(949) 346-1279
4501 Birch Street, Suite B
Newport Beach, CA 92660

Facelift Orange County Facelift

FACELIFT INTRODUCTION

This information has been assembled to familiarize you with the facts regarding facelift surgery. You are requested to read the following information thoroughly and to discuss any questions, which might arise with your surgeon before you proceed with the surgical procedure known as rhytidectomy. You are also requested to keep this information as a reference during your post-operative period. Facial rejuvenation is at the top of the list of the most common aesthetic surgical procedures performed by your surgeon at Orange County Plastic Surgery. Most people feel physically and mentally vigorous and energetic long after their appearance has begun to deteriorate due to aging. A face and neck lift procedure is designed to provide you with a rejuvenated appearance.

The degree of improvement achieved depends on the severity of the initial deformity, the age of the patient, tissue elasticity and the recommended procedure.

A face or neck lift may be beneficial whenever you have excessive sagging of the facial and neck skin or underlying structures. In a younger patient with minimal sagging, the degree of improvement will be subtle, but frequently the result is extremely satisfying to the patient caring about personal appearance. In such a younger patient, one of the newer midface lifts with minimal external incisions may be recommended.

Facial rejuvenation is at the top of the list of the most common aesthetic surgical procedures performed by your surgeon at Orange County Plastic Surgery. Most people feel physically and mentally vigorous and energetic long after their appearance has begun to deteriorate due to aging. A face and neck lift procedure is designed to provide you with a rejuvenated appearance. The degree of improvement achieved depends on the severity of the initial deformity, the age of the patient, tissue elasticity and the recommended procedure.

A face or neck lift may be beneficial whenever you have excessive sagging of the facial and neck skin or underlying structures. In a younger patient with minimal sagging, the degree of improvement will be subtle, but frequently the result is extremely satisfying to the patient caring about personal appearance. In such a younger patient, one of the newer midface lifts with minimal external incisions may be recommended.

This is considered to be an operative procedure. Contrary to popular belief and despite newspaper and magazine stories, this is not as simple as having your hair set or having a facial. Also, contrary to many of the non-medical reports, it is not possible to remove all folds and eliminate any of the wrinkles of the face, regardless of the treatment applied. As a matter of fact, facelift surgery is designed to tighten lax or sagging tissues - not to remove wrinkles or folds. Patients who wish to have fine lines or wrinkles removed will have to consider a skin resurfacing procedure (e.g. laser or chemical peel) in addition to a facelift. 

You must realize that your surgeon will tighten the sagging tissues as much as can be done safely to provide a natural result for your particular facial contour. The facelift procedure is directed toward improvement and does not remove each and every wrinkle or fold of the face. The type of skin, the age, and the aging rate of each patient, are factors that help determine your final result.

A common question regarding a facelift is "How long will it last?" This is impossible to state for a given individual, as there are many factors involved: continued sun exposure, the age of the patient, the patient's type of skin, healing ability, changes in weight, smoking history and general health of the patient. Your surgeon expects you to look better than had you not had a facelift for the rest of your life, but some laxity will return with time. As a matter of fact, the facial tissues continue to sag and loosen, at your natural rate, right after surgery. A small minority of patients, especially those who have a very marked degree of skin laxity in the neck area, will occasionally require a second facelift or a minilift within a few years of the initial procedure if optimal correction is to be achieved, but most patients receive sufficient improvement and only request one facelift during their lifetime. Skin aging continues after any operation – the best measure you can take to slow this process is to use sun block faithfully, and to take care of your skin with proper rejuvenating creams. Our office staff will be glad to help you with a skin care program. This surgical procedure merely turns back the aging process; it cannot stop the “hands of time.” Your surgeon may be able to give you a good idea of what can be expected following surgery by working with our office digital imaging system and by manipulating your skin in front of a mirror.

Skin is elastic! Regardless of how tightly the facial tissues are pulled, aging and stretching of the facial skin begins to occur immediately after the operation. It is usual to see some recurrence of jowls or looseness of the neck within three months of the operation. You can, however, look forward to a significant degree of improvement permanently. Most patients have sufficient improvement following a face and neck lift, which keeps them looking younger than their friends forever. However, you may choose to have another facelift in future years to maintain a more youthful appearance. Your surgeon always tightens your muscles and skin as much as it is safe to do and cannot control how quickly any individual will sag. Regardless of how quickly you sag, each patient will be responsible for the cost of a subsequent procedure should the patient wish to repeat the operation.

To maximize the degree of rejuvenation, many patients will choose to undergo a brow lift, midface lift, microfat grafting, an eyelid procedure or laser skin resurfacing at the same operative setting.

Before&After

Before
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After
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Facelift Patient 1046

76 year old male before and after a facelift, upper and lower eyelid blepharoplasty

Before
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After
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Facelift Patient 1060

47 year old female before and after a face and brow lift

FACELIFT PREOPERATION PREPARATION

You may visit your surgeon as many times as you wish to have all of your questions answered. At your preoperative visit, your final questions will be answered and you will confirm that you understand the procedure to be performed, that this material has been explained to you, that you have read and understand these information sheets, and that you accept the risks by signing the informed consent forms. You will be given prescriptions for pain pills and antibiotics along with instructions for their use. Certain laboratory tests will also be required within two weeks of surgery. If you are over the age of 50 or have a history of cardiac problems, you will have to obtain a cardiogram at your doctor’s office or any licensed laboratory. You may have blood drawn at your family doctor's office

 or any laboratory (e.g. Kaiser Hospital, etc.). All patients will be asked to stop smoking at least a month prior to surgery in an effort to maximize your body's ability to heal the incisions following the operation.

For a period of five days prior to the procedure, thoroughly cleanse your face two times a day, using one of the MD Performance® cleansers and water, and mist lightly with the MD Performance® Hydrating Vitamin Mist. MD Performance® MD Formula Sunscreen and makeup may be applied between these cleansings.

The evening before and the morning of treatment, gently scrub your face and neck, thoroughly with the MD Performance® Jojoba & Green Tea Foaming Scrub followed by the MD Performance® Deep-Pore Purifying Cleanser. Patients should shampoo their hair the morning of or the night prior to surgery. Absolutely nothing may be taken by mouth after midnight prior to the day of surgery (except medications prescribed by your family doctor, but please mention these to the anesthesiologist in advance.)

Your anesthesiologist may call you the night before surgery to discuss the anesthetic care plan with you. But if you miss the call or your anesthesiologist does not call you, do not worry as you will be able to discuss your anesthesia and have all your questions answered in the morning, at the Orange County Surgery Center in Newport Beach. It is absolutely imperative that you make arrangements in advance to have someone drive you to the surgery center on the day of your operation and to drive you home after surgery. Patients may choose to spend the first night with a nurse, either at a hotel adjacent to the surgical facility or at their home (depending on demands placed by children, pets, etc).

Please wear loose fitting clothing, which will be easy to get off and on after the operation. Wear no makeup to the surgical facility on the day of surgery, and do not apply facial moisturizers.

All patients anticipating an elective surgical procedure are to stop taking any medication containing anti-inflammatory agents (Aspirin®, Advil®, Motrin®, etc.) as these interfere with the body’s clotting mechanism and can result in dangerous blood loss and excessive bruising.

FACELIFT OPERATION

A facelift is an elective, cosmetic surgical operation in which the loose muscles of the face and neck are tightened and the skin redraped and the excess trimmed through incisions placed around the ears and under the chin. If excess neck fat is present, it will be suctioned as part of this procedure. Occasionally, the patient and surgeon may decide that in order to obtain the desired optimal result, additional ancillary procedures such as a midface lift, microfat grafting, eyelid surgery, a brow lift, skin resurfacing, or a chin implant may be required. These additional procedures will be discussed separately as they are not an actual part of the face or neck lift operation. If desired, your surgeon will go over these additional procedures with you.

A straight forward face and neck lift operation requires approximately three hours. Of course, if additional procedures are requested or if you have an exceedingly full neck, a longer time will be required. The surgery will usually be performed under a light general anesthesia or deep sedation. An anesthesiologist will be present to administer the medications and assist in monitoring all patients to ensure their safety.

At the completion of the operation, drainage tubes are placed beneath the neck skin to minimize swelling and bruising. These tubes are connected to a bulb; it will be necessary for your caregiver or nurse to empty the drainage fluid a few times during the first night. In the morning, this person will drive you to the office for your first post operative visit. The drains will be removed in the office, the incisions cleansed, you will receive an Oxymist procedure and a light wrap reapplied. If a nurse cares for you the first night, your family or other designated adult will pick you up from the office after this visit and home care instructions will be given.

A straight forward face and neck lift operation requires approximately three hours. Of course, if additional procedures are requested or if you have an exceedingly full neck, a longer time will be required. The surgery will usually be performed under a light general anesthesia or deep sedation. An anesthesiologist will be present to administer the medications and assist in monitoring all patients to ensure their safety.

At the completion of the operation, drainage tubes are placed beneath the neck skin to minimize swelling and bruising. These tubes are connected to a bulb; it will be necessary for your caregiver or nurse to empty the drainage fluid a few times during the first night. In the morning, this person will drive you to the office for your first post operative visit. The drains will be removed in the office, the incisions cleansed, you will receive an Oxymist procedure and a light wrap reapplied. If a nurse cares for you the first night, your family or other designated adult will pick you up from the office after this visit and home care instructions will be given.

A straight forward face and neck lift operation requires approximately three hours. Of course, if additional procedures are requested or if you have an exceedingly full neck, a longer time will be required. The surgery will usually be performed under a light general anesthesia or deep sedation. An anesthesiologist will be present to administer the medications and assist in monitoring all patients to ensure their safety.

At the completion of the operation, drainage tubes are placed beneath the neck skin to minimize swelling and bruising. These tubes are connected to a bulb; it will be necessary for your caregiver or nurse to empty the drainage fluid a few times during the first night. In the morning, this person will drive you to the office for your first post operative visit. The drains will be removed in the office, the incisions cleansed, you will receive an Oxymist procedure and a light wrap reapplied. If a nurse cares for you the first night, your family or other designated adult will pick you up from the office after this visit and home care instructions will be given.

FACELIFT POST-OPERATIVE CARE

The patient can expect swelling of the face and severe discoloration. If the eyelids are also done, the whites of the eyes will become temporarily bloodshot-this could last for many weeks, but always resolves spontaneously. If the eyes swell shut, or if the eyelashes stick together, your caretaker may clean the lashes with Q-tips and hydrogen peroxide. You may begin using an MD Performance® cleanser and moisturizer the day after your surgery. The discoloration will be most noticeable on the second and third days, and diminishes anywhere from one to six weeks after surgery. This, again, depends upon the type of skin, age, and healing ability of the patient. Most patients, with perhaps light makeup, can resume everyday tasks approximately one to three weeks after surgery.

The incisions in front of the ear and under the chin usually heal quickly and without problems but the scar behind the ear will remain firm and pink for about a year. It is recommended that patients begin applying MD Performance® Ultimate Scar Formula to the incisions about a week after surgery. The Ultimate Scar Formula should be applied twice daily until the scar has finished healing and no longer contains any hint of pink or purple.

You will return to the office daily for the first few days for Oxymist® treatments, which expedite healing, and skin care as required. All suture lines should be cleaned gently with Q-tips® and hydrogen peroxide a few times each day. Vaseline® ointment or Aquaphor® ointment should then be applied to the suture lines to inhibit further crust formation. You may shower by the second or third day. You may begin walking as soon as you feel able, but all lifting, straining and other vigorous activity is to be avoided until all bruises have faded. The best rule of thumb is to avoid any activity that causes you discomfort and to enjoy those that do not. Most patients are pleasantly surprised to discover the relatively mild degree of post-operative discomfort. The patient is requested to call the office if the discomfort is not readily quelled by the pain pills, or if significant bleeding appears around the incisions. Some drainage, particularly behind the ears, is normal for a few weeks. Sutures will be removed four to ten days post-operatively. When the sutures are out, you may begin using the MD Performance® Ultimate Scar Therapy silicone product on your incisions. A very thin layer should be applied twice a day. By this time, you should be using the MD Performance® Jojoba and Vitamin Lipid Booster® or the MD Performance® Cell Activator Complex. This should be followed by the MD Performance® BioLipid Hydrating Crème, which works synergistically with the MD Performance® high performance, antiaging products to leave you with nicer, more youthful skin. Consider a squirt of the MD Performance® Hydrating Vitamin Mist, Vitamin C product to instantly refresh and moisturize your skin. Finally, you should use the MD Performance® MD Sun Protection product to help preserve the investment you made in rejuvenating your face. The staff will be glad to help you customize a regiment with medical grade, MD Performance® professional skin care products.

Testimonials

62 Year Old Needs to Tighten Skin - Newport Beach, CA

As soon as I met Dr Bunkis I felt very comfortable. He answered all my questions and concerns. He is very knowledgable with a lot of experience. Another thing that I like is that he makes himself available. I think he is such a great guy.

Voluma, Botox and Facelift Consultation - Newport Beach, CA

Dr. Bunkis has a warm bedside manner and he explains everything in detail. I liked that he listened to my concerns and then gave me options to correct them without feeling pushed in to doing something I didn't want to do. I also appreciated that he took his time to show me a number of before and after photos so that I could see the level of his work.

FACELIFT POSSIBLE COMPLICATIONS

Every activity in life, whether driving automobiles or having surgery, is associated with risk. The following inherent risks must be understood and assumed by the patient if we are to proceed with this surgery. Although complications and bad results are uncommon from this type of operation, they do sometimes occur. Your doctor cannot guarantee a favorable result from any operation you are considering, but every effort will be made to provide you with the best result possible. Some of the possible complications from this operation include: blistering or sloughing of the skin with the possibility of permanently noticeable scarring, infection, bleeding, unequal discoloration and swelling of the face, abnormal contour, nerve damage causing temporary or permanent loss of feeling in the face

and weakness of portions or all of the face, personality changes and mental difficulties following the operation which may occur even when the operation has been a success, and allergic or other adverse reactions to one or more of the medications used during or after the operation. Some of the possible complications from this operation include: blistering or sloughing of the skin with the possibility of permanently noticeable scarring, infection, bleeding, unequal discoloration and swelling of the face, abnormal contour, nerve damage causing temporary or permanent loss of feeling in the face and weakness of portions or all of the face, personality changes and mental difficulties following the operation which may occur even when the operation has been a success, and allergic or other adverse reactions to one or more of the medications used during or after the operation.

Some of the complications associated with this operation can cause the need for further or touch-up surgery, which will result in additional fees to the patient. Some of the complications can cause prolonged healing, unsightly and painful scars, deformity and inconvenience. Some unsightly scars or asymmetry caused by nerve damage cannot be improved by further surgery.

Complications, particularly blistering and skin loss around the ears, without question are seen much more frequently in smokers, and you are urged not to smoke for at least a month prior and after your surgery to minimize the likelihood of such complications. (And if you can stop for that long, why not do your body a favor and quit this nasty habit permanently!)

There are also other, very rare, potential complications from this operation in addition to the ones that have been mentioned, but it is not possible to advise you of every conceivable complication.

Complications after any type of cosmetic surgery are relatively rare and most patients end up with a very satisfactory result. The purpose of this information is not to frighten you, but to insure that your decision to have this operation is not made in ignorance of the potential risks of cosmetic operations on the face.

USEFUL INFORMATION

The surgical scars are permanent; however, the incisions are placed so that they are barely discernable on normal visual observation, barring complications, which may result in thick and/or painful, disfiguring scars. If this problem occurs, treatment by excision or steroid injections may be indicated, but it may be impossible to improve an unsightly scar.The head must be kept dry initially. By the second or third day, the patient will be encouraged to begin showering and shampooing normally, but care must be taken not to tug on the drainage tubes or to rub the incisions hard. Coiffure procedures may usually be carried out after the drainage tubes have been removed and the wounds have stopped draining. Care must be employed when drying the hair during the first few months

 while you do not have normal sensation; the low heat setting should be used for the first two months to avoid inadvertent damage to the skin or hair.

Cosmetics and moisturizers may be applied over the skin of the face, up to the edge of the surgical incisions, two days after the operation. The office staff will not only be able to assist you with makeup application to help hide bruising, but also to give you guidance regarding skin care after you have healed.

FEES

Fees will be discussed freely in advance by the office staff. You will receive assistance with financing if desired. Naturally, additional fees will be required if the patient desires ancillary procedures such as forehead, eyelid, chin or nasal surgery at the same time. In compliance with suggestions adopted by the American Society of Plastic Surgeons®, it is customary for the patient to pay all fees for cosmetic surgery prior to the desired operation. This insures that the patient is sincere in her motivation and can afford the surgery, thus creating a better patient/physician relationship. A non-refundable deposit will be required to secure your desired surgery date. The remainder of the fees must be paid prior to the surgery, usually at the time of the preoperative visit, but no later than two weeks before surgery.

Additional fees are also required for laboratory tests, surgical facility fees, the anesthesiologist, and if necessary, mammography. If additional surgical procedures become necessary, additional facility, laboratory, anesthesia, implant costs and professional fees will be incurred. The surgical facility and anesthesiologist fees quoted will be based on our best faith estimate; the final fee may vary as these fees are based on surgical time, and it is not always possible to predict exactly how long a procedure will take to complete.

It is important that you understand that the patient is responsible for all costs associated with all secondary surgical procedures or for the treatment of any complications that may arise as a result of this elective surgery.

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