There are many different types of facelift but all are designed to tighten the underlying tissues and muscle, restoring the volume in the places it should be, and remove excess skin. The results of a facelift are consistently reliable and long-lasting.
I aim to give a subtle but significant result that leaves you looking natural, refreshed and rested rather than too tight or plastic.
Who is a Good Candidate?
Good candidates for a facelift include women or men who are healthy, in good physical shape, and at their ideal body weight. Candidates for facelift surgery should be emotionally stable, have the support of their surrounding friends and/or family members, and be fully educated about the procedure.
Who is not a Good Candidate?
Smokers, patients with multiple or untreated medical problems, and individuals who are psychologically unprepared for surgery are not good candidates for a facelift. Those who have been encouraged by others to change their appearance. Candidates with unrealistic expectations should not have this surgery.
A facelift uses incisions hidden in natural facial creases or in the hair-bearing region of the scalp. Traditional facelift techniques allow for the most reliable and long-lasting rejuvenation. I shorten scars whenever possible if your anatomy and specific situation allows. A facelift reverses the effects of gravity, correcting age-related changes by gently repositioning the soft tissues of the face to restore a youthful and refreshed contour. A facelift usually combines the techniques of subcutaneous and SMAS lift procedures. If there are alternative options based on your individual anatomy and aspirations these will be discussed with you at consultation.
How long will a facelift last?
A facelift will give you a refreshed and rejuvenated look that will endure over many years to come. However, you will continue to age appropriately; facial Plastic Surgery resets the clock, it does not stop it ticking! In the future, you will still appear younger than if you had not had your procedure, but your appearance will slowly change as you age. Excellent skin care, smart sun avoidance and non-surgical procedures can prolong the results of your facelift. If, over a long period of time, recurrent signs of aging appear, a Secondary Facelift may be recommended. A secondary procedure is slightly more complicated and requires experience and judgment by your surgeon.
Can I have other procedures at the same time?
A facelift rejuvenates the jaw line, cheeks and the nasiolabial area (from the nose to the corners of the mouth), but does not address the neck, forehead or eyes. At your initial consultation a full facial examination will allow me to assess which of the features you wish to improve can be addressed by facelift and identify surgical or non-surgical options for features that will not be improved by a facelift. A facelift is often complimented and further enhanced by a variety of other facial Plastic Surgery procedures such as neck lift, blepharoplasty (eyelid surgery), brow lift, liposuction and earlobe improvement. It may also be complemented by Non-Surgical treatments such as Botox and fillers.
What to Expect at Consultation
At your initial consultation I will take a full medical history including all details of current and past illnesses, medications (prescribed or otherwise), lifestyle and past history of any previous surgery. We will discuss what it is that you do not like about your features and what you are hoping to improve. It is important to be open and honest at this stage with regard to what troubles you and what your expectations are so that we have a shared vision of what you are hoping to achieve.
I will assess you clinically and take a number of measurements. It can be quite disconcerting to have someone stare at you face for a period of time and analyse it but this is an important part of assessment so please bear with me! Different facelift operations can be individualised to your particular anatomy, needs and aspirations. We will discuss what is and what is not possible for your individual anatomy and the potential outcomes, risks and complications of the surgery. I will also advise if any additional procedures are likely to enhance the results. I always see you a second time before proceeding to surgery to answer any questions that you may have.
Preparing for Facelift
You should be physically fit and at a healthy weight which should be stable prior to embarking on facial plastic surgery. Your health will be assessed pre-operatively and you may need some tests that will be arranged if required. You should stop smoking at least 6 weeks ahead of surgery to reduce the risk of wound healing problems. You should stop aspirin, anti-inflammatory medications and any non-prescribed medication at least a week before surgery. If there is any change in your health prior to your surgery date you should let me know. Your health and general well being are my primary concern when I am treating you therefore if you are unwell for any reason it may be necessary to postpone surgery.
What to Expect on the Day of Surgery
A facelift is done under general anaesthetic for optimal comfort, control and safety. The incision is made in the hairline in the temple region, in front of the ear hidden in a natural crease, around the earlobe and ending in the scalp behind the ear. The scars may be shorter if the desired outcome can be achieved via this approach. It may be necessary to make a small incision under the chin for chin and neck contouring. A facelift usually takes 2 - 3 hours but may be longer if you are having additional procedures.
During the procedure the skin of the face, cheeks and neck is generally elevated off the deeper tissues under surgical loupe magnification to protect blood vessels and nerves of the face. The deeper fat and muscle are visualized, repositioned and sculpted create a more youthful contour. The skin is then re-draped and excess skin trimmed before the incisions are closed with sutures. Staples are used on the scalp as they have better outcomes than stitches in hair bearing areas.
When you wake up there will be soft dressings to make you comfortable. I use drains infrequently but when I do they only stay in overnight. Facelift surgery is not normally very painful but you may feel some discomfort and tightness, which is normal. You will return to the ward around an hour after the procedure and be able to eat, drink and get up out of bed. You will be numb around the face, neck and earlobe but the feeling will gradually return over the coming months. It is unusual for the loss of sensation to be permanent. You would normally stay in hospital for the first night after the operation and go home the following day. You will need someone to pick you up from hospital and to give you some support for a couple of days at home.
What to Expect After Discharge
The face has a good blood supply so facelift incisions tend to heal very well with good quality scars. The skin is usually mostly healed at your first post-op visit when stitches are removed. You will be swollen and bruised at first and you may notice asymmetry or an uneven appearance of the skin in the first few weeks after surgery. This is normal and will usually settle down over the following weeks as healing progresses. At around two weeks post-op obvious signs of surgery such as puffiness or discoloration should start to dissipate and the improvements from the procedure will start to become more obvious. Sleeping with a few extra pillows to elevate the head can help speed the resolution of postop swelling. It may take several months for the final results to be evident and for all scars to settle to fine white line scars.
The scars are permanent but are normally well concealed in the natural contours of the face and within the hairline. Until the scars have settled it is important to minimise direct sun exposure to the face. If you maintain this as a life-long behaviour beyond the scar maturation process it will help to maintain your rejuvenated appearance and to minimise future sun related aging.
You will be able to wear makeup over sunblock at one week post-op. I can advise you on appropriate Medical-Grade skin care to use as part of you daily skin care regime. Some patients grow their hair a little longer than usual if prior to the procedure to help conceal the scars during healing. You should avoid hair colouring for at least a month after surgery.
You should plan to be off work for at least 2 weeks depending on the type of work you do. You can return to gentle exercise at 3-4 weeks but avoid anything vigorous for 6 weeks.
Risks and Potential Complications
When you are considering any type of surgery you should be fully educated about potential risks and complications. The majority of patients are delighted with their results. Common complaints are numbness, bruising and swelling. Infrequently patients may experience infection, a collection of blood called a haematoma, delayed healing, skin necrosis, seroma and abnormal scarring. Abnormal scars are those that become red, raised and prominent for longer than expected. You will be under regular review after surgery and if there are any concerns with how your scars are progressing we will commence scar therapy. The facial nerve controls the muscles of facial expression and in rare circumstances can be damaged. The resulting weakness can last a number of weeks but is rarely permanent. Having a general anesthestic carries risks of respiratory or cardiac compromise and venous thromboembolism (DVT and PE).