Rejuvenation procedures typically performed in conjunction with a facelift are brow lift, to correct a sagging or deeply furrowed brow, and eyelid surgery to rejuvenate aging eyes.
What a Facelift will not do
As a restorative surgery, a facelift does not change your fundamental appearance and cannot stop the aging process.
Who is an Ideal Candidate?
A facelift can only be performed surgically; non-surgical rejuvenation treatments cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate and complement the results of surgery. Facelift surgery is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires to to try to fit any sort of ideal image.
Facelift surgery is a good option for you if:
You are physically healthy
You do not smoke
You have a positive outlook and specific, but realistic goals in mind for the improvement of your appearance
The Primary Consultation
zThe success and safety of your facelift depends very much on your complete openness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
Why you want the surgery, your expectations and desired outcome, any medical conditions, drug allergies and medical treatments you might have undergone. You will need to inform about your current medications, vitamins, herbal supplements, alcohol, tobacco and drugs as well as any previous surgeries you have undergone. All options will be presented and the procedure best suited for you will be recommended. The likely outcome of the surgery, any risks or potential complications as well as type of anaesthesia that will be used will be explained.
General Guidelines to follow prior to Facelift surgery.:
Detailed Chest examination and measurements
Pre-Operative Photographs for medical record keeping
Obtain laboratory testing or a medical evaluation
Pre-operative Anaesthetic assessment for fitness for surgery
Sign an informed Consent Form
Take certain medications or adjust your current medications
Stop smoking well in advance of surgery
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they increase risk of bleeding.
Maintain a stable weight for 3 months prior to the date of surgery
Types of Facelift Surgery
Traditional (SMAS) Facelift
A traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends in the lower scalp. Fat may be sculpted or redistributed from the face, jowls and neck. Underlying Submusculoaponeurotic (SMAS) layer is repositioned, and commonly the deeper layers of the face and the muscles are also lifted.
Skin is redraped over the uplifted contours and excess skin is trimmed away. A second incision under the chin may be necessary to further improve an aging neck. Sutures or skin adhesives close the incisions.
Mini Facelift (Limited Incision)
In general, a mini facelift will use a smaller incision than traditional facelift, and healing times can be proportionately shorter. The best candidates for mini facelifts are usually younger patients with good skin elasticity.
Sagging jowls, loose neck skin and fat accumulation under the chin may be corrected with a neck lift. The neck lift incision often begins in front of the ear lobe and wraps around behind the ear ending in the lower scalp.
Strong sutures are used to suspend the deep tissues of the face (SMAS) from firm points near the ear and forehead. The operation is done through a shorter scar, so less dissection is required and therefore less risk of bleeding. The suspension technique is a more direct and simple way of lifting the deep tissues and is less risky. Recovery time is shorter as well. Good candidates are younger patients requiring volumetric lift of the midface.
A platysmaplasty is a procedure which targets the platysma muscle which is located beneath the skin on the neck thus separating it. As part of the aging process, some people develop bands of muscle running vertically down their necks. A platysmaplasty is commonly performed with facelifts and necklifts.
This type of lift is used to address patients with slightly drooping or lowered eyebrows without having the necessity of having to perform a more extensive full browlift procedure. During this procedure, an incision is made to lift the skin on the sides of the brows.
The Operative procedure
A Facelift may be performed in an accredited office-based surgical center, or in a major hospital setting.
Step 1 – Anaesthesia
The procedure is performed under general anesthesia. A variety of other procedures can further enhance the outcome of a facelift during or after the surgery, like Facial implants, Soft tissue augmentation to recontour the facial structure, Resurfacing techniques are used to improve the tone and texture of facial skin and wrinkle reduction by injection
Step 2 – The incision
Step 3 – Closing the incisions
Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear.
Post operative period
When your procedure is completed, a bandage will be gently placed around your face to minimize post facelift swelling and bruising. A thin tube may be present to drain any excess blood or fluid that may collect under the skin.
The visible improvements of a facelift appear as swelling and bruising subside. Your final result should not only restore a more youthful and rested appearance, but also help you feel more confident about yourself. Stitches are removed on the 5th post op day.
You will be given specific instructions that will include: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up.
Risks and potential complications
The decision to have a facelift is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.
You will be explained in detail the risks however rare, associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.
Bleeding/ Fluid accumulation
Poor wound healing
Correctable hair loss at the incisions
Facial nerve injury with weakness
Numbness or other changes in skin sensation
Pain, which may persist
Skin contour irregularities
Deep vein thrombosis, cardiac and pulmonary complications
Possibility of revisional surgery
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Another surgery may be necessary.
Long term Results
It may take several months for swelling to fully dissipate and up to 6 months for incision lines to mature. Life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend the results of your rejuvenated, more youthful appearance. Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Avoid wearing any clothing that must go over your head. Your doctor will give you specific instructions on how to care for yourself.