deeper structures so that the stretch of the skin is taken up by the heavy semi permanent sutures and not just the skin. This idea originally came from Professor Tord Skoog of Uppsala, Sweden in about 1970 and has been modified many times, most recently by Dr. Patrick Tonnard of Belgium. This operation has a much lower complication rate and gives about the same result. In older peoples with more severe wrinkles the full and extensive face lift in still the standard, despite the problems of bleeding and poor healing. Smoking or a history of smoking, and being male increases the risk significantly. Most of my bleeding cases have been in men though only about 10 percent of my patients are men. This fact is well known among plastic surgeons. The full face lift moves the temporal hair line back and if you have had more than one, may have completely eliminated that feature. The “short scar” face lift gives a scar around the temporal scalp and in front of the ear and a little behind the ear lobe. Smoking, though not recommended, does not seem to give such a big problem with the “short scar”. The skin in front of the ear will be numb for a few months after surgery and takes about 6 months for the feeling to return. Many other attempts to achieve wrinkle removal, such as barbed sutures and deep facial peels are only partially effective and are no substitute for the “meloplasty” since they don’t address the deeper structure and have significant limitations on how much the skin can be tightened. This operation takes about an hour an a half and is done under general anesthesia as an outpatient, though it can be done under local anesthesia. It is often combined with an eyelid operation the same time, as both can be done in about two and a half hours, well within the safe time for a general anesthetic. Young eyes on an old face look great but the reverse looks awful, so do the eyes first if you are going to separate the operations. You will have some black and blue for about 12 days, so 2 weeks way from work or church is suggested, though my wife went back at 5 days.

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