Harmonic Facelift

About Harmonic Facelift

In keeping with our interest in academic plastic surgery and remaining on the cutting edge of developments within cosmetic surgery, our surgeons at Park Meadows Cosmetic Surgery have recently become 3 of only a handful of surgeons in the country to begin using a special knife call the Harmonic Scalpel to perform Facelifts.  The Harmonic Scalpel uses sound waves to cut through tissues rather than a sharp edge.  What this translates into for our patients is significant decrease in swelling and bruising after surgery and a much more rapid return to work and social activities.  Our surgeons will assist you in determining if a Harmonic Facelift is right for you.

At Park Meadows Cosmetic Surgery, it is our belief that facial rejuvenation should be a natural enhancement of your facial features and not a tightened or unnatural appearance that is all too familiar amongst media types and Hollywood figures.

We recognize that our patients are seeking to erase the signs of aging not their individuality or unique features.  Facial rejuvenation can be accomplished in a natural manner restoring youthful facial features and contours without creating a “done” or operated appearance.  Using this newest technique and special equipment, our surgeons will assist you in choosing a procedure that is right for you and help you determine if you are a good candidate for the Harmonic Facelift.

Your pre-operative consultation with one of our surgeons is an important first step in the surgical process. Our goal is to fully educate you about the Harmonic Facelift procedure you have elected to undergo. Specifically, you will be told how to prepare for surgery, what you should expect on the day of surgery, and the guidelines that you will need to follow postoperatively to ensure optimal results. You must be aware that all surgery carries some risk, even when the procedure is elective. Complications are infrequent, but we want you to fully understand the possible risks involved.  We believe that education is the cornerstone of a successful outcome, not high-pressure salesmanship. 

During your pre-operative consultation, one of our surgeons will ask you questions about your medical history, current medications, and social habits. This information will help the medical team to provide you optimal care. Please feel free to ask any and all questions. After your appointment, we encourage you to read through all information provided and review this information and contact us with any remaining questions. It is important to us that you are fully informed about the Harmonic Facelift procedure to ensure that you have as smooth and pleasant a surgical experience as possible.

Is the Harmonic Facelift Right For Me?

A Facelift is an appropriate procedure for people with sagging facial skin and loose neck skin. By removing excess fat, tightening muscles and skin you can attain a more youthful and smoother facial appearance. This procedure is typically preformed in people over 40, although some may benefit from it at an earlier age. In some instances, a Neck Lift can be performed without a Facelift to address only excess skin and “bands” within the neck.

Face & Neck Lift Options

INJECTABLE FILLERS

At Park Meadows Cosmetic Surgery, we recognize that there can be great confusion within the area of facial rejuvenation. For many people, a surgical procedure is not necessary and less invasive procedures with soft tissue fillers (i.e. Restylane™, Juvéderm®, Botox™) can be performed to soften deep folds and wrinkles around the mouth. Please visit the Injectables Fillers area of our website to become better informed about these minimally invasive procedures.

Facial rejuvenation essentially lifts sagging tissues, restoring volume within the face and gently tightens lose skin establishing a “V-shaped” vector of beauty.  This “V-shape” is indicative of youthfulness with greater volume in the upper cheek bone region and a well defined jaw line with correction of jowling.  By tightening loose neck skin the entire lower face can be tastefully rejuvenated creating a healthy and refreshed look.

FACELIFT

The term “full Facelift” is often used to describe a Facelift and combined Neck Lift procedure.  As these two terms imply, this procedure improves the entire lower 2/3 of the face and neck region creating significant improvement in those patients with signs of both lower facial aging as well as neck laxity.  All Facelift procedures involve an incision (scar) in front of the ear region.  With a “full Facelift” the incision is carried behind the ear, within the crease behind the ear, and in some cases into the hairline to allow removal of excess neck skin in a discrete fashion.  Incisions that are in front of the ear are carefully and discretely placed into the creases around the ear to “hide” these scars as much as possible. 

Generally, these scars fade extremely well with time, but healing can be different from person to person.  In some instances, a small soft tube is placed beneath the skin (called a drain) that allows swelling and fluid to be carried out from under the skin into a collection bulb.  This tube is usually removed 24-48 hours after surgery.  A dressing is gently wrapped around the face and neck region at the time of surgery.  Your surgeon will inform you when these dressing can be removed.  Most patients will experience swelling and bruising during the first 1-2 weeks.  Sutures are removed from in front of the ears 5 days after surgery and from behind the ear approximately 10 days after surgery.  Recovery periods vary from person to person and each individual will have a different comfort level with returning to a social setting after surgery.  For these reasons it is important to allow ample time for full recovery prior to returning to work and social activities.

MINI-FACELIFT

A Mini-Facelift addresses only the lower face and does not include a Neck Lift procedure.  Because a Mini-Facelift is more limited, it only involves an incision in front of the ear, eliminating the incision behind the ear and in the hairline behind the ear.  This procedure is usually best for younger patients and those with better skin tone, though some older patients may benefit from a Mini-Facelift.  Recovery may be slightly shorter and no drainage tube is used.  Some people refer to a Mini-Facelift as a Mini-lift, an S-lift or recently, a Lifestyle Lift®.

NECK LIFT

A Neck Lift can be performed alone, but is most frequently performed along with a Facelift to restore youthful harmony to the entire lower 2/3 of the face.  The incisions for the Neck Lift begin in the crease behind the ear and in some instances extend into the hairline behind the ear to remove excess skin and tighten the muscles of the neck.  In some instances, a small incision is placed just beneath the chin to remove fatty tissue from under the chin and further tighten the neck region to recapitulate a youthful neck contour eliminating problem “double chins” and bands within the neck region.  Without question, rejuvenation within the neck region is one of the most dramatic changes in plastic surgery, often melting years away from one’s appearance overnight.

Preparing For Surgery

At least 1 month before surgery 
Stop smoking at least 1 month prior to your procedure. Smoking reduces circulation to the skin, impedes healing, and can result in major postoperative complications. 

2 weeks prior to surgery 
Stop all medications that can thin the blood 2 weeks prior to surgery. These include drugs such as Aspirin, Coumadin, Lovenox, Ibuprofen, Vitamin E, and multiple herbal preparations. These medications may cause bleeding during and after surgery.

1 week prior to surgery
Report any sign of a cold or infection that appear the week prior to your surgery. You may need to postpone your procedure to avoid unnecessary complications.
 
The day before surgery 
Do not eat or drink anything after midnight before your surgery. This includes water, ice, or hard candy. The only exception is that you may take your blood pressure or heart medication with a sip of water the morning of surgery. 
 
The day of surgery 
Plan to wear comfortable clothes to the procedure. Wear a button down top so it does not have to be put over your head. 

Do not wear jewelry or bring valuables with you on the day of surgery. 

The day before the morning of surgery you may wash your surgical site with regular soap. 

Do not wear cream or makeup on your face the day of surgery.

You must arrange to have a responsible adult drive you home after your procedure.

What To Expect On The Day Of Surgery

When you arrive, you will be escorted to a preoperative evaluation area where you will be asked to change into a gown and will be given foot covers. Your surgeon and the anesthesiologist will meet with you before you enter the operating room suite. During this time, the surgical consent form will be reviewed with you in detail and special markings may be made on your skin at the surgical site. You will have the opportunity to ask any last minute questions. 

Once in the operating room, you will be transferred to our padded operating room table. A nurse will start an intravenous drip in your arm and connect you to monitoring devices. The anesthesiologist will give you medication through your intravenous drip to make you feel drowsy. 

When your surgery is completed and your dressings are in place, you will be moved to the recovery room. During this period a recovery room nurse will assure your comfort and continue to monitor you closely. 

Your stay in the recovery room will last approximately 1 to 1 1/2 hours. Most patients are fully awake within 30 to 60 minutes after their surgery, but may not remember much about their time in the recovery room due to some of the anesthesia medication. Once you are ready for discharge, a postoperative appointment will be scheduled and your discharge instructions will be reviewed. 

You must have a responsible adult drive you home from the surgery center. This individual should have your prescription filled at the hospital pharmacy prior to taking you home. A responsible adult must stay with you the first night after your surgery because have been sedated.

Post-operative Instructions

Diet: Start with clear liquids and toast or crackers. If those are well tolerated, progress to a regular diet.

Driving: No driving for 48 hours after your procedure or while taking narcotics.

Activity: Light activity only for the first 48 hours to avoid excessive swelling, bruising, or bleeding. After 2 weeks you may resume moderate activity such as brisk walking. Do not lift anything heavier than a gallon of milk for the first 6 weeks after surgery. After 6 weeks you may resume most normal activity including strenuous aerobic work and lifting activities. 

Work: Depending on your career and your rate of healing you should be able to return to work within 1-3 weeks of surgery. Your surgeon will be able to give you a better estimate depending on you physical and professional profile. 

Wound Care: Keep your dressings clean, dry, and intact. You will have your first follow up appointment within 24-48 hours after your procedure, at which time your dressings and drains will be removed. After the dressings have been removed, clean your incision twice a day with hydrogen peroxide on a cotton swab. If crusting occurs along the incision line, apply bacitracin ointment twice daily. 

Swelling: Moderate swelling and bruising should be expected during the first 10 days after surgery. To minimize swelling, sleep on 2 to 3 pillows so that your head and shoulders are elevated at a 45-degree angle. Cold packs help to reduce pain and swelling, but should be wrapped in a towel before they are applied to the face. Apply cold packs 20 minutes every hour while awake for the first 48 to72 hours. Do not apply the cold pack directly to your face. It must be wrapped in a towel. Application of cold packs directly to the facial skin may result in serious burns. 

Bathing: Once the dressings and drains are removed at your initial postoperative visit, you may shower daily and wash your hair. Do not use curling irons or brushes. When you shower do not allow the spray of the water to directly hit the incision site. Do not submerge the incision in a bath or swimming pool for 4 to 6 weeks. 

Medications: Ask your surgeon when you may resume your blood thinning medication. All other prescription medications may be resumed immediately, as usual. While you are taking pain medicine, you are encouraged to follow a high fiber diet and take a stool softener such as Colace (available over the counter), as pain medications tend to cause constipation. Take the full course of antibiotics given by your surgeon, to help prevent infection. 

Smoking and Alcohol: Do not smoke for the first several weeks after surgery as it impedes wound healing and can lead to serious wound complications. Alcohol consumption is dangerous while taking pain medicine. It has a tendency to worsen bleeding. 

Post-operative Appointment: You will be seen within 24-48 hours of your surgery for a wound check. At this time your dressings will be taken down and drains removed. Your second appointment will be scheduled 1-2 weeks after surgery. At the second appointment your sutures will be removed. 

Special Considerations: Call your surgeon immediately if you experience any of the following: excessive pain, bleeding, swelling of the face, redness at the incision site, or fever over 101°F.

Sun Exposure: If new scars are exposed to the sun, they tend to become darker and take longer to fade. Make sure you wear a strong sunscreen with UVA and UVB protection, and or a brimmed hat for the first 6 months after surgery. 

Itching: It is common to experience itching or small shooting electrical sensations within the skin as the nerve endings heal. Cool compresses and massage are frequently helpful. These symptoms typically resolve within 3 to 6 months. 

Swelling: It will take several months for all swelling to resolve. During this period your skin may feel heavier and thicker than usual. 

Surgical Risks: 

All surgical procedures involve some risk, such as the effects of anesthesia, bleeding, pain, and swelling. There are also possible complications specific to Harmonic Facelifts that occur in a very small percent of people. After reading the discussion below, please contact your surgeon if you have any remaining questions. 

Bleeding: Bleeding is usually minimal and well controlled during this procedure.

Hematomas: A hematoma is a collection of blood under the skin. Small hematomas can be observed and allowed to absorb spontaneously. Larger hematomas may require aspiration or drainage for optimal results. 

Infections: Antibiotics will be given to you prophylactically before and after surgery for several days to help prevent infection. If a superficial infection does develop, it typically can be treated with stronger antibiotics by mouth. Deep infections require intravenous antibiotics and or incision and drainage of the wound. This may initially result in a larger scar, which can be revised at a later date.

Scarring: All new scars are red, dark pink, or purple. Scars of the face usually fade as they mature within the first 3 to 6 months. Abnormally thick, wide, or depressed scars may occur despite meticulous surgical closure. In this situation, the scar may be injected with steroids, placement of silicone sheeting onto the scar, or surgical revision may be necessary to achieve optimal aesthetic results. 

Numbness: Initially, expect some numbness on your face in particular along the suture lines. The sensation in this area typically returns within 2 to 3 months as nerve endings heal spontaneously. Some numbness and nerve damage may be permanent. 

Delayed Wound Healing or Wound Dehiscence: In some instances wounds take longer to heal than normal. Cigarette smoking, poor nutrition, and a compromised immune system can all cause delayed wound healing or wound separation. 

Skin Discoloration: Skin discoloration may occur after surgery. This may be revised after the healing process is complete. 

Facial Asymmetry: Motor nerve injury is rare. If it does occur it is usually temporary, but may persist.