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A facelift or Rhitydectomy is a popular cosmetic surgery where the skin on the face and neck is pulled back to remove wrinkles, sags, jowls etc to give a firm and youthful appearance to the face. As a person ages, the skin on the face gets wrinkled, the jaw line grows slack and jowly. This is due to gravity, sunlight, wear and tear and stress on the facial skin. In a facelift operation, a local anesthesia or a general anesthesia is given to the patient. Incision starts from the ear to behind the ear and ends near the hairline behind the ear. After the incision, undermining is done. Undermining is separating the facial skin from the underlying tissue below the neck, chin and cheeks using scalpel and scissors. After undermining the facial suspension system are tightened with stitches. Next the skin is pulled backwards and upwards to the required extent. Then the skin is tightened with stitches. The underlying excess tissue may or may not be removed. The excess skin is removed and the incisions are closed with sutures. Generally the incision is hidden around the ear and extends to the earlobes and into the hairline. Hence the incision marks are inconspicuous. For a facelift operation a thin skin and good bone structure is ideal. After the facelift operation a windswept look to the face is common. In men the side burns turn backwards giving an unnatural appearance. In women the earlobe is pulled downwards. Facelifts are generally combined with other operations like eye surgery (blepharoplasty) and skin tissue resurfacing with lasers. Before undergoing facelift operation, the patients are advised to stop smoking and drinking at least a month in advance. Growing longer hair is better to hide the incision scars. Recovery takes up to a month but most patients generally goes back home within a day. Sometimes tubes are attached under the skin to drain out excess fluid for a day or two. There can be complications like bleeding, damage to facial nerve, necrosis (death of skin), hair loss near the incision. The risk of post-operation complications is higher in case of patients with diabetes, hypertension, smokers etc. However they are not common. Patients should not take aspirin or anticoagulants before surgery. Further patients should discuss all their medical history and whether they are under any medication with the plastic surgeon. In the US it is desirable to be treated by a surgeon who belongs to association of plastic surgeon (AAPS) or any other national association. However all qualified surgeons are authorized to make a facelift operation. Results vary from subtle to dramatic depending upon the appearance of the patient before operation
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