As we get older, the effects of sun damage as well as the natural ageing process leads to loss of elasticity and tightness of the facial skin. Gravity can cause sagging and drooping of the face, especially around the eyes, cheeks, jowls and neck. Skin wrinkling is a result of these factors.
A facelift, also called “rhytidectomy,” is an operation designed to correct the effects of ageing in the face. It soothes the loose skin on your face and neck, tightens underlying tissues and removes excess fat. As a result, your face will appear firmer, fresher and more youthful. After the operation you should not expect to look a different person, but rather look refreshed, rejuvenated, and perhaps a few years younger. We aim to provide a natural ‘refreshed’ look.

Any of the following conditions may make you a good candidate for facelift surgery:

• A deep line, or fold, running from the corner of your nose to the corner of your mouth
• Jowls, or loss of a well-defined jawline associated with youthfulness
• Deep wrinkles in the cheeks and sagging of the “highlight” areas of the cheekbones
• Loose skin, wrinkles, vertical folds or excess fatty tissue in the neck

A facelift can improve all of these problems

During the initial consultation, you will be asked to describe exactly what you would like to see improved. This will help us to understand your expectations and determine whether they can be realistically achieved. You should always keep in mind that the desired result is improvement, not perfection.

You will be asked about your medical history including previous operations, past and present medical conditions and medications. In order to provide you with the best information and safest options, it is important that you provide your complete information. Photographs may be taken during your initial consultation and at subsequent visits for the purpose of preoperative planning and documentation. We will discuss with you the details of the operation and the possible risks and complications associated with the procedure.

In assessing you for facelift surgery, we will examine the thickness, texture and elasticity of your skin, as well as the severity of wrinkles and folds. Your hairline will be examined to determine where incisions can be discreetly placed. All these factors, as well as your bone structure and underlying tissues, will be considered in developing an individualized surgical plan. We may discuss with you additional procedures that can be performed along with a facelift in order to address all the concerns you have identified. For example, a facelift is frequently combined with a forehead/brow lift, liposuction, eyelid surgery, Botox injections or skin treatments.

Smokers will be asked to stop smoking before surgery. Aspirin, some anti-inflammatory medications, and some herbs cause increased bleeding (including arnica), so you should avoid taking these medications for 2 weeks before surgery and 2 weeks after surgery.

Although there are many variations to the facelift operation, incisions are hidden in the hairline of the temple and the natural creases in front of the ear. Sometimes the incision then curves around the earlobe, behind the ear and is camouflaged in the scalp. After surgery, incisions can be easily concealed by your hair. The placements of the incisions will depend on your individual surgery that you will discuss with your surgeon beforehand.

The deeper tissues will be repositioned in order to restore a more youthful contour to your face. The skin is then repositioned up and back and the excess skin is removed. If necessary, a small incision beneath the chin permits the removal of fatty tissue in that area. this is known as sub-mental liposculpture. We aim to provide a natural more youthful look.

How long does the operation take and what should I expect after?

The operation takes from 2 to 5 hours, depending on the extent of each case. You will have a facelift compression garment applied before you go home. You will continue to wear this for two weeks. Sutures and staples will be removed at a week after surgery.

Do not be alarmed by any unevenness or temporary asymmetry caused by this variance in swelling and bruising, which is normal. It may take several weeks before all puffiness is resolved. Most bruising will disappear within two weeks. You will also experience some numbness in the facial area, which may be present for several weeks or longer. It is important to realize that recovery time varies greatly among individuals. After surgery you will be asked to restrict your activities and simply relax for a week. Elevating your head when you sleep will help to minimize swelling and bruising. You will be instructed to continue to avoid aspirin and certain blood thinning agents. You should not smoke or be exposed to passive smoke for several weeks.

Although there are many variations to the facelift operation, incisions are hidden in the hairline of the temple and the natural creases in front of the ear. Sometimes the incision then curves around the earlobe, behind the ear and is camouflaged in the scalp. After surgery, incisions can be easily concealed by your hair. The placements of the incisions will depend on your individual surgery that you will discuss with your surgeon beforehand.

The deeper tissues will be repositioned in order to restore a more youthful contour to your face. The skin is then repositioned up and back and the excess skin is removed. If necessary, a small incision beneath the chin permits the removal of fatty tissue in that area. this is known as sub-mental liposculpture. We aim to provide a natural more youthful look.

How long does the operation take and what should I expect after?

The operation takes from 2 to 5 hours, depending on the extent of each case. You will have a facelift compression garment applied before you go home. You will continue to wear this for two weeks. Sutures and staples will be removed at a week after surgery.

Do not be alarmed by any unevenness or temporary asymmetry caused by this variance in swelling and bruising, which is normal. It may take several weeks before all puffiness is resolved. Most bruising will disappear within two weeks. You will also experience some numbness in the facial area, which may be present for several weeks or longer. It is important to realize that recovery time varies greatly among individuals. After surgery you will be asked to restrict your activities and simply relax for a week. Elevating your head when you sleep will help to minimize swelling and bruising. You will be instructed to continue to avoid aspirin and certain blood thinning agents. You should not smoke or be exposed to passive smoke for several weeks.

Facelift surgery makes you look more rested, refreshed and alert. Since the healing process is gradual, you should expect to wait at least 6 to 8 weeks to get an accurate picture of the results of your facelift surgery. Incisions will fade over a number of months until they become barely visible. Depending on the extent of the procedure, the result may last 3, 5 or 7 years and longer. The ageing process continues as gravity and facial atrophy continue to take effect.

Fortunately, complications from facelift surgery are infrequent. Every year many thousands of operations are performed with no major problems and good results. However, everyone considering surgery should be aware of both the benefits and risks. The subject of risks and potential complications of surgery is best discussed on a personal level between you and your plastic surgeon.

• Bleeding may occur after facelift. It is most likely to occur immediately following surgery or that evening. It is possible that return to the operating room will be required in order to correct the problem. Taking Aspirin within two weeks leading up to your surgery significantly increases the risk of bleeding. Do not take any aspirin or medications containing aspirin within two weeks of surgery.
• Infection following facelift is uncommon due to the superior healing qualities of the facial tissues. In addition, all patients are given a dose of antibiotics with surgery. An infection may require treatment with further antibiotics or additional surgery.
• Surgical scars can be expected to be minimal and unnoticeable. However, while great care will be taken to give the neatest closure possible, individual wound healing can be unpredictable and it is possible that scars may take longer than usual to mature and you may be unhappy with some aspect of your incision line.
• It is possible for scarring around the earlobe to result in tightness and tethering. Scarring behind the ear can become lumpy and uncomfortable. Scarring in front of the ear may cause tightness and winging of the tragus (cartilage in front of the ear opening).
• The tension on the face and neck is taken in the hairline. The scars in these regions respond by widening and a hairdresser may be able to detect them on close inspection. The scar behind the ear may be the most noticeable and it is helpful to have a hairstyle that conveniently covers this area. Keloid scars are due to a peculiarity of some patients’ healing process but are rare. Although unusual, scars in the hairline can create areas where hair growth does not occur.

Skin loss.

• It is possible to lose small areas of skin, particularly in front of the ear. It is very important not to smoke during the early post-operative period. If you are a heavy smoker, facelift is ill advised, and this should be carefully discussed with your surgeon before proceeding.
• Hair loss around the scalp incisions is an occasional complication of facelift surgery, occurring in less than 1% of operations.
• Bruising and swelling is usual and varies with each patient from being virtually invisible to extensive. Most of the severe cases have settled by about the third week, although some take longer. Swelling of the face can affect contour for some months and during this period of settling, improvement in facial contour can be expected. It is likely that scrutiny of your face following the procedure may reveal some small irregularity in contour or symmetry. Having expectations of improvement rather than perfection is most likely to result in post-operative satisfaction.
• As the final swelling settles, it may appear that t the face is beginning to “fall”. This is an inevitable minor consequence of the fact that the skin is stretched by post-operative swelling and is usually complete within about three months

Nerve injury.

Facelift involves facial dissection very close to the course of the facial nerve. This major nerve of the face is responsible for movement of the face, particularly around the mouth, nose and eyes. It is possible that some temporary or rarely permanent weakness of a part of the face may result following facelift. It is usual to have some temporary numbness of the cheeks and sometimes of the ears.