Face Lift Surgery
Our faces age for many reasons. Heredity, gravity, sun exposure - these all play a role. A face lift is a procedure that is over 60 years old; it is intended to reverse the aging process by smoothing and redefining the contour of the neck and jaw line to create a younger, fresher appearance.
No other kind of cosmetic surgery allows the surgeon more creativity; and no other kind of surgery is more deeply personal for the patient.
Gravity pulls at soft facial tissues. In time our cheeks begin to sag, the crease running from the nostrils to the sides of the mouth (nasolabial fold) is accentuated, and our jaw line and chin lose their smooth, refined appearance. As we age we also lose some of our facial fat and our skin becomes less elastic, leading to wrinkling and sagging of our skin, which affects our features.
Sun exposure can be a major contributor to accelerated aging. People who live in climates where the sun is strongest often suffer from prematurely aged skin, irrespective of their ethnic characteristics.
Other factors, such as smoking and drinking alcohol, especially if done to excess from a young age, can speed up the ageing process.
Years of research, and the cumulative experience of surgeons, have led to an increasingly sophisticated understanding of the ageing process and the more subtle elements in the anatomy of the face. From this, techniques have developed to restore a more naturally youthful appearance.
A face lift can help refresh your appearance, but it will not erase permanent creases, particularly those around your mouth. There are additional procedures like dermabrasion, laser resurfacing and chemical peels which can diminish those lines and can be performed at the same time as your face lift.
When you meet with your surgeon, you have an opportunity to receive information and ask any questions about the results you would like to achieve. Your surgeon should tell you what will happen during your surgery and help design a procedure that meets your individual needs. It is often helpful to bring a photograph of yourself when you considered you looked your best.
Your surgeon should take a detailed medical history and ask about any previous facial surgery you may have had. If you are a smoker, please discuss this with your surgeon as it may delay healing and affect your recovery.
He may also speak about normal differences in your facial symmetry, some of which you may have never noticed previously. Your surgeon will, in all likelihood, gently manipulate your facial skin. This performs a dual purpose; assessment of your skin and to show you the type of result you may expect after surgery. You should receive a comprehensive explanation of the other effects of your facial surgery, namely that the position of your hair in front of your ear may be a little higher. For men the beard area may move so that it is slightly under and behind the ear, necessitating shaving in that area.
He should discuss with you the risks, which may include scarring, bleeding and infection.
Your surgeon may also explain about procedures that can be used to improve the overall results of face lift surgery. These can all be tailored to meet your individual needs and include; deep (SMAS) lifts; chin fat removal and; remodeling of the neck muscles.
In addition, there are additional procedures that can be done at the time of your face lift, such as:
- Blepharoplasty - this is reduction of loose skin around the eye
- Forehead lift
- The use of fat from other parts of your body to plump up particular areas in your face
- Midface endoscopic lifts for more definition of the cheekbone area
In most cases your face lift will be done under general anaesthetic and you will spend the following night in the hospital or clinic.
Once you are comfortably asleep, the surgeon will make an incision that starts high in the temple area that is, at this point, hidden by the hair, following the curves in front of the top and bottom of the ear and behind the middle part (tragus). The incision then continues round the earlobe and up behind the ear, it will then curve softly back into the hairline.
In some cases a second incision in made under the chin where it will also be well hidden. Its purpose is to assist with definition of the chin and neck.
Using these incisions on both sides of the face, the skin, fat and muscle is remodelled. The incisions are closed with stitches in front of the ear and metal clips in the hair. Small drainage tubes are inserted under the skin during the operation and are removed several days after your surgery. These help to minimise bruising and swelling around the face and neck so that you may return to work and resume your normal social activities without too much delay. Some surgeons also apply a light bandage around your head at the end of the surgery.
The day after your surgery
Your bandages will be removed the morning after surgery and your surgeon will check that everything is all right. After that, your hair may be washed and you will be able to go home. You should receive a complete list of post-operative care instructions before you leave the hospital and advice such as:
- The importance of not engaging in overly vigorous activity for a few days after surgery, as this will help to prevent post-operative bleeding;
- Aspirin should be avoided. If you do experience any pain or discomfort a mild analgesic such as Paracetamol can be taken;
- Washing of your hair is fine with a mild shampoo (such as baby shampoo), making sure that you do not disturb the suture area.
In the week after surgery
As you continue to convalesce, you can expect that:
- Your sutures will usually be removed around seven days after surgery. It is advisable not to apply any hair colour for four weeks following surgery due to the strong chemicals like bleach or ammonia in the product;
- Your scars will usually be very faint at first, but usually these thicken and redden for a few months after your surgery before they return to a more natural skin colour and texture;
- It is normal to experience some bruising, swelling and numbness after a face lift. These symptoms are temporary and should mostly disappear after two weeks. Numbness sometimes takes longer to go. It may be present for up to a month in the cheek area and three to four months for the underside of the chin.
To help lessen post-operative bruising, arnica may be taken for one week prior to surgery and two weeks after. Products such as arnica cream may also be useful to reduce and clear the bruises more quickly.
Bleeding, infection (<1% risk), damage to the facial nerves producing weakness/paralysis/numbness, abnormal facial contour, visible scars/heavy scarring, haematoma (3-4% risk), adverse drug reactions, early relapse, damage to the ear and ear canal, skin breakdown (necrosis), delayed wound healing, and a tight face.
As a whole, facelift procedures are carried out without any adverse effects but any surgery has some risks. Some of the complications associated with facelifts may require further surgery and some may cause permanent scarring, deformity, and discomfort. Your risks are always minimised if you ensure your surgeon is a certified consultant plastic surgeon who is experienced in facelift surgery.
All surgical scars are permanent however, the incisions will be placed discretely so that they will not be noticed other than by very close inspection. The usual incision placement is running along the natural contours of the ear, extending into the hairline.
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