Informed Consent for Rhytidectomy (Facelift) Surgery

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Informed Consent for Rhytidectomy (Facelift) Surgery

Patient and Surgical Team Information

Nature and Purpose of the Procedure

A rhytidectomy (facelift) is a surgical procedure performed to reduce visible signs of aging in the face and neck, such as sagging, jowls, and loose skin. It is an aesthetic procedure designed to restore a more youthful contour. Under general anesthesia or intravenous sedation with local blocks, the surgeon makes incisions starting in the hairline at the temples, continuing around the ear, and ending in the lower scalp. The surgeon lifts the skin and redistributes or tightens the underlying muscle and connective tissue layer (SMAS, or superficial muscular aponeurotic system). Excess fat may be sculpted or suctioned, and the skin is re-draped over the new contours. Excess skin is trimmed, and the incisions are closed with sutures or metal clips. Drains may be temporarily placed. The procedure typically takes 3 to 5 hours.

Material Risks and Potential Complications

Hematoma: accumulation of blood beneath the skin (occurring in 1 to 3 percent of cases), which is a surgical emergency that requires immediate drainage to prevent skin flap necrosis.
Facial nerve branch injury: trauma to the motor nerves of the face (temporal, zygomatic, buccal, mandibular, or cervical branches) causing temporary or permanent weakness or paralysis of facial expressions (e.g. inability to raise eyebrow, close eye, or smile evenly).
Skin loss or delayed healing: necrosis of the skin flaps along the suture line (occurring more frequently in smokers or patients with microvascular disease) due to inadequate blood supply, which may require wound care or skin grafting.
Alopecia or hair loss: temporary or permanent thinning of hair adjacent to the incision lines in the temples or behind the ears.
Permanent skin sensation changes: persistent numbness, tingling, or hypersensitivity of the face or ears due to sensory nerve branch trauma.
Unfavorable scarring: thick, raised, or widened scars (hypertrophic or keloid) or distortion of the earlobe (pixie ear deformity) requiring revision.
Asymmetry: normal facial asymmetry exists, and while surgical adjustments are made, post-operative asymmetry in skin tightness, contour, or facial motion may persist.

Reasonable Alternatives

Non-surgical rejuvenation: injectable dermal fillers, neuromodulators (Botox), chemical peels, or micro-needling to improve fine lines and minor laxity.
Energy-based treatments: radiofrequency skin tightening, ultrasound therapy (Ultherapy), or fractional laser resurfacing.
Decline treatment and accept current facial appearance.

Critical Smoking and Nicotine Cessation Mandate

Facelift surgery requires wide elevation of delicate skin flaps whose survival depends on tiny capillary blood vessels. Nicotine severely constricts these vessels, drastically reducing oxygen transport to the healing tissue. Active smoking or nicotine use increases the risk of skin necrosis, wound breakdown, and severe infection by up to 12 times. Patients must completely cease all smoking and nicotine products for at least 4 weeks before and 4 weeks after surgery.

Questions and Understanding Confirmation

I confirm that I have had the opportunity to read this consent form. I understand the facial nerve risks, the emergency nature of a post-operative hematoma, and the nicotine cessation mandate. I believe I am making an informed and voluntary decision.

Signatures and Verification

Patient Signature
Consenting Plastic Surgeon Signature
Witness Signature
Date and Time of Consent
Document ID: CC-PENDING
CONSENTCOLLECT