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Face Lifts:
Pre-Op/Post-Op Instructions
You and Dr. Griffiths have decided that in order to improve your appearance, a face lift and/or neck lift and/or cheek lift and/or temple lift is necessary. These procedures are designed to tighten loose skin and/or loose fat beneath the skin of the temple, cheek, face, and neck. Incisions vary according to the extent of the correction and usually involve freeing of the skin and beneath its fat to the corners of the eyebrows, eyes, end of the cheeks, end of the lower face and jaw areas, and into the neck in order to achieve maximal correction. The extent of the skin freeing is dependent upon the nutrition of the skin and varies with sun damage, scarring, old acne residua, former x-ray treatment, water retention, and skin age. The procedure determined will bring about an improvement, but the extent will be determined by the individual case.
For example, it is usually not possible to remove or improve all wrinkling of the face, or to eliminate lines about the mouth or laugh lines around the eyes (Crow’s Feet), since these will return even after excessive tightening of the skin when facial expressions are re-established as they are related to the function of the facial musculature. Continued aging of the face and neck continues after surgery and no definite time can be given as to how long a "lift" will last. Additional surgery can be performed when it is indicated, and may involve re-tightening of the skin and fat beneath the skin or other procedures to improve one's general facial appearance, such as:
- Forehead lift,
- Eyebrow lift,
- Removal of forehead and frown wrinkle
- Upper and lower eyelid surgery,
- Face dermabrasion or facial chemo-peel,
- Nasal surgery (usually "tipping" or lift a fallen nasal tip), Chin surgery (for double-chin or receding chin)
- Fat Transplants
- Cheek or Chin Implants
OutPatient Surgery usually averages Six to Eight (6-8) hours, and admission is at 7:00 a.m. on the day of surgery. No food or fluids should be taken after midnight on the day of Surgery.
ANESTHESIA usually consists of Sedation/Twilight Sleep or a light General Anesthesia in our fully accrediated ambulatory surgical center or in the hospital associated with other procedures. A Board Certified (MD) Anesthesiologist will be in constant attendance to administer the anesthesia to ensure safety and comfort. The Center is certified by the Acceditation Association of Ambulatory Health Care (AAAHC) which is approved by the Medical Board and the Legislature of the State of California. Local anesthesia with Xylocaine to which Adrenalin is added is supplemented.
Post-Operative Recovery Facilities/ In House Nurses Aide: A Post-operative recovery facility is available. A Licenced Vocational Nurse will care for you for as long as you desire. Dr. Griffiths can arrange for a nursing attendant to assist you in your home in the immediate postoperative period. These services are at an extra charge.
These surgical procedures involve some preparation on your part.
DO NOT become sunburned or overexposed to sun rays two weeks prior to surgery.
Medications: Review your medications with Dr. Griffiths, he may want you to take some of your daily medications with a sip of water on the morning of surgery.
DO NOT take any drugs for two weeks before surgery (especially Aspirin, Excedrin, Bufferin, blood thinners: Coumadin, persanthine, Trental, birth control pills, weight reduction pills, sedatives, tranquilizers, and antihistamines).
Alert Dr. Griffiths to any medications allergies or reactions to anesthesia personal or family history (malignant hyperthermia).
Wash hair thoroughly with Phisohex the day before surgery and the morning of if possible. Do not spray or lacquer hair after washing. Do not reapply makeup before surgery. Make certain all mascara is removed.
No Smoking 3 weeks before the surgery and 4 weeks after. The risk of infection hematoma formation dramaticly increases with smoking.
Clothing: Wear light comfortable cothing that is easy to take off and put on ( sweat pants, sneakers, polo shirt, etc.).
Ride Home: You must arrange a ride home and someone to be with you at all times the first night of surgery. Arrange to be dropped off and give the contact number of this person to call approximately 30 min. prior to your discharge.
Contact Lenses: Please remove contact lenses and bring your glasses.
Jewlery/Watches/Valubles: Please leave at home, the office is not responsible for protecting them or in case of loss.
Surgical aftercare will involve cooperation on your part. First and foremost, it is necessary to limit swelling so that the tightening achieved by the surgery will be minimally compromised. Ordinarily some swelling will be expected from the surgery itself, but excessive swelling can be avoided by strictly following the diet prescribed and by staying calm. Tranquilizers will be given for the latter, and a relaxed environment after surgery is mandatory. DO NOT book for surgery if you can foresee emotional problems that would upset you during your convalescence.
After surgery you will find a cumbersome dressing over the hair, portions of your face and neck (the Mother Superior look) which will stay in place until all danger from infection and bleeding is over (usually 3 to 7 days) depending upon the extent of the surgery. A smaller bandage or neck support will be substituted to protect the wounds until all sutures are removed in 7 to 12 days. Following this, an elastic support bandage is worn to prevent loosening of the neck tissues and should be worn as much as possible in private to maximize the longevity of the result.
RISKS:
In accordance with the legal doctrine of informed consent promulgated by the California Courts, it is necessary to advise you of the possibility of complications after surgery.
- Infection
- Hematoma (Blood Clot under the skin)
- Skin Loss with due to poor circulation, infection, or hematoma
- Injury/paralysis of facial nerve to the forehead/eye/mouth
- Poor Uneven Result
- Poor Healing with Scar Formation
These are rare, and can include any consequence of a major operation. Suffice it to say that every safety precaution will be taken to insure the successful outcome of the operation and that any complication, if it should occur, will be managed as the need demands.
Consent and Arbitration Agreements
Dr. Griffiths will review this information with you and be sure that you are as completely imformed as possible. Dr. Griffiths utilizes medical-legal arbitration in his practice. This does not prevent you from claiming negligence and filing a medical malpractice suit. It does streamline the proceedings and does give up your right to a Jury Trial. Instead, the proceedings will be hear infront of an agreed upon arbitrator.
Dr. Griffiths will request that you sign a consent form and an arbitration aggreement.
In general, the following are to be expected after surgery and should not be cause for alarm:
1. The treated area will be slightly swollen for 1 to 4 weeks. Excess swelling is not the rule. If excessive swelling develops, notify Dr. Griffiths immediately. Do, however, expect more swelling on awakening in the morning than later in the day.
2. Bruising is common and will involve the lower eyelids (eyes may be closed), cheek, lower face and neck; in short, any area where the surgery was performed. This is especially likely in individuals with easy bruisability and is noted 2 to 3 days after surgery, occasionally later. In general, the younger the patient, the less bruising; while older patients may well experience bruising low into the neck and upper chest and shoulder areas.
3. Scars from the incision will be pink or red from 3 weeks to 6 months, depending upon the healing qualities of the individual. The scars will lie in the hair of the temple, in front of the outline of the ear cartilages, under the earlobe, in the groove behind the ear, and in the hair behind the ear. In order the hide the scars in the temple hair, some retraction of the hairline will occur. Some alteration in the hairline is also necessary behind the ear in order to make the scar less visible. Poor healing, however, may make the scar visible, especially at tension points above the ear and behind it. These can, at a later date, be removed and made less visible if desired.
4. Numbness and rarely sharp pains will occur in the operated areas due to surgical interruption in their sensory nerve supply. Regeneration will occur in time but occasionally some numbness may persist indefinitely. Tightness subsides gradually and is considered desirable for a satisfactory end result.
5. Some loosening of the skin of the face and neck is expected after the swelling subsides. The greatest loosening occurs in patients who swell the most, and then those who have the heaviest (most chubby) and most expressive faces and necks.
6. Rarely there is a blood collection under the skin which can be removed by a needle and syringe. Crusting of the incisions may occur and they may delay wound healing. Temporary hair loss occurs in the area of the incisions, in the hair itself, and in very nervous individuals excessive hair loss may be observed. Generally hair growth re-establishes itself and at times is more luxuriant than before surgery. Remember that some hair is removed along with the excessive skin and will never re-grow in order to hide the scars. This results in a different hairline at the temple areas and behind the ears. Generally, however, this causes little disturbance in the general management of one's coiffure.
7. Drains are occasionally used to prevent blood collection. If they are necessary, they will be removed 2 to 3 days after surgery and cause no or minor discomfort.
8. Pain after surgery is mild, if at all, and is easily controlled with narcotic pain relievers (Vicodin). If pain is severe, call Dr. Griffiths.
9. Antibiotics are prescribed for seven (7) days after surgery to prevent infection.
GENERAL INSTRUCTIONS AFTER SURGERY
1. Sleep on back on two pillows. Sleep alone. Wear white cotton gloves to prevent scratching or irritating treated area while sleeping. KEEP HANDS AWAY FROM FACE.
2. No smoking until doctor's okay.
3. Sneeze with your mouth open; blow nose gently when necessary.
4. Follow diet religiously after surgery.
5. No showers or tub baths for one week. You may sponge-bathe.
6. Hair can be washed usually after first week. Do not wash until Dr. Griffiths gives okay.
7. Rest for the first week. No undue exertion. Take tranquilizers. No excessive talking, smiling, laughing, or forced facial expressions. Keep head forward; turn only with full body (to avoid tension on neck incisions).
8. Eat or drink a glass of orange juice before coming into the office for post-op visits to avoid light-headedness.
9. Do not attempt to evaluate your result for at least one month. The final result may not be evident for 6 to 8 weeks. Avoid looking in the mirror during the early phases of surgery.
10. When Dr. Griffiths gives okay, you may do the following:
- A. Wash the skin with mild soap gently.
- B. Apply makeup (usually in 7 to 10 days, avoiding the incision).
- C. Hair styling (usually in 10 days to 2 weeks) which implies gentle combing over the incisions in the hair.
- D.Tinting (usually after 2 weeks).
- E. Exercise; limited after 10 days; normal, in 2 to 3 weeks. No swimming for 4 weeks, no diving for 2 months.
- F. Social activities; usually in 10 days to 3 weeks, depending upon the rapidity of healing.
- G. Travel; one should remain within reasonable traveling distance to the office for 2 weeks. No long distance traveling for 2 to 4 weeks.
- H. Wigs may be worn in 10 days to 2 weeks, while scarves can be worn over bandages.
- I. Dark glasses can be worn over the dressings, but should not put pressure on incision lines until healing is complete (usually 2 to 3 weeks)
Payment:
The fee has been agreed upon with Dr. Griffiths. Please bring Full Payment at the time of the pre-op appointment or on the day of surgery. Acceptable forms of payment: Cash, Cashier’s Check, Personal Check (requires 7 days advance payment to clear), or Credit Card (additional 3% fee is applied).
The Payment includes:
- Surgeon’s Fee
- Assistant’s Fee
- Anesthesiologist Fee
- Operating Room Fee
- Nursing/Supplies/Medication Fee
- Post-operative Visits
Note: The surgeon’s fee for any re-operation which may be necessary will be included in this price. Anesthesia and Supply fees are not which would be an extra charge.
Please Write Down Your Questions and Bring Them to Your Pre-Op Appointment to Review with Dr. Griffiths.
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