Facelift Washington DC/McLean/Tyson’s Corner

If You Are Considering a Facelift in the Washington D.C Area

A facelift is an operation that rejuvenates the middle and lower third of the face. The overall face can be aesthetically divided into three parts: forehead, mid-face (cheek) and neck. A facelift actually is a combination lift of the lower face and neck with the midface. Adding a forehead or brow lift would constitute a full face lift. But since aging in the midface and neck occurs more rapidly than it does in the forehead, not every patient, who is a good candidate for a facelift or neck lift, needs to undergo a forehead lift. Facial rejuvenation surgery should be customized to each patient. The aesthetic challenge is to create a natural appearance where patients look like themselves, only younger and refreshed.

Dr. Baker, a facelift surgeon in Washington, D.C., will help you choose the approach that best suits your goals. The general goal of cosmetic chin surgery is to provide a harmonious balance to your chin and facial features so that you feel better about the way you look.

Dr. Baker’s Credentials for Facelift

  • Professor of Plastic Surgery, Medstar Georgetown Department of Plastic Surgery
  • Director, Medstar Georgetown Center for Facial Restoration
  • Authored multiple peer-reviewed manuscripts on facial rejuvenation
  • Face Q pioneer and expert on outcomes studies in patient satisfaction in facial aesthetic surgery including facelift (one of several practices in the United States selected to participate in this study funded by the Plastic Surgery Foundation).
  • Training in plastic surgery, maxillofacial surgery, and craniofacial surgery provide him the tools to perform a complete assessment of each patient’s facial structure. He is trained in all modalities of addressing your problems, so he is not limited in the solutions he can provide to address your concerns.
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A traditional facelift incision begins in the hairline at the temples, travels around the ear and ends in the lower scalp. Fat may be sculpted, the underlying tissue is repositioned, and skin is trimmed.


Limited Incision Facelift

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The Best Candidate for a Facelift

The best candidate for a facelift is a man or woman whose face and neck have begun to reveal deep creases, redundant skin, or jowls, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well. The health of the patient is more important than the age.

A facelift can make you look younger and fresher, and it may enhance your self- confidence in the process. But it cannot give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Baker.

Evaluation

Facelifts are very individualized procedures. In a clinic in Washington, D.C., a facelift consultation with Dr. Baker begins with evaluating your face, including the skin, soft tissue volume, and underlying bone; and he will discuss your goals for the surgery. Based on your goals and your available recovery period, Dr. Baker will help you individualize your treatment plan so that it achieves your goals within your desired recovery period. Your consultation will include a detailed assessment of your face and all the tissue layers that are contributing to your concerns. Three-dimensional predictive imaging will be used to predict what Dr. Baker feels would be a realistic result in your situation. It is hoped that his will help you to determine if this procedure is something you would like to undergo.

Depending on each patient’s goals, ability to recover, and budget, an individualized treatment plan can be developed to achieve your individual goals in a manner that best suits you. Rather than using techniques with trendy names and cute acronyms, Dr. Baker anatomically evaluates your face and specifically focuses on what matters to you, the patient. He will give you his honest opinion, but ultimately, what are most important are the patient’s goals. Dr. Baker will discuss the safest, most predictable way to achieve these with each patient and when appropriate, offer multiple approaches to address your concerns.

Dr. Baker will check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. Be sure to tell Dr. Baker if you smoke or are taking any drugs or medications, especially aspirin or other drugs that affect clotting.

If you decide to proceed with a facelift, Dr. Baker will explain the techniques and anesthesia he will use, the type of facility where the surgery will be performed, and the risks and costs involved. Do not hesitate to ask him any questions you may have, especially those regarding your expectations and concerns about the results.

What is a Facelift?

For Washington, D.C. area residents, Dr. Baker’s facelift usually takes four to five hours-or longer if you are having more than one procedure done. To rejuvenate and restore youthful facial proportion, it is not necessary to pull the skin into the “wind tunnel” look. The majority of the tissue that creates the undesirable signs of facial aging occurs deep to the skin. The creases and folds are created from deeper tissues descending down the face secondary to the effects of gravity and the loss of tissue elasticity. Therefore, the goal of surgery is not to pull the skin tight but rather restore the deeper tissue to a more youthful position.

Once the underlying sculptural qualities of youth have been restored, the skin can be gently redraped over the deeper tissue. The skin redundancy is then removed with the skin under minimal tension or pull. This restores a youthful appearance without an unnatural tight look.

Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. To achieve an optimal result in some necks, a small incision may also be made under the chin. The deeper tissues are then redraped into a more youthful position prior to skin closure. Fat is removed in undesirable areas, but may be added to other areas to create the volume of youth in the upper or midface.

Following surgery, a small, thin tube may be temporarily placed under the skin behind your ear to drain any blood that might collect there. Dr. Baker may also wrap your head loosely in bandages to minimize bruising and swelling.

Preparing for Your Facelift

Dr. Baker will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, quitting smoking, and taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it is especially important to stop at least three weeks before and after surgery. Smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas. If your hair is very short, you might want to let it grow out before surgery, so that it is long enough to hide the scars while they heal.

Whether Dr. Baker performs your facelift lift at Georgetown University Hospital (Washington D.C.), Inova Fairfax Hospital (Falls Church, VA) or an ambulatory surgical facility (McLean, VA), you should arrange for someone to drive you home after your surgery, and to help you out for a day or two.

Anesthesia

Dr. Baker performs most facelifts under general anesthesia. Occasionally, he will perform facelifts under IV sedation or twilight sleep. However, Dr. Baker feels it is safer for his patients to have a protected airway so he will likely recommend general anesthesia. If a patient is sedated and moving during surgery, the procedure will be more difficult. To minimize movement, more sedation can be given until the patient is no longer moving. The definition of general anesthesia is the induction of a state of unconsciousness with the absence of pain sensation over the entire body, through the administration of anesthetic drugs. As sedation is increased to keep the patient unaware of the procedure and to keep them from moving, what started as twilight sleep may actually begin fit the definition of general anesthesia. Now the patient is under general anesthesia without a protected airway. Safety is Dr. Baker’s primary concern, especially in elective surgery. For this reason every procedure is performed under the care of an anesthesiologist in a facility with multiple anesthesiologists available in the need of additional assistance.

Risks and Complications

When a facelift is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Still, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable. Complications that can occur include hematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles (usually temporary), infection, and reactions to the anesthesia. Poor healing of the skin is most likely to affect smokers. You can reduce your risks by closely following Dr. Baker’s advice both before and after surgery.

Recovery

There is not usually significant discomfort after surgery; if there is, it can be lessened with the pain medication prescribed by Dr. Baker (severe or persistent pain or a sudden swelling of your face should be reported to Dr. Baker immediately). Some numbness of the skin is quite normal; it will disappear in a few weeks or months. Dr. Baker may tell you to keep your head elevated and as still as possible for a couple of days after surgery, to keep the swelling down. If you have had a drainage tube inserted, it will be removed one or two days after surgery. Bandages, when used, are usually removed after one to five days. Do not be surprised at the pale, bruised, and puffy face you see. Just keep in mind that in a few weeks you will be looking normal. Most of your stitches will be removed after about five days. Your scalp may take longer to heal, and the sutures in your hairline could be left in a few days longer.

You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first. Dr. Baker will give more specific guidelines for gradually resuming your normal activities. They are likely to include these suggestions: avoid strenuous activity (including sex and heavy housework) for at least two weeks (walking and mild stretching are fine); avoid alcohol, steam baths, and saunas for several months. Above all, get plenty of rest and allow your body to spend its energy on healing.

At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff and you will probably be self-conscious about your scars. Some bruising may persist for two or three weeks, and you may tire easily.

By the third week, you will look and feel much better. Most patients are back at work about ten days to two weeks after facelift surgery. If you need it, special camouflage makeup can mask most bruising that remains.

Your New Look

The chances are excellent that you will be happy with your facelift-especially if you realize that the results may not be immediately apparent. Even after the swelling and bruises are gone, the hair around your temples may be thin and your skin may feel dry and rough for several months. Men may find they have to shave in new places-behind the neck and ears-where areas of beard-growing skin have been repositioned.

You will have some scars from your facelift, but they are usually hidden by your hair or in the natural creases of your face and ears. In any case, they will fade within time and should be scarcely visible.

Having a facelift does not stop the clock. Your face will continue to age with time, and you may want to repeat the procedure one or more times-perhaps five or ten years down the line. But in another sense, the effects of even one facelift are lasting; years later, you will continue to look better than if you had never had a facelift at all.

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