JAMA PATIENT PAGE Rhytidectomy (Face-Lift Surgery) Rhytidectomy is a surgical procedure meant to counteract the effects of time on the aging face. In the rhytidectomy procedure (also known as a “face-lift”), the Rhytidectomy (Face-Lift Surgery) tissues under the skin are tightened and excess facial and neck Rhytidectomy is a procedure used to counteract the effects of aging skin are excised. by tightening the tissue beneath the skin of the cheek, jaw, and neck. Rhytidectomy literally means wrinkle (rhytid-) removal (-ectomy). The targeted area includes the cheek, midface, jaw- 1 A skin incision is made following line, and neck areas. The name is misleading because rhytidec- natural crease lines around the ear and in the hairline. tomy does not actually remove wrinkles. Wrinkles are removed by 1 resurfacing procedures like peels or laser therapy. Medications 2 Beneath the skin is a layer of muscle (platysma) and such as botulinum toxin injected into underlying muscle can also connective tissue that is pulled soften the appearance of wrinkles. up and back to tighten the face. A rhytidectomy may be performed alone or in combination with a forehead lift and/or eyelid lift (blepharoplasty) or nose sur- gery (rhinoplasty). 2 A S M Y T A Steps of Rhytidectomy L P Incision: The surgery consists of an incision starting in the hairline near the temple, tracing a path in front of the ear, around the ear- 4 lobe, behind the ear, and ending again in the hairline. If a neck lift will also be performed, a small incision is made under the chin. For men, the incision is made to accommodate natural beard lines. In 3 The tensioned tissue is secured to bone behind 3 all cases, the incisions are placed where they will fall into a natural and in front of the ear. skin crease for camouflage. 4 The skin incision is closed using 3 Procedure: A skin flap is elevated over the tissues that will sutures and/or staples. Excess be lifted in surgery. A second tissue layer, deep to the skin, is skin is trimmed if necessary. then elevated and sutured. Tensioning of this layer allows for tightening of facial jowls and improvement of jawline contour. Optional Neck Tightening This tissue layer is then suspended from the upper face and A small incision is made beneath the chin and sutured roughly horizontally, allowing for tightening of the lower the platysma is connected across the neck. face and jawline. If neck tightening is required, an incision is made under the chin. The platysma muscle is exposed. The platysma is continuous with the tissue layer used for “lifting” the face and Skin incision Platysma is stitched tightening it allows for rejuvenation of the neck. This muscle also together across the midline. causes “neck bands.” The platysma is secured behind the ear to the mastoid bone for a more horizontal pull, using sutures that ultimately are absorbed. Excess skin left over from these proce- dures is removed. Closure: Once the surgeon is satisfied with the “lift” and ex- cess skin has been trimmed, the skin is then closed with sutures. FOR MORE INFORMATION American Academy of Facial Plastic and Reconstructive Surgery A combination of absorbable and permanent sutures is used. Staples www.aafprs.org/patient/procedures/rhytidectomy.html may be used in the skin in the hairline, as this does not cause dam- age to the hair follicles. A face-lift dressing is applied to put pres- To find this and other JAMA Patient Pages, go to the For Patients sure on the incision lines and surgical area to limit swelling and de- collection at jamanetworkpatientpages.com. crease the chance of fluid collection in the surgical wound. Authors: Akshay Sanan, MD; Sam P. Most, MD The JAMA Patient Page is a public service of JAMA. The information and Conflict of Interest Disclosures: The authors have completed and submitted the recommendations appearing on this page are appropriate in most instances, but they ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page Source: American Academy of Facial Plastic and Reconstructive Surgery may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776. jama.com (Reprinted) JAMA December 11, 2018 Volume 320, Number 22 2387 © 2018 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/26/2021.