Let us help you realize the YOU of your dreams!
2525 4th St Boulder, CO 80304
303-578-4193
HANS R. KUISLE, MD, FACS
WINFIELD HARTLEY, MD, FACS


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Facial Rejuvenation Procedure

Rhytidectomy: Cosmetic Face & Neck Lifting Surgery

Rhytidectomy Procedure:

Improving sagging facial skin, jowls, and loose neck skin by removing excess fat, tightening muscles, re draping skin. Most often done on men and women over 40.

Length of Procedure:

4 hours

Anesthesia:

General anesthesia, usually outpatient. Some patients may require short inpatient stay.

Side Effects:

Temporary bruising, swelling, numbness and tenderness of skin; tight feeling, dry skin. For men, permanent need to shave behind ears, where beard-growing skin is repositioned.

Risk:

Injury to the nerves that control facial muscles. Numb feeling (usually temporary but may be permanent). Infection. Poor healing. Excessive scarring. Asymmetry or change in hairline.

Recovery:

Feel OK around 2 weeks. Look better than Pre-op around 4 weeks, subtle/soft improvement for 6 months. Back to work 10 to 14 days.

Exercise:

1/3 Intensity around 3 weeks, 2/3 Intensity around 6 weeks, Full intensity around 8 weeks.

Fading & Scar Improvement:

6 to 12 months.

Hair Care:

Color or highlights around 4 weeks.

Bruising:

2 to 4 weeks.

Swelling:

Moderate/significant 4 weeks, subtle (mild) 2 to 3 months, all of which are dependent upon extent of procedure(s).

Duration of Results:

Usually 5 to 10 years.

Office Visits:

1st Visit: 1 day / 2nd visit 5 days. Anticipated office visits: 7 to 10 the first 3 months, 6 months then yearly.

Garment Worn:

Neck strap for 4 to 6 weeks.

Pain Meds:

Ibuprofen or Narcotics as needed.

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More Information About Rhytidectomy:

The RHYTIDECTOMY OR FACELIFT operation is designed to IMPROVE FACIAL WRINKLING and to TIGHTEN OR LIFT THE SOFT TISSUES OF THE FACE AND NECK which tend to sag increasingly with age. The amount of improvement from the operation depends on the degree of wrinkling, and the quality and consistency of the facial skin and underlying tissue. The duration of improvement varies from patient to patient. No operation can prevent aging which is a normal on-going process. The facelift sets the clock back so the individual appears younger than if the operation had not been performed. If the aging process in the skin is very rapid, the wrinkling and sagging will reappear more rapidly. In ideal cases, the duration of improvement is at least five to ten years. Overall good health, exercise, nutritional supplements, good genetics, and not using tobacco products can clearly lengthen the duration of cosmetic improvement.

The success of a cosmetic procedure and a patient’s suitability for that procedure depend on several factors. The surgeon must clearly understand the patient’s goals and expectations and must assess his ability to achieve these expectations. The patient in turn should understand the reasons for performing the procedure, the inevitable risks involved, the possible complications of the procedure, and the results which may be achieved.

In addition to the information contained here, during your consultation and examination, we will review specific factors which pertain to your individual case. (As you review this information, please write questions in the margins that we can address during your consultation.)

The term facelift may denote a wide variety of procedures. The aging process which produces wrinkling and sagging of facial soft tissues occurs in all areas of the face. Often it is more apparent in the lower two-thirds of the face (from the eyes down) than in the upper one-third of the face, but usually occurs simultaneously in both areas. FACE LIFT procedures usually refer to correction of sagging skin and wrinkling in the LOWER TWO-THIRDS of the face. BROW LIFT procedures refer to operations directed at improving the UPPER ONE-THIRD of the face. It is important to recognize aging abnormalities in the upper one-third of the face, since after correction of the lower two-thirds of the face, an uncorrected forehead/brow area may be more apparent.

In general, the facelift operation involves mobilizing facial skin off the underlying tissues, accurately placing tension on the elevated skin in a front to back and vertical direction to tighten loose skin and reduce prominent wrinkling, and removing excess skin. A thorough facelift also improves neck contour by repositioning neck tissues to correct sagging or banding. If excess fat is present beneath the chin, a separate procedure for removal (submental lipectomy) may be necessary for optimal correction.

Over the past 5-10 years, the facelift operation we perform has become more extensive in an attempt to provide better, longer lasting results. By suspending deeper supporting layers of the face (SMAS-superficial musculoaponeurotic system layer), as well as skin, less tissue weight and tension are redistributed directly to the skin following surgery. This reduces the rate at which the skin will loosen or sag over ensuing years. I must also be able to individualize and “customize” the composite nature of this lifting technique, and vary the technique depending on anatomy and patient desires. No two faces, and therefore no two facelifts are exactly the same. The trend is towards shorter incisions and directed changes in specific anatomic areas for a more natural and less “operated” look.

To achieve a good, long lasting result from rhytidectomy, adequate tension must be placed to reposition the tissues and correct sagging. There is however, a definite limit to the degree of tightening which can be achieved. EXCESSIVE TENSION MUST BE CAREFULLY AVOIDED SINCE IT CAN RESULT IN AN UNNATURAL, OVERPULLED, BLANK-STARE TYPE OF APPEARANCE. It can also compromise blood supply to the lifted tissues, and does not necessarily produce a longer lasting result. My goal with rhytidectomy is to create a fresher, brighter, less-tired appearance and a natural look that does not appear over-operated.

Mini-facelift, a term popular in numerous lay publications, implies lifting of only a small area of skin in front of the ears. Facial deformities of sagging and wrinkling, however, are very rarely localized to these small areas and usually involve all facial and neck tissues. MINI-LIFTS, THEREFORE, PREDICTABLY PRODUCE MINI RESULTS IN MOST CASES.

That said, a face-lift procedure must be individualized and customized. A face-lift can be a “full” lift or a “modified” lift. The neck is usually included in a face-lift procedure if appropriate. Suction contouring and suspension techniques can be utilized along with tissue grafting and resurfacing of the skin with laser or chemical peels.

Facial aging tends to be a process of the development of abrupt transitions in facial aesthetic units, for example, the lower eyelid region into the cheek or malar region. Facial rejuvenation softens and smoothes transitions and restores more youthful character to aging facial features.

Facial rejuvenation surgery may be performed as an isolated procedure or more frequently done in conjunction with other cosmetic procedures of the face. They may be performed under local or general anesthesia depending upon the extent of the procedure being performed, medical indications or patient preference. In general, I do believe, (along with our board certified anesthesia colleagues) that for longer and more complex surgical procedures, general anesthesia is a better and safer choice than local anesthesia alone or local anesthesia under sedation.

The purpose of all types of cosmetic surgery is to improve your appearance as much as possible. This change will hopefully improve your quality of life by improving your self image in a very positive way. By addressing and improving those specific areas which detract from your appearance, leaving the positive aspects of your appearance undisturbed, this type of surgery results in an overall improvement in your appearance. Cosmetic surgical procedures are not magic. They are detailed procedures designed to improve specific aspects of your appearance. They can do no more than that. Whether you are happy with the results of cosmetic surgery will depend largely on how well you communicate to us which specific aspects of your appearance you are unhappy with and how well we communicate to you what a surgical procedure can and cannot do toward alleviating the problem. Plastic surgery does not perform transforming miracles. A combination of art and science, plastic surgery is not an exact science. Some of the factors involved in producing the result (such as your healing characteristics) are not totally within your or our control, and therefore, it is impossible to warrant or guarantee the results of your surgery. How predictable the result of your surgery will be depends on a number of factors such as the condition of your skin, the presence or absence of facial fat beneath the skin, the age characteristics of the skin, numbers and types of wrinkles present, and the nature of underlying bony structure of the face, as well as hereditary and hormonal influences.

It is not possible by cosmetic surgical procedures to make someone who is 50 years old appear 30 years old or younger. Although this may seem obvious, through misconception or misinformation, these ideas reach the public. All surgical procedures which involve an incision in any area must leave a scar. While these scars are usually inconspicuous and easily camouflaged by makeup or hairstyle, they are nevertheless permanent and cannot be erased.

After talking with you and examining you, I will make every effort to clearly and precisely give an opinion about whether a specific surgical procedure can significantly improve your areas of concern with a high degree of reliability and a minimal level of risk. All cosmetic surgical procedures involve some trade-offs. I will try to outline these clearly for you and answer any questions you might have. The final decision regarding having the surgery is yours, and I encourage you to consider it carefully and deliberately.

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At Your Initial Consultation Visit:

When I visit with you in the office, I will review your past medical history, as well as your desires regarding facial rejuvenation. Age is not a limiting factor in determining who can have facial rejuvenation, as long as your general health is good. We will review extensively the information contained here, as well as more specific information with respect to your specific needs. After examining your face, I can much more precisely define recommendations for you.

In this consultation, I would expect you to be frank in discussing your expectations with me. Do not hesitate to ask any questions that you may have. I will be equally frank with you, explaining the factors that could influence the procedure and the results.

I cannot make the decision for you regarding whether to undergo surgery or not. I can only advise you regarding the surgical options and anticipated outcomes I would expect for you based upon your individual anatomy, desires, and realistic expectations. I will define goals in a surgical plan at this initial consultation. Follow up appointments will include time to ask further questions or review the procedure so that you are comfortable with its nature and implications. I will educate you and define the operative scenarios and choices available to you, but you must make the final decision regarding the surgical procedure.

When a decision is made to proceed with surgery, preoperative photographs will be taken. These photographs are essential to the planning, execution, and follow-up of your procedure. They are taken with you in the standing position (the position in which you are most often seen). You are lying down during the procedure and I refer to these photographs frequently as your tissues appear very differently than when you are standing. Surgical fees for the procedure will be discussed with you. They depend upon the nature and the extent of the procedure being performed. All fees for cosmetic surgeries are payable in advance and include the cost of surgery as well as all postoperative follow up care. Additional fees are required for the surgical facility and anesthesia care, and will be collected on the day of your preoperative visit at the surgery center.AT YOUR INITIAL CONSULTATION VISIT:

When I visit with you in the office, I will review your past medical history, as well as your desires regarding facial rejuvenation. Age is not a limiting factor in determining who can have facial rejuvenation, as long as your general health is good. We will review extensively the information contained here, as well as more specific information with respect to your specific needs. After examining your face, I can much more precisely define recommendations for you.

In this consultation, I would expect you to be frank in discussing your expectations with me. Do not hesitate to ask any questions that you may have. I will be equally frank with you, explaining the factors that could influence the procedure and the results.

I cannot make the decision for you regarding whether to undergo surgery or not. I can only advise you regarding the surgical options and anticipated outcomes I would expect for you based upon your individual anatomy, desires, and realistic expectations. I will define goals in a surgical plan at this initial consultation. Follow up appointments will include time to ask further questions or review the procedure so that you are comfortable with its nature and implications. I will educate you and define the operative scenarios and choices available to you, but you must make the final decision regarding the surgical procedure.

When a decision is made to proceed with surgery, preoperative photographs will be taken. These photographs are essential to the planning, execution, and follow-up of your procedure. They are taken with you in the standing position (the position in which you are most often seen). You are lying down during the procedure and I refer to these photographs frequently as your tissues appear very differently than when you are standing. Surgical fees for the procedure will be discussed with you. They depend upon the nature and the extent of the procedure being performed. All fees for cosmetic surgeries are payable in advance and include the cost of surgery as well as all postoperative follow up care. Additional fees are required for the surgical facility and anesthesia care, and will be collected on the day of your preoperative visit at the surgery center.

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Before Your Rhytidectomy:

Our nurse and office manager will make all arrangements regarding scheduling of your surgery and will give you specific instructions as well as reconfirm these with you by telephone and/or letter. Since both of our schedules must be coordinated with the surgical facility and anesthesia schedules, please allow our personnel a reasonable amount of time to make these arrangements. They will make every attempt to accommodate your requests.

Good general health is mandatory for a problem free and predictable recovery from any surgical procedure. Wellness and good general health result from proper diet, regular exercise and appropriately timed medical evaluations focused on preventative medicine. Good nutrition, vitamin and herbal supplements, as well as adherence to holistic health principles are important concepts in maintaining wellness. Certain supplements, although generally beneficial, may have adverse effects during surgery. Please advise us about all your medications and supplements, so we may advise you regarding their safety in regards to your surgical procedure.

We believe that good nutrition is an important component to excellent surgical outcomes. Multiple studies show that most Americans aren’t getting the recommended daily intake of necessary vitamins and minerals, much less the optimal amount. These suboptimal levels of nutrients have been linked with major diseases from heart disease to cancer.

We use a three phase healing program with nutritional supplements to help you recover more quickly and with less downtime. We have you start this a week or so ahead of time to ensure that you are boosting your body’s immune system and removing anything that could interfere with anesthesia or increasing bleeding. Immediately following surgery we give you nutrients that help reduce pain and inflammation and detoxify the anesthesia and other medications. The third phase has additional healing nutrients to support your recovery.

Routine laboratory tests including blood counts and blood chemistries, a pregnancy test when applicable, and an electrocardiogram if you are over 50 years old, will be performed prior to surgery. These tests are performed routinely to screen for any abnormalities, which might complicate your anesthesia or surgery.

Nicotine causes constriction of blood vessels, and can impair circulation to tissues following any surgical procedure, especially those of the skin. Smoking should be discontinued prior to the procedure for a minimum of 2 weeks. You should cease smoking for a minimum of 4 weeks following your procedure.

Do not take any aspirin or any drug containing aspirin for at least two weeks prior to your surgery. Aspirin may retard platelet function, a blood component that is important to normal blood clotting mechanisms. There are many drugs, which contain aspirin. Before taking any drug, check the label carefully to assure that it contains no aspirin.

Do not eat or drink anything 8 hours prior to surgery. Safety in the administration of anesthesia or sedation requires that your stomach be absolutely empty for this interval of time before surgery.

Shower or bathe normally the evening prior to surgery.

You should wear loose fitting, comfortable clothing the day of surgery. A loose fitting shirt with buttons in front is preferable to any type of clothing which must be put on over the head. Please be sure that you have all of your questions answered prior to going into the surgical facility. I prefer that you make additional appointments in the office if necessary to answer questions regarding your surgery. On the day of surgery, I will visit with you briefly immediately prior to surgery. Any final questions will be answered at that time.

Arrange for someone to drive you home at the appropriate time following your procedure, and arrange for someone to stay with you the night of surgery.

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The Day of Surgery:

I usually prescribe sedation or pre medication prior to your being brought to the operating room. In order to minimize total necessary doses of drugs, sedation is best administered through an intravenous line rather than given in shot form into your muscle. It is normal to be slightly excited or apprehensive immediately prior to the surgery, and this will be alleviated quickly once your intravenous line is inserted. Our anesthesiologist will speak with you and answer all of your questions regarding your anesthetic.

Prior to moving to the operating room, I will ask you to sit up briefly so that I can mark your surgical site(s), depending on the approach, to use as guidelines during your surgery. Once in the operating room, you will then be positioned comfortably, and will have no recall of further events during your surgery.

The operation is performed using a general anesthetic. In addition, the medications have a profound amnesic effect, and you will have no recall of any events during the procedure. Actual surgical time usually ranges from 3 to 4 hours depending on the technique chosen.

The operation is performed though incisions which begin in the hairline in the area of the temple, pass in a crease in front of the ears, around the earlobe, behind the ear, and then extend into the hairline behind the ear. The skin is elevated from the underlying tissues of the face and neck. Tissues are tightened, repositioned and sculptured to give better definition to the jaw line and neck. Excess skin is removed.

At the completion of your operation, you will be transferred to the appropriate recovery area where you will remain until you awaken. I purposely like for you to remain drowsy, since you will be much more comfortable. After an appropriate interval of observation, usually a few hours, you will be allowed to leave with someone to drive you home and stay with you the evening of the surgery.

You will have been given prescriptions for pain medication and antibiotics with instructions for each at your preoperative visit.

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After Your Rhytidectomy:

Since I want you to remain drowsy and comfortable the evening of your surgery, fill your prescription for pain medication before surgery and take one immediately on arrival at home. Pain medication is best taken with a small amount of food and not on an empty stomach since nausea may occasionally occur. Make yourself comfortable, not necessarily in bed; a couch or comfortable chair is fine. You will continue to be drowsy and will awaken intermittently during the evening. Use the pain medication as directed to remain comfortable. Intermittent cold compresses for the first 48 hours after surgery may help with swelling and discomfort.

Do not try to eat any heavy foods the evening of surgery. Liquids or light foods are preferable. You may resume a normal diet the next morning. Should you experience any nausea the evening of surgery, drink small amounts of liquids only; no food until morning. Anti nausea medications are generally not needed; any nausea experienced from the medications used in surgery will usually be gone the next morning. If you have a history of nausea after anesthesia, please inform your anesthesiologist the morning of surgery and you will be given anti-nausea medications during the procedure that will help minimize this occurrence after surgery.

Areas of the face and neck, particularly the neck and areas behind the ears, will feel extremely tight to you for several days to weeks. This feeling is caused by a combination of placing the tissue under tension to achieve the desired result, and the inevitable swelling which occurs following the procedure. In most areas of the face, the skin will be numb to touch, a numbness which resolves over a period of weeks to months.

Most of the sutures which have been used to close your incisions have been placed beneath the skin and will reabsorb over a period of weeks and months without requiring removal. The sutures on the outside will be removed at appropriate intervals. You may wash your hair the day following surgery, after dressings are removed, and towel dry it or gently blow it dry. Avoid using high temperatures on a blow dryer, since areas of numbness are subject to burning without your recognition. You may wash or cleanse your face normally beginning the second day after surgery. If you have had chemical peeling or laser resurfacing procedures performed at the same time as your facelift, you will be given specific instructions regarding care of those areas.

Avoid strenuous activity for the first week following surgery. Activities of this sort include any type of heavy lifting, straining, or strenuous physical exercise which may raise your blood pressure and can produce bleeding. Light exercise may be resumed 3 weeks following surgery, and strenuous exercise 6 weeks following surgery.

As discussed with you preoperatively, there will be numerous areas on the face and neck which feel lumpy or may have very small amounts of fluid which you can feel beneath them. This is normal and these areas resolve over a period of two to three months, with the vast majority resolving in the first four to six weeks. They are seldom visible, but can be felt to the touch.

Minimal special care is required along your suture lines. If small areas of crusting or scab form, leave them intact, wash over them normally, and they will separate when appropriate. A light coating of antibiotic ointment is applied to these crusted areas until they separate.

Normally following a facelift, swelling subsides at different rates in different areas of the face. Some areas of the face may seem to move more normally, while some areas will feel particularly tight and immobile. These variations are normal and resolve as swelling resolves.

An absolute minimum amount of hair in the areas of your incision has been trimmed to allow access to perform your surgery. Any residual areas where hair appears to have been clipped will re grow over a period of weeks, and any hair loss in the area of incision is usually quite minimal.

Tenderness around the ears is normal following surgery and will persist for one to two weeks. Sutures which anchor the new position of the soft tissues are attached in these areas and are the source of this discomfort. As swelling resolves and tension decreases somewhat, the discomfort similarly resolves.

As the swelling begins to resolve in your face and before normal mobility and feeling returns to all areas, you may feel that your face looks different, unnatural, or simply not my face. At some point following surgery, most patients experience a period of moderate depression or lowering of their mood, and may even question their motives in having the operation. These feelings are quite normal and predictable, and resolve over a period of two to three weeks for most patients. Although your face appears fresher, or less tired, and younger, it nevertheless has a different appearance, and this change in your self image requires time for adjustment.

As sensation returns to the skin of your face and neck, it is normal to experience tingling sensations, occasional sharp pin-prick type sensations, or vibratory sensations. These effects are caused by aberrant signals sent to your brain by sensory nerves which are re growing in these areas. These nerves are distinct from the motor nerves which govern movement in the face. All of these sensations resolve over a period of weeks.

When you resume using cosmetics one to two weeks following surgery, I will recommend a water soluble, hypoallergenic type which will not clog your pores.

Significant bleeding can occur postoperatively in 2-5% of patients, is recognized by a significant increase in swelling in a single isolated area or side of the face usually accompanied by a marked increase in bruising in the same area, as well as increased pain. Should this occur, contact our office immediately.

When the drains were placed above and behind your ears, there were small open puncture areas through which the tubes were placed. These require no special attention whatever, can be washed over, and will close spontaneously within the hair over a period of a few days.

If you are given a prescription for antibiotics following surgery, take the prescription until ALL of the antibiotics are completed.

Resume normal tasks of daily living as rapidly as possible. The pain from the procedure decreases to about half of its intensity each 24 hours following surgery. Postoperative discomfort is most marked only during the first 24 hours and regresses rapidly thereafter. Resumption of normal activities, for example, lifting the arms to comb the hair and lifting objects of normal weight, speeds the recovery process and reduces the pain more rapidly. Immobility tends to cause continued discomfort and increased muscle spasms. The only limitation to activity is if you feel significant pain. Discomfort is normal with motion initially, and there is nothing that can be harmed by normal activity. Most patients are back at work in 1-3 weeks. Call the office for an appointment to be seen as directed following surgery.

You may resume light exercise at 3 weeks following surgery. This includes low impact activities at 1/3 duration of exercise, repetitions, amount of weight, and pulse rate. Your exercise tolerance should gradually increase to 2/3 intensity at 6 weeks, and be at full intensity by 8 weeks. This includes high impact activities such as running, horseback riding, and high impact aerobics.

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Limitations, Risks & Possible Complications:

With any surgical procedure, a very small percentage of untoward complications can occur. These complications are rare, and I mention them not to alarm you, but only to inform you.

There is usually minimal pain associated with postoperative recovery from facelift. A feeling of tightness, particularly in the area behind the ears is desirable, since this is the area where the skin tension is distributed to correct laxity and improve the facial wrinkles. Appropriate medications for discomfort will be prescribed.

All scars in visible areas will be slightly red for a period of time following surgery, usually 6-12 weeks. As the scars complete their healing and maturing, the redness will fade and the scars will be similar in color to the surrounding skin. Exposure to sunlight will increase scar redness at any stage and may ultimately produce persistent redness in scars if excessive.

In 5% or less of patients, excessive bleeding may occur after the facial incisions have been closed, resulting in an accumulation of blood beneath the skin of the face. Should this occur, it will be obvious due to swelling or excessive bruising in an area, and it may be necessary to remove the fluid with a needle when I see you in the office. If a larger amount accumulates, it may be necessary to return to the operating room to reopen the incision partially for adequate removal of fluid or blood.

During the course of mobilization of skin from the face, particularly when more extensive procedures are required to achieve the desired result, branches of the facial nerve which control movement of facial muscles may be bruised or injured. This may result in temporary inability to equally move the muscles in both sides of the face. This weakness in the vast majority of cases is transient, with normal return of function in a period of weeks. The possibility of permanent damage with permanent weakness exists, but is extremely small, in the range of 1-2%.

In order to achieve the desired result with facelift, the skin after elevation must be re draped under tension to correct excessive sagging and wrinkling of the tissues. If areas of circulation to the skin are compromised, there may be delayed healing or partial loss of skin in these areas. When this occurs, it is usually evidenced by slight crusting or blistering of the surface of the skin. In most cases this heals spontaneously with simple wound care. If larger areas of skin loss occur, additional procedures may be required.

When critically examined, the two sides of any individual’s face are not symmetrical in appearance and will not be totally symmetrical postoperatively. I make every effort to correct excessive wrinkling and sagging exactly to the same degree on both sides, but the operation does not achieve perfect symmetry (which is also not present preoperatively).

Infection may develop after any surgical procedure. Infection is extremely rare in the face, but if it occurs, treatment is usually with antibiotics by mouth or occasionally drainage of a localized area of infection. You will receive antibiotics at the time of surgery and for an appropriate period postoperatively in an attempt to further prevent chances of infection.

It is possible to have untoward side effects to any drug which is administered during surgery. Severe side effects are extremely rare, but can be life threatening. It is for this reason that I insist on performing your surgery in an optimal setting where all conceivable equipment and medical backup are available should you have an unexpected reaction. Anesthetic or sedation risks are extremely minimal. Many cases have been vastly over publicized by the media, and most have occurred in settings where less than optimal facilities, equipment and personnel are present.

Following extensive facelift procedures, after removal of small silicone rubber drains, small amounts of fluid will collect in areas beneath the skin. These are normal and will be reabsorbed by the body over a period of 4-6 weeks. The skin of the face feels numb in some areas, and you may be able to feel small lumpy or firm areas when you touch the face. All of these sensations and feelings occur normally and subside over a few weeks as healing progresses. Most are not apparent visually after 2-3 weeks. In general, the more extensive the procedure required to correct your problem, the more swelling and bruising you can expect.

All of the above mentioned complications of face lift surgery are unusual, but occur occasionally despite the most vigorous standards of surgical practice. They are listed not to alarm, but simply to adequately inform you prior to your surgery.

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Conclusion:

Although the term facelift is applied to a number of different procedures, the operation must be carefully individualized and meticulously executed in order to achieve optimal results in each individual patient. This summary provides general information, but I encourage you to list other questions which may arise as you review it and discuss with me in detail any questions you have. An optimal result requires good communication and your being well informed and comfortable prior to your surgery.

Among aesthetic procedures to improve facial appearance, an extensive, well executed facelift can offer significant and often dramatic improvements. The fresher more youthful appearance of the face and neck is extremely satisfying to our patients, with a very positive effect on self-image.

During your office consultation, additional and more detailed information regarding all of the areas mentioned in this information sheet will be provided you as well as an opportunity for you to ask in-depth questions. Please review this sheet carefully and write down any questions you may have.

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Testimonials

Thank you for my perfect reflection, for being you and taking such good care of me. MW

Thank you for all that you have done for me. I admire you work ethic and how much your practice has grown. You are a credit to your profession, and a man with tremendous charisma! I feel very lucky to have you as a surgeon. DM

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Recovery Tips

Postoperative healing requires some mandatory down time as part of the surgical recovery process. Post surgical healing requires the body to repair the surgical wound (whether in the skin, fat, muscle or bone) with scar tissue. The bruise and tissue fluid in the wound are gradually replaced by stronger scar or fibrous tissue over a period of 6-8 weeks. Until the time that the healing area is strong enough to maintain tissue integrity, the wound is held together by the sutures (stitches) placed at the time of surgery. Too much wound tension (stress) before the strength of the healing tissue is satisfactory, can cause disruption of the incision. I place sutures very precisely to account for these healing characteristics to maximize your postoperative activity, comfort, and safety. However, your inherent healing characteristics significantly dictate these parameters. Stretching, movement, massage, and return to normal activities of daily living in the early postoperative recovery allow for the optimal return to your full normal life style.

After the initial burst of high energy healing and the “bulking up” of scar tissue, the wound enters a maturation phase, and the scar tissue becomes thinner, less red, and stronger. The maturing and stabilization of scar tissue occurs over a period of 6 to12 months. Long-term changes tend to be more subtle, slower, and less evident than short-term changes that occur in the first 6 to 8 weeks.

There are no absolute parameters regarding return to postoperative activities and one must adjust for variation in pain tolerance, invasiveness of surgery and healing variations.

In general, you cannot speed up the healing process, only slow it down by too much activity too soon. Overexertion can lengthen the period of time for pain to decrease, swelling and bruising to resolve, and the final surgical results to be evident. Healing occurs for up to one (1) year, sometimes longer. The latter changes tend to be subtle and gradual, and therefore not nearly as dramatic as in the initial 6 to 8 weeks.

Please be patient with your own healing. Any change in your appearance affects your perception of self-image and requires an adjustment period of days to weeks. It is normal to have mild feelings of doubt or a low mood during this period in the first 1 to 3 weeks following surgery. These feelings are then rapidly replaced by positive feelings as healing progresses and you adjust to your improved appearance.

Should you develop any of the following symptoms, please call our office: a) elevation of temperature to or above 101 degrees, b) extreme swelling or tenderness in your face or neck, c) any prolonged or significant bleeding from incision lines (slight drainage for 24 hours is normal), d) redness along the incision lines or elevation of temperature.

If you should have any other questions or problems, please contact our office at (303) 443-2277.

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Estimated Cost

$11,00 – $12,500 includes surgeon, operating room and anesthesia.

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Forms & Documents

Please ask your physician for the required documents for this procedure.

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