Your Personal Guide to Facelifts

1. Your Personal Guide to Facelifts 858-455-0290 | WWW.RSINGERMD.COM

2. Considering a facelift? Having a facelift is an important decision. Does what you see in the mirror not match what you feel on the inside? Do you want to look as young as you feel? That’s why we’re here. We created this guide to provide you with all the information you need to know about Facelifts: Who Needs a Facelift, How To Choose Your Plastic Surgeon, the Facelift Procedure, Recovery and more. We’re here to help you through this life-changing journey. 858-455-0290 | WWW.RSINGERMD.COM

3. Who are we? Dr. Robert Singer has helped thousands of people in Southern California and around the world attain the rejuvenated appearance they have always wanted. Dr. Singer has been engaged in private practice in the La Jolla area of San Diego since 1976 and is now an internationally recognized plastic surgeon. Board Certified Plastic Surgeon (American Board of Plastic Surgery) in La Jolla, San Diego, California. Dr. Singer appears regularly on radio and television programs such as Larry King Live, in national and local newspapers, and in national and international fashion, news, and health magazines. Dr. Singer has also been a resource for plastic surgery information to the Medical Board of California and the Congress of the United States. Dr. Singer is a sought-after speaker who lectures to prominent surgical organizations and non-medical audiences in the United States, Europe, Asia, and Central America, including the prestigious Young Presidents’ Organization, CEO, and World Presidents Organization. Throughout his career, Dr. Singer has also authored many scientific publications on various aspects of reconstructive and aesthetic plastic surgery. We want to ensure the best education and support for anyone interested in plastic surgery. We aim for each patient to experience excellence. 858-455-0290 | WWW.RSINGERMD.COM

4. What is a facelift? Technically known as rhytidectomy, a facelift is a surgical procedure that smooths loose skin on the face and neck, tightens underlying tissue and muscles, and removes excess fat. It is one of the most sought after and satisfying aesthetic surgical procedures. A face lift can remove many, but usually not all, wrinkles, and it can remove much of the sagging skin of the face and neck. It will give you a more youthful, fresher, and natural appearance. Plastic surgery is the fusion of art and science. To sculpt the face through plastic surgery requires an approach that is individualized, studied, and measured. Achieving the most appropriate result for each face requires the ability to evaluate facial anatomy and then to apply scientific principles, skill, and artistry. Dr. Robert Singer is known worldwide for his expertise and skill in the facelift procedure. He has performed this delicate surgical procedure at his La Jolla practice for many people wanting a rejuvenated, younger appearance. 858-455-0290 | WWW.RSINGERMD.COM

5. Who needs a facelift? Today, men and women increasingly want to look as young as they feel. No one wants to look tired, especially when he or she isn’t. The facelift helps reverse the signs of aging, producing a more natural, youthful facial appearance. You should consider a facelift when what you see in the mirror does not match what you feel on the inside, when you have a support structure in place to facilitate a comfortable recovery, and when you are confident you are doing this for yourself and not to please others. Most patients who seek a facelift are 40 - 70 years old, but there is no “correct” age. If you are not physically or emotionally ready, there are non-invasive, temporary procedures to rejuvenate your face such as supervised skin care, chemical peels, injectable fillers, microdermabrasion, lasers, and injectables. If you are under 40 years of age, you can probably undergo a more limited variation of the facelift procedure called a Mini or Mid-facelift. The best candidate for a facelift is a person whose facial and neck skin has started to sag but whose skin retains some elasticity. Additionally, a good candidate will have a strong, well-defined bone structure. It is important for patients to be physically and psychologically healthy, have realistic expectations of their surgery, understand the risks and benefits of a facelift, and desire improvement rather than perfection. 858-455-0290 | WWW.RSINGERMD.COM

6. How to Choose Your Plastic Surgeon • The most crucial factor in achieving the results you desire is selecting the best plastic surgeon for your facelift. Don’t feel pressured in your decision-making process; instead, take your time to make an educated choice. Before every consultation, do your own research and look into the surgeon’s training and experience. Being well-informed will ensure your comfort and confidence throughout the entire process and your procedure. • What to research and verify about your surgeon: • Plastic surgery specialty • Plastic surgery board-certification by the American Board of Plastic Surgery (ABPS) • Ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) • Years of experience and training • Hospital privileges for the breast procedure that will be performed in any facility • Surgical facility/office accreditation by a nationally recognized organization such as: • American Association for Accreditation of Ambulatory Surgery Facilities. (AAAASF) • State licensure as a surgical facility 858-455-0290 | WWW.RSINGERMD.COM

7. Plastic Surgery Certification • There are several ways to find a qualified plastic surgeon. You can begin with referrals from friends or family members who’ve had facelifts. You can also look up plastic surgeons in your area, and on their website, you can read testimonials from their past patients. • Additionally, you can contact any of the following highly respected professional organizations: • American Board of Plastic Surgery (ABPS) • American Society for Aesthetic Plastic Surgery (ASAPS) • The American Society of Plastic Surgeons (ASPS) • American College of Surgeons • International Society of Aesthetic Plastic Surgeons (ISAPS) 858-455-0290 | WWW.RSINGERMD.COM

8. Does the doctor adhere to a strict code of ethics? • Has he fulfilled continuing education requirements, including patient-safety techniques? • What percentage of the doctor’s practice is cosmetic vs. reconstructive plastic surgery? • How long has the doctor been performing the procedures you are considering? • Does the doctor have hospital privileges to perform the procedures you are considering? • Can you receive a copy of the doctor’s professional biography that summarizes his training, qualifications and credentials? • Does the office provide, at the consultation, an itemized “fee quotation sheet,” listing all proposed services and charges? • Who will administer the anesthetic- an anesthesiologist (physician specialist), or will it be a nurse, a nurse anesthetist, or the surgeon? • Is the surgery performed entirely by your surgeon? Or is a part-delegated surgeon-in-training or associate? • Will the operating surgeon and the staff perform all of the postoperative care? • Is the outpatient surgical facility located in a medical building or immediately adjacent to a major hospital? • Is the surgical facility accredited by AAAASF? Questions for Your Plastic Surgeon Asking questions during your consultation will help you better assess your plastic surgeon in order for you to feel at ease with him/her throughout the process. Your surgeon should listen well and answer your questions in a patient, respectful manner. After you research your surgeon, you may want to find out more about him/her as well as the facility where your surgery would take place. 858-455-0290 | WWW.RSINGERMD.COM

9. Key Questions About Facelifts • After you are confident about your choice of surgeon, it is always necessary to ask additional questions during your initial consultation about your procedure. The following are common facelift questions that you may have when considering the procedure: • What do I do to prepare for surgery? • What happens at the preoperative appointment? • Where will my incisions be places? • What does informed consent mean? • What are the benefits and risks of a facelift? • What if I have a history of bad scars? • What about my daily vitamins, supplements and medications before surgery? • Do I need any special prescriptions before surgery? • Why will I be asked not to eat or drink anything? 858-455-0290 | WWW.RSINGERMD.COM

10. Your Facelift Consultation During a facelift consultation, Dr. Singer will personally listen to your desires and expectations for your procedure. He will then evaluate your anatomy and physical appearance to create a custom treatment plan that best suits your needs. There is no ideal single technique or single approach that is appropriate for every patient. The goal of your facelift is to improve your overall facial appearance in a natural manner. 858-455-0290 | WWW.RSINGERMD.COM

11. The Facelift Procedure Facelift techniques have evolved significantly over the past 15 years. Prior generations of facelift operations tightened only the skin and ignored important principles of aging and facial structure. Unfortunately, tightening only the skin produced distortions of the facial features and often resulted in an unnatural, flattened, wind-blown, pulled look, as well as a shorter length of efficacy. Dr. Singer performs a modern multi-vector underlying support facelift that is individualized for your needs and more precise, more natural, and longer lasting. The supporting deeper tissue – the SMAS (superficial muscular aponeurotic system) – is tightened, lifting the underlying muscle layers of the cheek and the neck. The fat in the cheek is contoured into an improved position, or sculpted if it is excessive. Micro-fat grafts are added to depressed, deficient areas. 858-455-0290 | WWW.RSINGERMD.COM

12. The Facelift Procedure The fullness of the upper cheek area below the eyelid is corrected by elevating it into a more youthful position, counteracting the direction of the descent of the tissue that occurs with aging. The skin is then redraped without tension, and any excess skin is tailored. The loose skin, muscle, and fat under the chin and neck are addressed if those areas need improvement. Dr. Singer will personally perform the entire facelift surgical procedure, which can take 2½-6 hours depending on the individual case. Focus is put on not how quickly, but on how successfully the procedure can be completed. Incisions are placed along the hairline and hidden in the curves around the ear, and there may be a small incision under the chin. In addition to a full facelift, Dr. Singer also offers the maintenance facelift (mini or mid-facelift), cheek reduction, and secondary facelifts. 858-455-0290 | WWW.RSINGERMD.COM

13. Anesthesia at an Accredited Facility At our AAAASF-accredited (American Association for Accreditation of Ambulatory Surgery Facilities) private operating facility in La Jolla, you will be taken care of by thoroughly trained personnel, including carefully selected, experienced, board-certified physician anesthesiologists. Most of our patients are anesthetized using sedation, allowing them to be asleep while breathing on their own, but usually not requiring deeper general anesthesia. In some cases, Dr. Singer may recommend that you spend a night in the hospital after your surgery. We will discuss these options with you during your consultation. 858-455-0290 | WWW.RSINGERMD.COM

14. Facelift Recovery You will be allowed to go home, accompanied by a responsible adult, 1-2 hours after your surgery. If you are spending a night in Scripps Memorial Hospital-La Jolla, which is immediately adjacent to our office, you will be transferred there. Following the procedure, you will have a soft head wrap around your head and under your chin to minimize swelling. You will also have a tube with a ball on the end of it called a drain just behind each ear. We will teach you and whoever is taking care of you post-operatively how to empty these drains every night. The drains will generally be removed in the office in 1-2 days, and the head wrap will be freshened or removed at 3-5 days. Some of the stitches will be removed 4-5 days after surgery and the remainder at about 2 weeks. You may have some bruising and swelling, which typically are more pronounced 24-48 hours after the procedure. You can minimize bruising by using topical Arnica Montana 1-2 days before and after surgery. The swelling and bruising, along with bloodshot eyes, will continue with gradual improvement for 2-3 weeks. You will also feel sensations of tightness for several days to weeks. Intermittent sensations of tingling, burning, and itching can be expected behind or on your ears for several weeks. Numbness of the cheeks and neck will gradually improve over several months. 858-455-0290 | WWW.RSINGERMD.COM

15. Facelift Recovery You should “take it easy” the day of your operation and the following days. Depending on the kind of work you do, you may return to your job as soon as you are comfortable. Sleep on your back for 2 weeks, elevating your upper body on 2-3 pillows. By keeping your head elevated above your heart, swelling can be minimized. Because of the medications you will be given, you may need assistance getting to and from the bathroom for 24 hours or so. Avoid aspirin, alcohol, smoking, and driving for 5 days after your surgery. You may wash your hair after the dressings have been removed, but do not use a hot hair dryer, electric rollers, curling irons, or hair coloring/bleach for 3 weeks following surgery. You can apply makeup after the bandages have been removed, as long as you keep the makeup away from the incisions for 2 weeks. Strenuous sports and exercise should be avoided for 3 weeks, and refrain from any other activity that significantly raises your body temperature and/or blood pressure for 3 weeks, such as hot tubbing, sex, and brisk walking. Most people can expect the results of a facelift to last between 8-12 years. 858-455-0290 | WWW.RSINGERMD.COM

16. Before & After View Before & After images of real patients who have had facelift surgery with Dr. Robert Singer to see examples of excellent facelift results. Before and After images are a great way to help visualize what your facelift results can be like. Search through our library for more Before and After images to help you visualize your desired results. Dr. Robert Singer’s Facelift Before and After Images 858-455-0290 | WWW.RSINGERMD.COM

17. Helpful Resources • To help get you started on your journey through research, surgery, and recovery, view the helpful resources below. These resources can help connect you to those in the community who have also had facelifts, information on facelifts, and common questions answered about facelifts. • American Society for Aesthetic Plastic Surgery • American Society of Plastic Surgeons • Dr. Singer’s Facelift FAQ • Dr. Singer’s Facelift Before and After Photo Gallery • NewBeauty • RealSelf • Smart Beauty Guide 858-455-0290 | WWW.RSINGERMD.COM