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Proud to bring you information via The Web since 1996

DONALD J. CAPUANO, M.D.
Plastic Surgeon

Board Certified in Plastic Surgery _

INFORMATION SHEET FOR FACE LIFT PROCEDURE

You are interested in undergoing the surgical procedure known as the fact lift procedure. Face lift surgery in my experience is a highly individualized undertaking. Deciding what the individual would like to achieve is perhaps the most important part of face lift surgery. It is easy to say 'well I want to look younger' but there are so many ways to look younger and there are so many 'looks'. Usually no one wants to look 'fake'.

And indeed our goal is to give a natural, younger look. You should note that mere lifting the face is not enough to give a younger look. Skin texture is very important along with the sagging of skin. Please also refer to our information on chemical peels, laser surgery, etc. Depending upon the extent of the surgery, scars will be present in the scalp, in front of and behind the ears, and on the neck. These will be outlined for you. Face lift surgery has developed so that scars are usually hidden or almost so. Most people heal very well with scars that fade and blend in over time. There has been a rare exception in my experience. While hair is not routinely shaved for this procedure, there is the possibility that if excess scalp tissue is removed, some hair may also be removed. The Doctor will discuss this with you. You should be aware that in some cases following surgery, hair may be thinner, and you may need to use a topical treatment ( Rogaine - minoxydil ). There have been cases of localized hair loss, which has not to date been permanent.

You must be aware that your hairline can be different after surgery, and your hairstyle may have to be changed to accommodate this. In some cases, the hairline can remain the same, but you may have incisions along the hairline instead of into the scalp. Again you might consider changing your hair style if needed. If you have particular concerns about your hair and hairstyles, discuss this in detail with the Doctor before surgery. You should be aware of the possible risks and complications of surgery, which include, but are not limited to bleeding, infection, numbness in the areas treated, and risks of anesthesia. These anesthesia risks can be explained to you in more detail by your anesthesiologist prior to your surgery. Since the surgery involves the separation of tissues, injury to skin, fat, nerves, bone and muscles, while not anticipated, may occur, and injury has been reported by surgeons. In our experience the number of true complications have been very few and have been able to be 'fixed' by other minor procedures. Face lift carries with it a high degree of patient satisfaction in our experience. Interestingly, in rare cases following face lift, the ears can look more prominent. This is usually noticed more by people whose ears are already quite prominent. If you have large or outstanding ears, they may seem to protrude more afterward. There are multiple factors involved with this, but many times the tightening and lifting of tissues of the face can accentuate the ears. You may wish to consult with the Doctor regarding the possibility of ear reduction following face lift surgery if this is a concern. You may wish to wear a different hairstyle after surgery if this is noticeable to you. In the few instances when this has happened the 'look' did improve in a short time. Please discuss this with the Doctor if you have questions or concerns.

There are many factors to be considered in surgery, and many judgments to be made by Dr. Capuano. We try to make as many decisions before surgery, but some judgments can only be made at the time of surgery.

The vast majority of individuals go home within two to four hours after surgery. Someone to care for you should be present for twenty-four hours after surgery (NY State Health Code).

In a rare case, if your surgery requires an overnight stay at the hospital, there will be an additional charge. We have not had a patient have to stay longer than overnight. This keeps the cost reasonable.

In most cases, this procedure can be performed as an out-patient, which means you will have your surgery in the morning and go home in the afternoon. You are advised to have someone drive you home and stay with you through the first night following surgery. If you plan on staying anywhere other than your home following surgery, please notify the office as we need to be able to contact you after surgery, so give us a phone number where we can reach you. Arrangement for staying overnight if your situation dictates, can be arranged at a reasonable cost.

We ask that you refrain from taking products containing aspirin for at least two weeks prior to your surgery. Do not eat apples, as they contain an aspirin-like substance. If you are taking aspirin on the advice of a physician, please let us know. Aspirin thins the blood, and may cause more bleeding during surgery.

The evening prior to your surgery, and the morning of your surgery, please shower with Safeguard or Dial soap. Wash your hair thoroughly. No lotions, creams, oils, makeup or nail polish, please.

After your surgery, you will have a bulky dressing on your head, surrounding your face. This should not be removed, except on the orders of the Doctor. Immediately following surgery, and for up to forty-eight hours afterward, you will apply ice on the areas to reduce swelling. A small tube or drain may be put in place for one to two days after surgery.

The brown ace bandage may be adjusted by re-wrapping it if it feels too tight. If the neck area feels too firm, you may gently adjust this by placing two fingers inside the dressing and carefully pulling downward. This will be shown to you after surgery.

"Black and blue", swelling, localized areas of discomfort, and numbness in some areas can be expected. These resolve in the majority of cases in one to two weeks. Unusually, it takes longer.

The first few days you might be somewhat swollen. After one week you should notice quite an improvement. If incisions are made in the hairline, there is a good chance you will have at least some swelling and bruising around the eyelid areas. This is to be expected.

The estimated time away from work depends to a large degree upon the nature of your job. Under usual circumstances, two to three weeks is needed before moderate activity can be resumed.

Problems with wound healing are rare. They rarely delay your return to work.

Please discuss with the Doctor the nature of your job activities so that you may obtain a better estimate of time away from work.

You will be given prescriptions for medications for swelling, discomfort and infection, and you should take these medications as directed.

If you notice a sudden onset of swelling or extreme discomfort, call the office immediately.

At the time of your first post-operative visit to the office, some sutures may be removed, depending upon the healing present. You will be advised regarding wound care. You may gently wash and comb your hair after this visit. You will be seen at intervals in the office for further suture removal and follow up care. You may begin to gently increase your activity level after this first visit. Please ask the Doctor about any activity of which you are unsure.

Regaining your full level of activity is an individual matter, and may take some time. Avoid situations that may increase your blood pressure. You should be aware that your looks may be significantly changed by surgery. You may have to get used to the new "you" .

Surgery can take a number of years off your looks, but can also alter your appearance. Loose skin will be tightened, perhaps giving a less soft look than you are used to seeing. The changes can be quite remarkable. Family, friends and acquaintances will have to adjust to a "new you". You should be aware and ready for comments regarding your new appearance.

Tighter skin and removal of fat can cause underlying tissues and structures to become more noticeable, i.e. cheekbones, the muscles of the neck, glands, etc. The jaw outline may be more prominent. The ears may appear larger, or of a different shape. Areas not treated may become more obvious. We mention these things to you so you might think about it before undergoing surgery, as opposed to being surprised afterward.

A few patients have noticed a number of months following surgery that the skin of the neck begins to loosen a little. This is due to many factors, including gravity, the age of the patient, the thinness of the skin. Rarely is this loosening significant. It is welcomed by some.

Another factor is that following surgery, skin in other areas, i.e. upper chest, collarbone and the back of the neck not treated by surgery tend to pull on the neck skin, causing this to loosen. It is impossible for the neck to continue to be as tight as it is immediately after surgery. You may wish to have further surgery at a later date to tighten the neck skin again but this is very infrequent and would involve small incision surgery as opposed to open wide neck lift surgery.

For the most part, patients are much improved, and very pleased with the contour of the neck. Factors influencing the results of surgery include skin thickness, elasticity, pigment, sun exposure, age, blood coagulation, blood pressure, nutritional status, smoking, general health, healing abilities and the support of family and friends.

Motivation for surgery should come from within, not because someone else wants you to look a certain way. People without the correct motivation can have a difficult time accepting a different look. In summary, most people do quite well and are very pleased after face lift surgery. We do want you to be as informed as possible before having this or any other surgery.

This information is provided for your general information How such information exactly applies to an individual would depend on a face to face history, examination, perhaps laboratory exams and individual treatment plan. Further because of the nature of electronic media and information - there is no doctor - patient relationship but merely a general information display - THANK YOU.

COMPARING DIFFERENT PROCEDURES LENGTH OF SURGERY

** ONE PROCEDURE **

------------------------------------------ SUCTION - 1 - 1 1/2 HOURS NECK - 2 - 3 HOURS FACE - 2 - 4 HOURS BROW - 2 - 4 HOURS FORE - 2 - 4 HOURS MORE - 3 - 6 HOURS COST OF SURGERY - ** APPROXIMATE ** --------------------------------------- - SURGICAL FEE 1200-2400_ HOSPITAL FEE _0000-0800_ave_450 NECK - SURGICAL FEE __________ HOSPITAL FEE _0000-0800___ FACE - SURGICAL FEE __________ HOSPITAL FEE _0500-1500___ - BROW - SURGICAL FEE __________

HOSPITAL FEE _0500-1500___ FORE - SURGICAL FEE __________ HOSPITAL FEE _0500-2000___ MORE - SECOND PROCEDURE ABOUT ONE - HALF TO THREE-QUARTERS THE USUAL COST THIRD PROCEDURE ABOUT ONE - HALF TO ONE - FORTH THE USUAL COST MORE PROCEDURES ONE - HALF TO ONE - FOURTH OR LESS OF USUAL COST ANESTHESIA LOCAL & SLEEPY TOTALLY ASLEEP ----------- -------------- -------------- SUCTION - USUALLY RARELY NECK - FREQUENTLY RARELY - SOMETIMES FACE - FREQUENTLY RARELY - SOMETIMES BROW - FREQUENTLY RARELY - SOMETIMES FORE - FREQUENTLY RARELY - SOMETIMES ALL - SOMETIMES USUALLY LOCAL MEANS - LOCAL ANESTHESIA (LIKE NOVACAINE ) SLEEPY MEANS - MEDICATION IS GIVEN IN A VEIN WHICH CAUSES SLEEPINESS TOTALLY ASLEEP - MEANS A GENERAL ANESTHESIA - SAME DAY OVERNIGHT HOSPITAL ------------------------------------------------------- - USUALLY RARELY RARELY NECK - USUALLY RARELY RARELY - USUALLY RARELY RARELY - USUALLY RARELY RARELY - SOMETIMES SOMETIMES SOMETIMES SCARS ----- - SMALL SCAR - BENEATH THE CHIN - BACK OF EAR & HAIR LINE - SOMETIMES IN FRONT OF THE EAR - IN FRONT & BACK OF THE EAR & HAIR LINE SOMETIMES IN HAIR - TEMPLE AREA - SOMETIMES IN FRONT OF EAR - AT OR ABOVE EAR - TO THE TOP OF HEAD - HAIR LINE or BACK or FRONT OF EAR or TEMPLE or TOP OF HEAD RETURN TO WORK ** USUALLY ** ------------------------------------- - 5-10 days - 7-10 days - 7-14 days [ NOTE BLACK AND BLUE MAY TAKE LONGER ] - 7-14 days [ TO RESOLVE - BUT MAKEUP USUALLY COVERS ] - 7-14 days [ ADEQUATELY - THERE ARE EXCEPTIONS BUT ] - MORE - 10-14 days [ THEY ARE FEW. ] *********************************************************************** IMPORTANT ** FACE LIFT SURGERY ** IMPORTANT ***********************************************************************

-GOAL - TO CONTOUR AND IMPROVE THE SHAPE OF THE FACE, GIVING A MORE YOUTHFUL APPEARANCE,

WITHOUT PROBLEMS OR COMPLICATIONS.

SOCIETY REQUIRES THAT YOU BE AN INFORMED PERSON. WHILE COMPLICATIONS ARE NOT EXPECTED AND WE HAVE NO REASON TO BELIEVE THAT THEY WILL OCCUR IN YOUR SURGERY, THEY COULD HAPPEN. THIS CHECK LIST DOES NOT STATE ALL POSSIBLE HAPPENINGS AS THIS IS IMPOSSIBLE

- IT DOES GIVE YOU AN IDEA OF MANY OF THE KNOWN RISKS OF THE SURGERY.

** WE ENCOURAGE YOU TO ASK QUESTIONS ABOUT THE INFORMATION GIVEN TO YOU OR ASK ABOUT OTHER INFORMATION YOU MAY HAVE, FOR EXAMPLE MAGAZINE ARTICLES.

** NOTE THE FOLLOWING ABOUT SURGERY AND COMPLICATIONS

--------------------------------------------------------------

OUT PATIENT SURGERY (SAME DAY SURGERY) RARELY EXTENDED STAY (overnight) AT THE HOSPITAL

INCISIONS (SURGICAL CUTS)

- USUALLY IN THE SCALP, IN FRONT OF AND BEHIND THE EAR, AND NECK - BRUISING - BLACK AND BLUE - SWELLING - NUMBNESS (** **) - WRAP AROUND DRESSING - TUBES FOR FLUID DRAINAGE (MOST CASES) - LESS THAN COMPLETE CORRECTION - INCOMPLETE CORRECTION OF 'JOWLS' 'NOSE FOLDS' - TOO TIGHT - TOO LOOSE - NECK TOO TIGHT - UNEQUALNESS - SCARS - SCAR SURGERY OR INJECTIONS - SLOW HEALING - WIDENED SCARS - ITCHING - SMALL LUMPS - ALLERGIC REACTIONS (MEDICINES ) - NEED FOR MASSAGE, ULTRASOUND OR INJECTIONS - SEVERE BLEEDING - NEED FOR MORE SURGERY - INFECTION - ANESTHESIA PROBLEMS ( DEATH, PARALYSIS, VEGETATION, MENTAL DIFFICULTIES ) - ADMISSION TO THE HOSPITAL FOR COMPLICATIONS - INJURY TO OTHER TISSUES (BONE - NERVES - SKIN - AND SO FORTH) - SERIOUS COMPLICATIONS ARE RARE BUT COULD OCCUR - THE RESULTS OF SURGERY CANNOT BE GUARANTEED -------------------------------------------------------------- - VERBAL INFORMATION - YOU AND THE DOCTOR TALKED - PRINTED INFORMATION ABOUT SURGERY - OPERATION PERMISSION SHEET - BEFORE OPERATION INSTRUCTIONS - AFTER OPERATION INSTRUCTIONS - A COPY OF THIS SHEET

All information written and pictorial
on this page and all links at CapuanoUSA.com
Copyright and Copy 1982 through present Donald J Capuano MD


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