| |
Facelift (Rhytidectomy)
Cosmetic plastic surgery of the face can “turn back time” by reducing the appearance of wrinkles and lines, sun damage and sagging skin that can make you look angry, sad or tired.
Dr. Rizk is highly specialized in Facelift and Necklift surgery and is a double board certified facial plastic surgeon who does not perform body plastic surgery.
Dr. Rizk performs many different types of facelifts and customizes the lift for each patient to achieve a natural, long lasting result with the most rapid recovery. As we age, muscles become loose and drop underneath the skin. Dr. Rizk's Lift differs because it addresses the deeper tissue by going under the muscle sliding it backwards into its original youthful position. This technique results in less bruising and swelling since he lifts deeper beneath the muscle. Skin scars heal better because there is no tension on superficial layers and skin. Once the deeper tissue is lifted, the excess skin is trimmed.
The facelift results in a natural, softer look and creates definition along the jawline and neck, without tightness. Dr. Rizk takes special care to hide scars inside the ear which allows wearing hair up after surgery with no visible scarring. Most patients are able to resume their normal routines within 7-10 days after surgery. Dr. Rizk also performs other types of shorter lifts for younger patients with lesser degrees of aging.
Dr. Rizk's "Rapid Recovery Neck Lift," featured on Fox 5, incorporates the use of the Endotine Ribbon
and tissue glues which results in a rapid recovery and creates a more
natural lift with longer lasting results. Dr. Rizk was the first
surgeon to use this ribbon device in the deep plane facelift and neck
lift, and he incorporates the use of tissue glues to expedite the
healing process and decrease bruising and swelling. In addition, Dr.
Rizk incorporates use of various vitamins and herbal supplements to
expedite recovery.
The key to Dr. Rizk's facelift surgery is best expressed by
former Miss California, Francine Newton, who stated in a New York Times featured article,
"No one knows I had a facelift - I had to tell them. My friends have
never seen anything like what he's done for me."
Does Dr. Rizk do these Media-Advertised lifts, like the Nonsurgical Y lift, Lifestyle lift, or Liquid Lift? What are they?
There are many short-lived lifts, most of which are not even lifts, but are just filler injections hyped by catchy names like Y lift or Liquid lift (merely filler injections in the face). Of course, most filler injections will make patients look better, but fillers are used in conjunction with a real lift which lasts 10 years or more, makes patients look natural, and the recovery is rapid. Fillers may be used alone or in conjunction with real lifts and do help with the nasolabial folds, but do not lift the neck or jowl. Too many fillers, especially in the lower face and around the mouth can look UNNATURAL. Dr. Rizk does not tout his lifts with NAMES, only giving his patients NATURAL RESULTS and LONGEVITY.
What are face and neck changes that occur with age and
how should a facelift, neck lift or both address these changes?
As we age, gravity, sun-exposure, genetic factors, smoking, pollution,
and life stresses all combine to loosen and sag our facial tissues (muscles,
fat and skin). These
aging changes may deepen the folds between the nose and mouth (nasolabial
fold) and result in jowl formation around jaw line where definition is
lost. Additionally, accumulation of fat under
the chin may produce a double chin. Loosening of the neck muscles (named platysma) may produce appearance of
hanging cords (particularly visible in thin patients). It is important to note that any
facelift or neck lift or both must address the muscle layer, fat and
skin in order to look natural and achieve longevity.
Definition is the key to beauty, not tightness.
Lifting skin alone will result in an unnatural tight look, will loosen
quickly and will result in a stretched scar. This is an important point because many facelifts advertised on
broadcast or print media taunt the consumer into believing that there
are these magical “weekend lifts”, short lifts, with 2 day recovery
times and long lasting results. My advise to patients is “if it sound too
good to be true, it usually is “. My facelift or neck lift surgery looks natural, lasts over 10 years
and patients may be socially presentable in a week. I have presented
extensively at scientific plastic surgery meetings and published my
techniques in peer reviewed journals. These techniques are tested over time and incorporate the latest
technology and advances. I refer you to my textbooks and articles
in ‘in the news section’ for more information. To summarize some important concepts, I perform my facelift and neck lift
deep to muscle and fat layer and lift in a natural vector of
elevation. By doing so, I am able to reestablish
youthful look by repositioning drooping tissue to its original
youthful home. The cheek fat pad in the midface is important for a
beautiful face. I reposition this fat pad over its
youthful home right under the cheekbone and eliminate the hollowed
area created by aging under the cheekbones. Injecting fat in this
region is unpredictable and I do not believe fat injections work as
they clump and create deformities over time. It is better to reposition you own tissue. By lifting sagging, deeper
tissue it result in natural definition along jaw line, rather than
unnatural tightness evident with more superficial lifts advertised all
over today’s media. By
lifting deeper, the superficial tissue and skin is merely trimmed away
and closed with no tension, thus resulting in the thinnest best
healing scars. Additionally, lifting deeper results in less bruising
and a more rapid recovery since most bruising is linked to more
superficial blood vessels under the skin.
How do facelift/neck lift techniques differ and how do
Dr. Rizk’s techniques differ?
To put it simply all facelift and/or neck lift techniques
differ by length of incision and depth of lift. Dr. Rizk performs many types of lifts, with some partial shorter scar
lifts for younger patients addressing a specific region, either lower
face, neck or midface separately or together, and customizes the lift
to the patient’s degree of aging. His signature lift is the modified deep plane
facelift which addresses the midface, lower face and neck. He
has pioneered the use of high definition 3-D telescopes from the
facelift or neck lift incisions around ear or under chin to visualize
face and neck structures and increase surgical precision and safety
(featured as lead clinical story in face section of Plastic Surgery
Products Magazine, December, 2008) Dr Rizk has developed a graded
customized approach to facelift/neck lift surgery which means that a
younger patient in his/her 40’s may only need an isolated neck lift. An older patient with jowl formation in lower face may be a candidate
for a partial lower facelift/neck lift and some patients may require
the full facelift. The full facelift addresses the mid-face as well as
lower face, jowls, and neck. The brow is not part of a facelift and is
addressed separately with a browlift. This graded approach to facelifts allows for
shorter scars depending on the lift. A neck lift scar alone is behind the ear and under the chin. A facelift scar is tucked away inside the
ear and hair to hid the scar and allow hair to be placed up without
scar visibility. Dr.Rizk
has added certain technology/medications such as tissue glues and
herbal medicines to expedite recovery. The use of high definition
telescope technology (high definition camera systems) through the
facelift incisions around the ears allows better visualization to
maximize safety. Facelifts/neck lifts very often are performed
together in one procedure but an isolated neck lift may be performed
in a younger patient without a facelift or visa versa. Some
heavy necks and most male necks require a midline tuck of the muscle
done through a small scar under the chin with this telescope system,
in addition to the lift sideways behind the ear, to achieve a better
result. Various herbal medications are
added pre/post-operatively such as arnica Montana, bromelin, and
tissue glues to expedite recovery. A moratorium is placed on use of aspirin and other NSAID’s such as
ibuprofen, Alieve, Excedrin which cause bleeding and bruising as well
as fish oil, and herbal supplements which may increase bleeding and
bruising for 2 weeks before and 2 weeks after surgery.
What is typical age of facelift and neck lift patient?
Typically, patients in their early 40’s may be a candidate for
a neck lift alone and later in their 40’s for a partial facelift and
neck lift. Patients in
their 50’s or 60’s usually require a full facelift/neck lift. Age range for facelift/neck lift is
40’s-70’s with some exceptions below age 40 in patients with weak chin
structure and increased fat deposition under chin. Facelifts can also be successful in patients in their 80’s.
How long does it last?
Because Dr. Rizk addresses the deeper tissues and fat layers in face and
neck, facelift typically lasts 10 years. Face continues to age but the clock is
turned back and benefits of facelift and neck lift surgery will last even beyond
10 years as patients will look much better thereafter as compared to not having
the procedure done. Another facelift may performed after 10
years. Dr. Rizk has successfully
performed third or fourth facelift procedures on older patients.
What are differences in male versus female facelift and
neck lift surgery?
Male skin is thicker and heavier with more blood supply because of the
beard. In all male facelift/neck lift patients, Dr Rizk performs the midline
muscle tuck (midline playsmaplasty or submentalplasty) done from a small
incision under the chin with the high definition telescope system. This is done in addition to the lateral
(sideways) pull of the platysma muscle in the neck. Male patients tend to be concerned more
about their necks than their faces as compared with female patients. Some female patients with neck cords or
significant fat under the chin also benefit from this midline muscle tuck in
addition to the lateral pull to the side behind the ears. Male patients show a particular advantage
in a more rapid recovery with the use of tissue glue (see section on “in the
news” and view Dr Rizk’s peer reviewed articles published in Archives of Facial
plastic Surgery on deep plane facelift with tissue glue).
What is a weekend lift? And a thread lift?
There are many facelift/neck lift techniques advertised in the media
daily with many claims. Dr. Rizk does not believe that there is a
weekend lift that can result in natural, long-lasting outcome. It has never been addressed in scientific
plastic surgery meetings and it is just a catchy media phrase. The thread lift is done using fish wire
which is tunneled under skin from small incisions to lift facial tissue. No skin is excised. This results in unnatural puckering of
skin and facial tissue and the fish wire becomes infected frequently. There is a move away from this procedure
which has been presented in scientific meetings and Dr Rizk does not perform
this procedure because of complications and unnatural puckering.
What is typical recovery? How about pain?
Typically, patients can be socially presentable in 1 week after
facelift or neck lift surgery. However, there is still some swelling
which will subside with time. The patient undergoes procedure as an outpatient either in Dr. Rizk’s
JACHO certified surgical facility on Park Avenue or at Manhattan Eye,
Ear and Throat Hospital or Lenox Hill Hospital. Dressing is removed the day following the surgery. Dr. Rizk does not use drains after surgery so the pain of having drain
is eliminated. The tissue glue used at end of procedure
replaces having a drain in your face after procedure. The pain, in general, is minimal. Some tightness in the neck and face is
expected for first two weeks after facelift and neck lift surgery. Most stitches are removed in 7-10 days. Makeup may be worn in 7 days. It is recommended hair be dyed before
surgery.
What anesthesia is used for facelift/neck lift surgery?
Anesthesia is provided by board certified anesthesiologists with many
years of training in ambulatory anesthesia (not nurse anesthetists). Either twilight (sedation) anesthesia or general anesthesia can be used. General anesthesia has become very safe and same medications are used for
sedation as general. The patient breaths on his own in both
types of anesthesia. The difference
is in General anesthesia; a breathing tube is employed to establish a safe
airway for breathing. The
anesthesiologist will speak to the patient beforehand and discuss all options
and make recommendations accordingly.
What new innovations are
employed?
- Dr.
Rizk’s innovations include high definition telescopic assisted visualization
of facial anatomy resulting in precision and increased safety. Imagine the difference between a regular TV and a high definition TV and then
add the 3d concept to that to just give you an idea of the immense advantage
of this technology. (featured in Plastic Surgery Products article in ‘in the
news section’)
- Dr.
Rizk is the first surgeon to use endotines (absorbable devices which can
replace stitches that raise and hold deep tissue in face) in the deep plane so
they are non-palpable. Because of their multiple securing areas, they provide a longer
lasting lift and secure tissue better in a more natural method. Dr. Rizk also modified the device
to use it in the deep plane and this is currently being modified by the
company for Dr. Rizk.
- Addition of tissue glue eliminates need for drains. Tissue glues have been employed in
medicine for many years in open heart surgery to seal blood vessels and in
other types of surgery. These
glues (see extensive publications in textbooks and peer-reviewed articles in
‘in the news’ section) have immense benefits. They are used inside face after
surgery and dissolve over a period of a week. They seal small blood vessels which cause bruising and oozing. They are meant to replace drains
and expedite recovery. They do not
replace using stitches. Drains are
an old guard method which can increase infection rates, malfunction, cause
more scarring and are painful upon removal (see peer reviewed articles on my
website). I have been teaching for
many years about these glues when they were first introduced to plastic
surgery for burn victims to attach the graft tissue. More surgeons are starting to use
them all over the country.
- Deeper tissue surgery is the key-Dr Rizk has modified the deep plane facelift
by using the endotines and shortening the incision to improve longevity and
result in a much more rapid recovery. His signature lift is the modified deep plane facelift/neck lift.
- Herbal medications used before and after surgery also expedite recovery
What procedures can be performed at the same time as a
facelift/neck lift surgery?
- Lasers-
sometimes lasers are used in conjunction with a facelift or neck lift to
improve skin texture, eliminate fine wrinkles around the eye or remove sun
damage. The latest and most
advanced laser I use is the fraxel-co2 combination laser. This is not a fraxel
laser or a co2 laser but a combination which results in a much more dramatic
improvement than a fraxel laser alone and a much quicker recovery than a co2
laser alone. Typically, face looks
good in 1 week after this laser. This laser is the latest and most
advanced buzz in skin rejuvenation. I have and still occasionally use the erbium laser and co2 lasers
but the recovery from this new laser is far quicker and far superior to the
erbium or co2.
- Implants- sometimes I may add a chin implant to support a weak chin or a cheek
implant to augment a flat cheek. The bone is the support of the face and weaknesses in certain bony regions may
result in the face dropping quicker so this improves my facelift/neck lift
results. As much as 25 percent of facelift/neck lift patients also undergo
concomitant chin implant and/or cheek implants.
- Rhinoplasty- sometimes a very subtle improvement in a long drooping aging nose
can make a dramatic difference and really improve overall facial harmony. Sometimes patients notice their
noses more after facelift and/or neck lift surgery and opt to undergo a
rhinoplasty in a later procedure so i will sometime discuss a minor lift of
millimeters in the nasal tip to improve overall facial balance and harmony. It really can enhance the facelift with no additional recovery or pain. I will
perform this procedure in about 10 percent of facelift/neck lift patients.
- Browlift- a complete or partial browlift may
enhance the youthful look. Though I
only occasionally recommend a browlift, I am very conservative in lifting the
brow and only recommend it if the eyebrow is below the bony region of the eye. I offer many partial browlifts which lift only the corner of the eye (the
lateral hood) and not the complete brow. I will perform a browlift with a facelift/neck lift procedure less than 10
percent of the time.
- Eyelids- surgery (either upper or lower eyelids) is the most common procedure
performed with facelift and neck lift surgery. Approximately 60 percent of facelift/neck lift patients also undergo
an eyelift procedure to enhance their youthful look.
What is the cost of a facelift/neck lift?
There is a range of fees and it depends on whether it is a full
facelift or a partial facelift or isolated neck lift. It also depends on size of face and extent of work. In general, there are 3 fees: operating room fees (time dependent), anesthesia fees (time dependent) and
surgical fee.
To obtain an estimate of the surgical fee, either pictures have to be seen from
front view and side view or after a consultation. For more information, you may call the office to inquire about fee ranges.
To read about Surgical versus Non-Surgical Facelift, click here.
Medical Publications:
Other Links:
|
|
