As we age, the skin covering the upper and lower part of the face and neck begins to wrinkle and lose elasticity. Signs of this natural process are manifest in the deepening of the nasal labial folds (the lines that run from the corner of the nose to the corner of the mouth), deeper vertical wrinkles, and loose skin or fat under the chin. The eyelids begin to look heavier, and crows feet begin to appear next to the eyes. Creases in the forehead and between the eyebrows become deeper and give the face a tired, frustrated look.

Rhytidectomy
The face-lift and neck-lift procedures are performed to tighten the skin of the lower half of the face and neck, giving the patient a more youthful, refreshed appearance. Depending on the condition and age of the skin of the person undergoing the surgery, the results will range from subtle to dramatic.

Rhytidectomy surgery, while commonly done, is a more invasive procedure that usually lasts several hours. Dr. Boss's experience in microsurgery and endoscopic techniques allows him to use smaller incisions leading to less scarring, bleeding and hair loss. 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 ear lobe to the lower scalp. If the neck needs to be done, a small incision will also be made under the chin. Dr. Boss separates the skin from the fat and the muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. He then tightens the under lying muscle, pulls the skin back, and removes the excess. He then stitches the layers of the tissues and closes the incisions. Dr. Boss may also wrap your head loosely in bandages to minimize bruising and swelling.

Forehead Lift
Also known as a brow lift, this procedure surgically alters the muscles and tissues that cause furrowing or drooping in the area above the eyes. By raising drooping eyelids and improving the horizontal 'frown' lines and deep furrows, a forehead lift results in a smoother forehead and a more youthful appearance.

Endoscopic brow lift is performed using a small microsurgery device with a lens and light inserted through a small incision through the hairline. The device is connected to a video screen that allows Dr. Boss to visualize the surgery as it is performed. Sometimes a second incision is made for the use of a tiny scalpel or other instrument. Dr. Boss performs the surgery by manipulating the special small instrument and by using the images from the video screen as a guide.

Are you good candidate?
The best candidate for facelift is a person whose face and neck has begun to sag but whose skin still has some elasticity and whose bone structure is strong and well defined. A brow lift, which can be performed alone or with a facelift or cosmetic eyelid surgery, is best for people with heavy wrinkles of the forehead and a drooping, heavy brow. Most patients for the above procedures are in their 40's and 50's, but face and brow lifts can be done successfully on people in their 70's or 80's. Both procedures can make you look younger, which in turn may enhance your self-esteem. However, it is important to remember that a face-lift will not give you a totally different look, but rather a fresher version of yourself.

About the consultation
During your initial consultation, Dr, Boss will evaluate your face, including the skin and underlying bone and discuss your goals for surgery. Dr. Boss will also review your medical history to determine if there are any reasons for you not to proceed. He will explain the various techniques possible, and make a recommendation based on the your goals and needs.

Risk Factor
When a face or brow lift is performed by a qualified plastic surgeon, complications, if they occur at all, are usually minor. However, as with any kind of surgery, there are risks. Dr. Boss will discuss the possibility of complications with you at the time of the consultation.

After the surgery
There is not usually significant discomfort after surgery, but any relieved with pain medication. Some numbness of the area is normal and will disappear in a few weeks or months. Patients should keep their head elevated for a few days after surgery to diminish swelling. If a drainage tube has been placed, it will be removed one or two days after surgery. Bandages are removed after 1 to 5 days. Stitches are removed for the face-lift in 5 - 10 days and for the endoscopic brow-lift in 10 days to 2 weeks. Most endoscopic brow lift patients can return to work in 5 - 10 days and facelift patients can return in 2 weeks. By the third week, most of the swelling is down and chances are you will be happy with your younger appearance.