Facelift

The term "facelift" is not a single type of operation but rather a variety of options that should be tailored to the individual patient's needs. Facial aging occurs as a result of both “deflation” and “sagging” of tissues. It’s essential that a well-designed facelift addresses both of these components.

Modern advances in facelift surgery have been immense. We now understand that in order to obtain natural and long-lasting results, the deeper layers of the face need to be re-positioned. A good facelift is 3-dimentional sculpting procedure, rather than a 2-dimensional pulling or tightening procedure. And it’s essential that your surgeon is an expert at Deep Plane, Extended or High SMAS procedures that achieve gold-standard results.

During our consultation we will likely discuss the following together:

  1. Your area of concern
    The face does not age as one unit, as is often thought. For some people, the eyelids / eyebags are the main concern. For others, it is sagging of the mid-cheek or jowling, or loose skin around the neck. Genetics and familial traits are also involved. It’s not uncommon to hear a patient say that they feel they look more like their grandmother / aunt / father as they get older!

    It’s essential that I understand and specifically address what troubles you the most.

  2. Anatomy of facial aging

    Using diagrams, we will discuss the underlying causes of facial aging and how surgery can correct these.

  3. SMAS lifts / deep plane lifts
    The SMAS or Subcutaneous Musculo-Aponeuritic System is a thin but strong layer underneath the skin to which the muscles and soft tissues are attached. Better understanding of the SMAS has really been the key step forward in being able to effectively and durably lift and relocate the tissues of the face that have moved downward with age.


    These deeper plane lifts do require a detailed knowledge of facial anatomy and meticulous surgical technique, but the gains are well worth the extra time taken to perform the surgery. In most patients, this is the technique that reliably gives the best and most impressive results that stand the test of time.

    I have found more modern variations referred to as High SMAS or Extended SMAS lifts to give outstanding restoration of the characteristic youthful appearance of the cheek and jawline.

  4. Short scar techniques / MACS lift
    In some patients it is possible to avoid extending the facelift scar behind the ear. There are a number of names given to this approach but the important issue again is correct patient selection. Patients that benefit from this sort of approach are the younger patients who do not have significant age-related changes in the neck.

  5. Expectation of results
    I will show you a number of my pre- and post-operative results so that you are able to have a very realistic expectation of what can be achieved with surgery. We will also go through and discuss what is involved with the post-operative recovery.

Neck lift and platysmaplasty

Obtaining an excellent result in the neck is an artistic imperative in any facelift procedure.

All deeper plane facelifts tighten the muscles of the neck to improve the jowl area and the definition of the jaw line in both the frontal and side views. To eliminate vertical folds in the neck and improve the neck and chin definition as much as possible, I would almost always perform an anterior platysmaplasty (tightening of the anterior neck muscles to obtain the best contour) in combination with a lower or full facelift to achieve the same effective rejuvenation in the neck as in the rest of the face. This may require a small incision below the chin.

Scars

The scars for all types of facelift fall within the hairline and around the ear. They are designed in such a way that you will be able to wear your hair in any style that you wish once they have had a chance to mature.

Additional Procedures

There are a number of additional procedures that complement the results of a facelift and may be carried out when required. These include browlift, upper or lower blepharoplasty (eyelid surgery), rhinoplasty, bony adjustment of cheeks or chin, liposculpture or fat grafting around the face or lips, and skin resurfacing with chemical peels or laser. Bony adjustment of the chin (genioplasty) can produce a subtle yet dramatic improvement in the facial proportions.

Fat grafting is an excellent and generally permanent way to add volume and restore youthful fullness to the areas of the face where this has been lost.

What to expect on the day of and after surgery?

We will provide you with specific information about what to do before and after surgery but you may find the following guidelines useful in planning your operation and knowing what to expect.

Most patients stay one night in hospital after face or neck lift surgery.

You will have a light padded dressing which will be removed the day after surgery and prior to you going home. You may have some tape on your face and also cool pads on your eyes, particularly if you have had eyelid surgery. It is advisable to rest as much as you can in the first 48 hours and then gently resume normal activities in 7 to 10 days. The sutures are mostly dissolving, and will be trimmed at 5-7 days.

You should allow 10-14 days before you can put on makeup and socialize in public. Usually you will be able to resume most activities such as excercise at 4 weeks, perhaps slightly longer for more vigorous exercise.

Most people describe this type of surgery as not particularly painful and generally only low level pain medication is required for a few days after surgery. The neck however does feel “tight” for a few weeks.

We will see you regularly in the postoperative phase to make sure you are looked after and longer term followup will also be arranged. All postoperative dressings, visits, and appointments are part of the surgical care and you will not incur any additional cost.