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Facelift (Rhytidectomy)

Facelift (Rhytidectomy)

Technically known as rhytidectomy, a facelift is a surgical procedure that smooths loose skin on the face and neck, tightens underlying tissue and muscles, and removes excess fat. It is one of the most sought-after and satisfying aesthetic surgical procedures in La Jolla and San Diego.

A facelift can remove many, but usually not all, wrinkles and it can remove much of the sagging skin of the face and neck. It will give you a more youthful, fresher, and natural appearance.

Plastic surgery is the fusion of art and science. To sculpt the face through plastic surgery requires an approach that is individualized, studied, and measured. Achieving the most appropriate result for each face requires the ability to evaluate the facial anatomy and then to apply scientific principles, skill, and artistry. 

Dr. Robert Singer is known worldwide for his expertise and skill with the facelift procedure. He has performed this delicate surgical procedure at his La Jolla practice for many people wanting a rejuvenated, younger appearance.

Many men and women who opt for a facelift consider other procedures to be performed concurrently, when possible, to shorten the overall recovery time and create a harmonious result. These include nose surgeryeyelid surgerybrow lift, micro-fat graftschin and cheek augmentation, or injectables like Juvederm, RestylaneBotox, or Dysport. Injectables can further smooth some of the fine lines that remain after a facelift.

For more information about facelift surgery in La Jolla and San Diego, contact us or call Dr. Singer at 858.455.0290

Who Needs a Facelift?

Today, men and women increasingly want to look as young as they feel. No one wants to look tired, especially when they aren’t. The facelift (rhytidectomy) helps reverse the signs of aging, producing a more natural, youthful facial appearance.

You should consider a facelift when what you see in the mirror does not match what you feel on the inside, when you have a support structure in place to facilitate a comfortable recovery, and when you are confident you are doing this for yourself and not to please others.

Most patients who seek a facelift are between 40 and 70 years old, but there is no “correct” age. If you are not physically or emotionally ready for a facelift, there are non-invasive, temporary procedures to rejuvenate your faces such as supervised skin care, chemical peels, injectable fillers, microdermabrasion, lasers, and injectables such as Dysport or Botox.

If you are under forty years of age and have substantial loose skin of the face and neck, you can probably undergo a more limited variation of the facelift procedure called a Mini or Mid-facelift.

The best candidate for a facelift is a person whose facial and neck skin has started to sag but whose skin retains some elasticity. Additionally, a good candidate will have a strong, well-defined bone structure.

It is important for patients to be physically and psychologically healthy, have realistic expectations of their surgery, understand the risks and benefits of a facelift, and desire improvement rather than perfection.

Your Face Lift Consultation

During a facelift consultation, Dr. Singer will personally listen to your desires and expectations for your procedure. He will then evaluate your anatomy and physical appearance to create a custom treatment plan that best suits your needs. There is no single technique or single approach that is appropriate for every patient. The goal of your facelift is to improve your overall facial appearance in a natural manner.

Before & After Photos

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The Facelift Procedure

Facelift techniques have evolved significantly over the past 15 years. Prior generations of facelift operations tightened only the skin and ignored important principles of aging and facial structure. Unfortunately, tightening only the skin produced distortions of the facial features and often resulted in an unnatural, flattened, wind-blown, pulled look, as well as a shorter length of efficacy.

Dr. Singer performs a modern multi-vector underlying support facelift that is individualized for your needs and is more precise, more natural, and longer lasting. The supporting deeper tissue – the SMAS (superficial muscular aponeurotic system) – is tightened, lifting the underlying muscle layers of the cheek and the neck. The fat in the cheek is contoured into an improved position or sculpted if it is excessive.

Dr. Singer will correct the fullness of the upper cheek area below the eyelid by elevating it into a more youthful position, counteracting the direction of the descent of the tissue that occurs with aging. 

The skin is then redraped without tension, and any excess skin is tailored. He will also address the loose skin, muscle, and fat under the chin and neck if those areas need improvement.

Dr. Singer will perform the entire facelift surgical procedure, which can take 90 minutes to six hours depending on each patient. His focus will be on the success of the surgery, not in how fast he can complete the procedure.

Incisions are placed along the hairline and hidden in the curves around the ear, and there may be a small incision under the chin.

In addition to a full facelift, Dr. Singer also offers the maintenance facelift (mini or mid-facelift), cheek reduction, and secondary facelifts.

Anesthesia at our Accredited Operating Facility

At our AAAASF-accredited (American Association for Accreditation of Ambulatory Surgery Facilities) private operating facility in La Jolla, you will be taken care of by thoroughly trained personnel, including carefully selected, experienced, board-certified anesthesiologists.

Most of our facelift patients are given a twilight anesthetic, allowing them to sleep while breathing on their own, but usually not requiring deeper general anesthesia. In some cases, Dr. Singer may recommend that you spend a night in the hospital after your surgery. We will discuss these options with you during your consultation.

Recovery from a Facelift

You will be allowed to go home, accompanied by a responsible adult, one to two hours after your facelift surgery. Dr. Singer may suggest you spend the night after surgery at Scripps Memorial Hospital which is next door to our office.

Following the procedure, you will have a soft head wrap around your head and under your chin to minimize swelling. Dr. Singer will place drains behind each ear for excess fluid to escape. We will teach you, and you’re caretaker on how to empty these drains every night. We will remove these drains one or two days after surgery in our office. Your bandages will be changed or removed three to five days after surgery.  We will have all your sutures removed within two weeks.

You may experience some bruising and swelling, which should subside dramatically within two days. Applying Arnica Montana topical cream two days before and two days after surgery will help reduce bruising.  Bruising and swelling will continue to subside for three weeks after surgery.

We advise you to sleep on your back for two weeks with your head elevated. This position will help you with swelling and make you more comfortable.

You should avoid strenuous sports and exercise for three weeks, and you should refrain from any other activity that significantly raises your body temperature and blood pressure.

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Frequently Asked Questions

A facelift is one of the most sought after and satisfying aesthetic surgical procedures. It can remove many, but usually not all wrinkles. It can remove much of the sagging skin of the face and neck. Excess fat can be removed or sculpted as needed. The facelift will give you a more youthful fresher natural appearance, but your expectations must be realistic. There are limitations to what it can accomplish. Magazines and non medical articles may lead you to believe a facelift is a simple procedure: in fact, it is real surgery. It requires complex incisions that are placed to make them inconspicuous, dissection of the skin, contouring of the fat, and tightening of the underlying muscles. It should be performed only by a qualified, capable, and experienced plastic surgeon.

A facelift can turn back the clock, but will not stop the process of aging. The length of time the improvement is acceptable before any additional surgery may be considered varies with each person. However, most people can expect their results to last between eight and twelve years.

Heredity is important. If your parents aged slowly, you probably will, too. Your diet, general health, time spent in the sun, smoking, weight gains and losses, emotional traumas, and type of skin will all play a role in determining how long the improvement will last. For many men and women, a rhinoplasty can improve the shape of the nose, while eyelid surgery, forehead lift, dermabrasion, micro-fat grafts, skin rejuvenation, or cheek and chin implantation can enhance the results achieved by the facelift.

Most of the women and men who would benefit from facelifting are between 40 and 70 years old. However, there are exceptions. Some people age prematurely and may consider improvement at an earlier age, while others age more slowly and can successfully undergo the surgery in their seventies or eighties.

In some cases, a partial limited incision facelift (mini-lift) or a neck lift may be all that is required to restore a natural more elegant and youthful contour to the face.

Technically known as rhytidectomy, a facelift is a surgical procedure that smoothes loose skin on the face and neck, tightens underlying tissues and muscles, and removes excess fat.

There are a variety of procedures which claim to replace a facelift, but in reality do not. Fillers, Dysport or Botox, peels, laser treatments, and radio-frequency all may improve appearance in some patients. We incorporate some of them at the Singer Surgical Centre in our options of treatments, but they do not produce the same long standing result of a well performed natural appearing facelift. They provide a lesser degree of improvement, the results are usually temporary, and in the long run may be more expensive.

Many of the claims of alternatives to a facelift are scientifically unsubstantiated. There are no “facelifts in a bottle”. If it sounds too good to be true, it probably is!

Most patients who seek a facelift are 40+ years old. However, if a patient has substantial loose skin of the face and or neck at a younger age, they can undergo a more limited variation of this procedure. Unfortunately, if a patient’s skin elasticity has diminished too much during the aging process, he or she may get a significant improvement, but not an ideal result, nor will it be as long lasting as in the patient with better elasticity.

You should consider a facelift when what you see in the mirror does not match what you feel on the inside, when you have a support structure in place to facilitate a comfortable recovery, when you are confident you are doing this for yourself and not to please others. There is no “correct” age, and if you are not physically or emotionally ready for a facelift, there are non-invasive and less-invasive procedures to rejuvenate your face such as supervised skin care, chemical peels, injectable fillers, microdermabrasion, lasers, and Dysport or Botox.

The best candidate for a facelift is a person whose facial and neck skin has started to sag but whose skin retains some elasticity. Additionally, a good candidate will have a strong, well-defined bone structure. It is important for patients to be physically and psychologically healthy, have realistic expectations of their surgery, understand the risks and benefits of a facelift, and desire improvement rather than perfection.

Most of the women and men who would benefit from facelifting are between 40 and 70 years old. However, there are exceptions. Some people age prematurely and may consider improvement at an earlier age, while others age more slowly and can successfully undergo the surgery in their seventies or eighties.

The results of a facelift may be considered permanent in that you will continue to look younger years later than you would have without undergoing the facelift. However, a facelift cannot stop the aging process and the face will continue to age. You will, however, always look younger and better than a twin, if you undergo a facelift and your twin does not.

The results will vary from person-to-person. Most patients can expect their results to last between eight and twelve years. The length of time that patients enjoy a satisfactory improvement after a facelift depends on many factors including the quality of their skin, which is influenced by the degree of sun damage or loss of elasticity. Smokers typically have poorer quality skin. Older patients will see an earlier return of laxity, while younger patients will see a more long-lasting improvement.

Heredity is important. If your parents aged slowly, you probably will, too. Your diet, general health, time spent in the sun, smoking, weight gains and losses, emotional traumas, and type of skin will all play a role in determining how long the improvement will last.

Yes, it’s generally preferred to combine procedures. It is financially beneficial because you only undergo 1 anesthesia and minimize the cost of the operating room and surgical supplies. In addition you minimize downtime by having to go through the recovery process following surgery only once. Commonly combined procedures with face lift surgery include the following:

• Eyelid surgery
• Brow lift
• Micro-fat transfer
• Laser or dermabrasion
• BOTOX® Cosmetic or Dysport
• Chin implant
• Rhinoplasty (nasal surgery)

This will depend on the individual. Most people are able to return to work between 10 and 14 days after their surgery even though some residual swelling and bruising may take up to three weeks to disappear. You should refrain from any strenuous activities for at least three weeks. Strenuous activities or exercise before that time will increase the risk of bleeding, swelling, and bruising. Sun exposure should also be avoided during that time. Your return to your normal activities is more determined by swelling and bruising and by your personal feelings about how you want to look as you resume social activities. A lot of the swelling will be resolved within eight to ten days, which is when most patients resume more normal limited activities. Bruising generally resolves in 2-3 weeks but it can be fairly easily covered with make-up prior to total resolution. Many patients prefer to wait until the bruising has disappeared before attending any major social events, or if they want to look their best before being seen by their friends.

Most patients who have facelift surgery say they are surprised at how mild the discomfort is that they experience. Patients more typically complain of tightness from swelling or a pulling sensation under the chin or in the temple area. Understandably, after any surgical procedure, some discomfort can be expected and pain tolerance varies from patient to patient. Patients are provided with prescriptions for pain medication. Many patients use the prescription medication 2-5days after surgery and then switch to Extra Strength Tylenol. It is uncommon for patients to report extreme pain after surgery.

Most patents will have some bruising. You can minimize bruising by following instructions and using Arnica 1-2 days before and after surgery.

Most patients look reasonably good at 2-3 weeks, but subtlely improve over months. It takes a year to see the final results.

You should expect:

  • Moderate swelling, bruising, and bloodshot eyes that may last for about two to three weeks. Don’t be concerned if blood appears on your bandage, especially behind the ears.

  • Sensations of tightness, which subside slowly over several days to weeks.

  • Intermittent sensations of tingling, burning, and itching behind or on your ears. These also subside over several weeks. Numbness of the cheeks and neck that gradually improves over several months.

Call: (858) 455 0290 if you have:

  • Severe pain that doesn’t respond to medication.

  • Significant swelling, and/or unrelenting pain which occurs more on one side than the other.

  • Bandages that become too tight.

  • Any other problems or questions.

Activity: You should “take it easy” the day of your operation and the following days. Sleep on your back for two weeks, elevating your upper body on two or three pillows. By keeping your head elevated above your heart, swelling can be minimized. Because of your medications, you may need assistance getting to and from the bathroom for the first day.

Medications: Take the medications we’ve prescribed according to the instructions on the bottle. You may feel a little drowsy, so have someone help you. If you need a refill, call the office and give us the telephone number of your drugstore or pharmacy. Do not take aspirin for five days after your surgery.

Pain: Most patients feel that the discomfort from this surgery is minimal. The greatest period of discomfort usually lasts about twenty four to forty eight hours. Thereafter, you should have less discomfort and less need for medication. Occasionally, it lasts a little longer.

Smoking: Do not smoke for five days after surgery.

Alcohol: Do not drink alcohol for five days after surgery

Driving: You may drive after five days.

Diet: Start with liquids (fruit juice, milk shakes with Carnation Instant Breakfast, etc.) the first day then for the remainder of the first week progress to soft foods (pudding, macaroni and cheese, mashed potatoes, oatmeal, pasta) that do not require much chewing, restricting salt and artificial sweeteners.. To prevent dehydration, please drink as much juices and nutritional fluid as possible.

Hair: You may wash your hair after the dressing is removed. We suggest that you wash it in a shower with ordinary shampoo. You may dry it with a towel, or blow dry it with a cool dryer. Do not use a hot hair dryer, electric rollers, or curling irons for three weeks following surgery. Do not color or bleach your hair for three weeks after surgery, or until you are completely healed.

Makeup: You may apply makeup when the bandages are removed, keeping the makeup away from the incisions for two weeks.

Sun: Do not sit in the sun at all for three weeks after surgery. If the incisions are exposed, apply sunscreen for six months.

Sports: Strenuous sports such as golf, tennis, swimming, bowling, jogging, aerobics, jazzercise, or bicycling may be resumed after three weeks. Refrain from any activity that significantly raises your body temperature, and/or blood pressure for three weeks after surgery. This includes hot tubbing, sexual relations, and brisk walking.

Work: Depending on the kind of work you do, you may return to your job as soon as you are comfortable.

Postoperative visits: The day after surgery: If the procedure is to be performed as an outpatient, you will be seen at our Centre. If you are hospitalized, you will be seen there. You will be examined at this time. Subsequent visits: They will be determined by your progress. The drains are removed one to two days after surgery. The dressing is removed three to five days after. Some of the stitches will be removed four or five days after surgery, the remainder at about two weeks.

This does not hurt. A consultation will be provided by our cosmetologist at no charge to you.

You will feel more comfortable using the private waiting room for your initial postoperative visits.

Please feel free to call us at any time during your healing period. THE OUTCOME OF YOUR SURGERY IS IN YOUR HANDS AS WELL AS THE DOCTOR’S. IT IS YOUR RESPONSIBILITY TO FOLLOW ALL INSTRUCTIONS GIVEN TO YOU.

Related Facial Surgery Procedures

Forehead
Lift

Cheek
Reduction

Chin
Augmentation

Ear
Surgery

Eye
Surgery

Lip
Augmentation

Microfat
Grafts

Mini-Mid
Facelift

Neck
Lift

Nose
Surgery

Why Choose Dr. Singer?

Dr. Singer has the respect of his peers and patients across San Diego and the surrounding Southern California area. He has helped thousands of San Diego residents with an eye for balance and beauty and the skills of an artist. Dr. Singer has been engaged in private practice in the La Jolla area of San Diego since 1976 and is now an internationally recognized plastic surgeon. You are in the best of hands with Board Certified Plastic Surgeon (American Board of Plastic Surgery) Dr. Singer.

Please learn more about Dr. Singer’s affiliations, memberships, awards, honors, and accomplishments. The full list and Dr. Singer’s curriculum vitae are available upon request.

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