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A face-lift or rhytidectomy reverses some of the visible effects of ageing. These are mainly sagging of fat tissues and laxity of skin in the mid- to lower face and neck. Modern surgery aims to lift up deeper tissues and to tighten the skin while avoiding a windblown look. If the main concern is sagging of the deeper tissues but not excess skin, the scars can be reduced (MACS lift) or virtually avoided (Silhouette lift). Although many different techniques have been described, no technique is perfect for all patients. A good surgeon customises the technique to the individual patient.
Facelifts and necklifts are the most effective ways of tightening the skin of your face and neck. They do not get rid of wrinkles around your eyes, forehead and mouth. Other treatments such as Botox injections can help with this.
Facelifts and necklifts do not change the texture and look of your skin, though treatments such as laser resurfacing (where a laser is used to burn the surface of your skin in a controlled way) or chemical peels (where a chemical is applied to peel off the surface of the skin) may help with this. Sometimes, fat grafting or lipofilling (where fat removed by liposuction from another part of the body, such as the flanks or thighs, is injected into the face) can be performed instead of or as well as facelift, to make your face and skin look younger. Sometimes sagging eyebrows can be the main problem. In this case, a browlift, either on its own or with a facelift or necklift, may help to tighten the skin on your face.
A facelift, technically called a Rhytidectomy, is a form of cosmetic surgery where the noticeable signs of ageing that occurs in the lower two-thirds of the face and neck can be reduced. This is achieved by removing the excess fat, tightening the neck muscles and removing drooping skin.
A facelift involves raising and repositioning the skin and soft tissue of the face. During the operation, cuts are made on both sides of the face in front of the ear, extending up along the hairline, just in front of or behind the cartilage, and around behind the earlobe, into the crease behind the ear and then into the lower scalp.
The standard facelift helps the lower half of the face, but modifications of the procedure can improve the upper face by lifting the outer angle of the eye and reducing crow’s feet (also known as laughter lines).
A facelift may be performed under sedation anesthesia or general anesthesia depending on patient preference. General anaesthesia is not necessarily needed but is a very safe form of anesthesia
Risks of anaesthetic:
- Allergic reaction
- Chest infection
- Blood clots
- Heart attack or stroke
Local anaesthesia procedures can be done in a sterile outpatient setting. General anaesthesia requires hospital admission and surgery in an operating theatre.
Usually 3-4 hours.
It is normal for there to be some numbness of the skin of the cheeks and ears. This will usually improve in a few weeks or months, although there may be long-term loss of sensitivity of the skin in front of your ears. It is better to keep your head up to reduce swelling. In particular, sleep with extra pillows to keep your head raised for the first few days after surgery. You will be out of bed on the same day as your surgery, and doing light activities after two weeks. Avoid strenuous activity, saunas and massage for at least two weeks. At first your face will look a little puffy and may feel rather strange and stiff. The scars can be very well hidden with your hair so that you can return to work and socialising within a couple of weeks. Men find it more difficult than women to disguise the scars, and their beard will grow closer to their ears as a result of the skin being lifted.
Camouflage make-up can be helpful in covering bruising. The scars in the hairline do not usually show, but the hair will have been cut shorter immediately around the wound. There may be some slight reduction in hair growth in the temples, but this is not usually a problem unless the hair is very thin and several facelifts are carried out.
Do not lift heavy things for several weeks, and avoid bending down or having sex for at least two weeks. With all activities, start gently. Do not drive until you feel safe and are comfortable wearing a seatbelt. Check your insurance documents if you are not sure.
As with all operations, there are risks involved in having a facelift or necklift. Although the risks are unlikely, it is important to weigh them up against the potential benefit of the surgery. Discuss each of them with your plastic surgeon to make sure you understand the potential complications and consequences.
Some of the complications include:
- Healing problems
- Loss of blood supply to skin
- Change of the colour of skin
- Paralysis of fascial muscles, which is only temporary in the majority of cases
- Swelling, bruising and pain
- Increased or reduced sensation
- Damage to deeper structure
- Allergic reaction
- Localised hair loss
- Distorted ear lobes
- Wound breakdown
After surgery an antibiotic should be applied to the wound for a few days until the wound is dry. For the first 7 days the wound should be cleaned with running water only. No soap, shower gel or ointment should be used and manual interference should be avoided. After 7 days the wound can be washed with chemicals and regular massage with ointment can be done to improve scarring.
General measures involve drinking enough fluids, protein-rich diet (Meat…), Vitamin-C (Kiwis, lemons…) and getting enough fresh air. Smoking should be completely avoided in the weeks leading up to and following surgery since it can increase the complication risk 2-3 fold. Medical conditions such as diabetes should be optimized.
You can find more information regarding to the facelift procedure at the BAAPS (British Association of Aesthetic Plastic Surgeons) website.