Face Lift
( Rhytidectomy )

From Dr. Federico Macaya


The face lift surgery improves sagging facial skin, jowls and loose neck skin by removing excess fat, tightening muscles and redraping the skin.     

A facelift (technically known as rhytidectomy) improves the most visible signs of aging. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.


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 your ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin.

The skin is separated from the fat and muscle below. Fat may be trimmed from around the neck and chin to improve the contour. The underlying muscles and skin are pulled back.

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AFTER YOUR SURGERY                                              

Keep your head elevated and as still as possible for a couple of days after surgery, to keep the swelling down. Don't be surprised at the pale, bruised, and puffy face you see, just keep in mind that in a few weeks you'll be looking normal. Most of your stitches will be removed after about five days.

You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first.

Avoid strenuous activity, including sex and heavy housework, for at least two weeks (walking and mild stretching are fine) avoid alcohol, steam baths, and saunas for eight weeks; limit your exposure to sun for six months.

At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff, and you'll probably be self-conscious about your scars. Some bruising may persist for two or three weeks, and you may tire easily. It's not surprising that some patients are disappointed and depressed at first.

By the third week, you'll look and feel much better. Most patients are back at work about ten days to two weeks after surgery. If you need it, special camouflage makeup can mask most bruising that remains.

Even after the swelling and bruises are gone, the hair around your temples may be thin and your skin may feel dry and rough for several months. Men may find they have to shave in new places-behind the neck and ears-where areas of beard growing skin have been repositioned.

You'll have some scars from your facelift, but they're usually hidden by your hair or natural creases of your face and ears.

You must stay in Costa Rica at least 10 days after surgery. I recommend the Las Cumbres Inn where you will receive personal attention, required medication and transportation to and from surgery. I visit my patients at Las Cumbres frequently following surgery to check on your recovery.

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Complications are infrequent and usually minor. Still, individuals vary greatly in their anatomy, their physical reactions, and their healing abilities, and the outcome is never completely predictable.              

Complications that can occur include hematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles (usually temporary), infection, and reactions to the anesthesia. Poor healing of the skin is most likely to affect smokers.

I prefer general anesthesia. This is a surgery that takes several hours.

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