Question 1

Facelift overview

Answer

As people grow older, the natural aging process, genetic influences, exposure to the sun and other factors cause the skin to wrinkle and sag. Skin folds become more prominent, particularly around the chin, on the jaw line and on the neck. A facelift | necklift can significantly reverse these signs of aging. The facelift | necklift procedure is performed under general anesthesia in a sterile hospital setting. Incisions are made running in front of the ear, then around the earlobe and behind the ear ending in the hair of the scalp. Loose skin is separated from the underlying tissues and pulled up and back, with excess skin removed. Connecting tissue and muscles are tightened, and in some cases, fat deposits are removed from beneath the chin and neck. This may necessitate an additional small incision under the chin. Tiny sutures are used to close the incisions. A rhytidectomy or facelift can take from 3 to 5 hours or more depending on whether other procedures are done at the same time. Additional procedures such as blephoraplasty/eyelid lift, forehead lift, fat transfer, and lip lifts are commonely added. After surgery, loose bandages are applied to the area which are removed the following day. It is then recommended a compression garment be worn fulltime for up to two weeks to help with the swelling and to ensure maximum tightening of skin to underlying tissue. The compression garment can then be worn for weeks 2-4 just at night. Post-surgery pain is generally minimal to moderate and is controlled with oral medication.

Question 2

What a facelift cannot do

Answer

A facelift will help you look younger by reducing the obvious signs of sagging skin and folds around the lower face and neckline. However, a facelift will not improve the quality of the skin or remove all wrinkles. If you have lost volume due to the aging process this may be solved with fat transfers to the face or by silicone implants. A facelift will not stop the aging process but will keep you looking younger relative to your age and to others who have not had the procedure. Usually it has been expected that a facelift 'lasts' 7 to 10 years before the sagging of the tissues begins to be noticeable again. In relative terms, the clock has been turned back ten years so many choose to let the natural process continue at its own pace, while others have a second procedure. A facelift may smooth skin, but for additional effect, Botox can be used on crows feet and other wrinkles to enhance the facelift's rejuvenating results. The quality of the skin can be improved by chemical peels or laser. Lines on the upper lip can be corrected with dermabrassion, laser or fillers. Sometimes the nasolabial folds or marionette lines can be improved with fillers or fat transfer if the facelift alone was not able to accomplish this completely.

Question 3

Am I a good candidate?

Answer

You are an ideal candidate if: • You are in good health
• You do not smoke • Your pre-op lab work is normal • You have reached your desired weight • You have friends or family available for your post-operative care • You are willing to follow post-operative instructions • You are able to take 7-14 days off work to rest at home and heal

Question 4

Prepping for your surgery

Consultation
During the consultation, your medical history will be taken in order for Dr. Sigler to evaluate your general health. A careful examination will also be conducted. Together with Dr. Sigler, you will discuss the procedure and communicate your desires, your concerns and the results you hope to achieve. You may bring photographs to show Dr. Sigler examples of what you are looking for. Dr. Sigler will go over details of the procedure itself and the possible risks and complications as it pertains to any medical or structural issues she sees in your case. She will go over the type of anesthesia to be used. Once you have all your questions answered, you will both agree on a surgery plan and a proposed date. Photos are taken before and after the surgery in order to determine the amount of improvement.

Setting Your Surgery Date
A deposit is required to confirm the date and time of the procedure. See pricing and payment above for details.

If You Smoke
If you smoke, this habit should be stopped at least two months prior to surgery. This includes vaping and marijuana smoking.

Two Weeks Prior to Surgery
Review and download this list of medications and supplements to avoid.

Stop taking any medication on this list two to three weeks before the surgery. Avoid any intake of aspirin, ibuprofen, Naproxen (excedrin, Motrin, Aleve, Advil), vitamins that include vitamin E, and energy drinks as well.

Arrange for family or friends to be available for assistance when you return home to recuperate. Clear your schedule. Make a list and organize your environment to be safe and condusive to bedrest. Stock your kitchen and plan ahead for a period of time spent watching TV, reading or simply relaxing.

Labwork
Pre-op labwork should be done two weeks before the surgery with your own doctor, and then sent to Dr. Sigler. If you prefer Dr. Sigler to do the labwork, you will need to make arrangements prior to your surgery date. Required labwork includes:

CBC (Complete Blood Count), CMP (Chemical Metabolic Panel), PT (Prothrombin Time) and INR, PTT (Partial Thromboplastin Time) and any other labwork specific to your particular medical condition(s), such as a Thyroid Hormonal Panel.

If you are over 50, it will be necessary to have a cardiovascular assessment including an EKG and possibly a chest x-ray. Dr. Sigler will advise.

Approval for Surgery
If you are currently undergoing treatment for a medical condition or disease, a letter from your treating specialist must be sent to Dr. Sigler at least two weeks prior to the surgery stating you are cleared to go ahead with the procedure, and include any pre-op and post-op recomendations in order to avoid possible complications during or after the surgical procedure.

Night before Surgery
Eat a lighter dinner and do not eat or drink past midnight. Fast at least 8 hours prior to surgery.

Day of Surgery
Do not eat or drink anything except a little water. Allow sufficient time to get to the surgery center. Using Dr. Sigler’s car service is usually the most efficient way to ensure a timely arrival. Intake is typically scheduled two hours prior to the actual surgery. You will meet with Dr. Sigler for your pre-op consultation, pre-op photos and markings on body or face, and for a final discussion about your procedure. Paperwork is completed and final prepping by your surgical team is carefully performed.

Answer

Dr Sigler’s preferred technique is the one where the SMAS layer containing the muscles are lifted, tightened and sutured prior to tightening the skin itself. Excess skin is then removed and sutured. This method allows the lift tension to be located in the SMAS layer and not on the skin incisions. The resulting scars will be narrower and become barely noticeable upon full healing. Dr Sigler’s technique also leaves the earlobs looking natural, avoiding the 'pixie earlobe' look that is a sure sign the patient had a facelift. Sideburns are also left in place to give the patient a more natural look. The coronal incision has been replaced by the endoscopic browlift or minimal incision in the forehead. Commonly added to the facelift is an eyelid lift or blephoraplasty. Sagging eyelid folds, extra skin and sometimes muscle and fat bags are removed through incisions that hide in the palpebral fold, resulting in a very natural and refreshed look overall to the facelift surgery. Fat transfer to various parts of the face, lip lifts and forehead lifts as other procedures that may be added to a facelift.

Answer

"Dr. Sigler is an incredible human being. She is honest and has great bedside manners. I have special needs, and she made sure every lab was cleared before surgery. I have, and will continue to recommend her to everyone I know." —Sherry, facelift patient "After hours of Internet sleuthing and emailing Drs I found Alicia Sigler in Tijuana. Her email responses to me were so spot on I knew my search was over. I ended up having a lower and mid facelift, lip lift (life changing!) and corner brow lift. I thought I might need my eyes done but she said brow was only needed and she was right. The whole experience was great and I'll go back. Highly recommended!!!" — Karen C. on RealSelf

Question 5

Post surgery care

5-7 days stitches out pending Dr. Sigler's evaluation — this also may be done over several visits depending on surgery and patient
5-7 days regular activities (keep head elevated to avoid excessive blood flow)
2-3 weeks regular exercise

You can expect redness and swelling around the incision areas. Bruising may occur, depending upon the type of surgery you had. It is important to keep the stitches covered in antibiotic ointment.Keep the head elevated and use ice or cold compresses every few hours for the first three days and three nights. week to reduce swelling and bruising. Continue to use for the rest of the first week if swelling and brusing are still present.

Use extra pillows to prop yourself up at a 45 degree angle in bed or on the couch. Rest and sleep on your back for the first week. Avoid physical efforts such as bending over or lifting anything heavier than 1 pound for the first two weeks in order to keep strain and blood flow away from the neck and face.

Post-surgery pain is minimal to moderate and the jaw may typically feel tight; accompanying soreness may be treated with analgesics.

Avoid heat or sunlight to the face in orde to reduce swelling. Avoiding sunlight to bruises on face will avoid permanent dark discoloration to the skin.

When a necklift is performed, the patient must avoid turning the head sideways since bleeding in this area may occur up to two weeks after the surgery. Therefore, driving is prohibited for two weeks following a facelift/necklift.

A compression garment to the neck is sometimes recommended (depending the case) to be worn day and night for the first week and then only at night for the following week(s).

Dr. Sigler will determine when the sutures are to be removed and this may be done in stages in order to minimize scarring. Scars from the incisions fade significantly with time and are, for the most part, inconspicuous because they are located within natural creases. Swelling and discoloration disappear in a week or two. Swelling can be reduced by keeping the head in a slightly elevated position when reclining. A tightness or numbness of the treated area may be present for weeks or months, depending upon the patient's healing and lifestyle.