The removal of excess skin of the face and neck area, and the tightening of underlying support structures, such as muscle and superficial fascia.
- A rhytidectomy is often performed in combination with a blepharoplasty.
- As the natural aging takes place, skin around the face and neck begins to lose its tone and will sag.
- This procedure, commonly called a “facelift” if performed to improve the appearance of the patient, provides both emotional and social benefits.
- The procedure may be performed under general or local anesthesia, depending on the preference of the patient and the surgeon.
- Supine with arms tucked in the sides.
- The head may be supported on a headrest.
- A nasal preparation is usually performed prior to begin the skin preparation.
- Basic plastic tray
- Small Deaver retractors
- Head rest
- Sitting stools
- Basin set
- Needle counter
- Local anesthetic with epinephrine
- Syringes and needles
- The incisions are made close to the hairline or in the hair so that the resulting scars are unnoticeable.
- A small amount of hair may need to be shaved from the hairline; in most cases, this is performed by the surgeon.
- The skin and subcutaneous tissue are mobilized by undermining (separation of skin and subcutaneous tissue from their attachments underneath).
- Care is taken to avoid injury to nerves such as facial nerve branches and greater auricular nerve.
- After hemostasis is secured, placation sutures are placed in the musculofacial tissues.
- Tension is placed on the flap and traction sutures are used to pull the flap superiorly and posteriorly.
- The excess skin is trimmed.
- Wound closure is completed with fine interrupted sutures.
- A closed-suction drainage unit may be inserted before closure.
- A light pressure dressing is then applied, padding the ears.
Perioperative Nursing Considerations
- Do not allow the preparation solution to pool in or around the eyes or ears.
- A head drape should be used for all facial surgery.
- The table may be flexed for added patient comfort.
- A foam mattress should be used for extra support.