In its simplest and first incarnation, a face lift is an operation that lifts the facial skin off the fascia and muscles beneath, stretches it taught again, re-drapes it and then removes the excess. Over time, surgical knowledge and capabilities have developed to the point where today various techniques and approaches exist and very few surgeons simply lift the facial skin.
I perform a more modern facelift technique which corrects the deeper facial layers as well as the skin, in order to rejuvenate and reposition the deeper structures which are structurally responsible for the appearance of facial aging. My purpose is to make you look naturally youthful again, rather than to give you a plastic ‘operated’ look.
Commonly asked questions about face lift surgery.
- Am I a good candidate for a face lift?
- Are there any reasons why I couldn’t have a facelift?
- What should I expect from my consultation?
- How is the surgery performed?
- What does my operation involve?
- What about my recovery and return to normal activities?
Am I a good candidate for a face lift?
This is best decided during a consultation, but generally speaking, the ideal candidates for face lifting are women or men with good skin elasticity and well-defined bone structure whose face and neck have begun to sag.
Several factors contribute to facial aging; but genetics; gravity and environmental insults such as lifetime, cumulative sun exposure and smoking are the main players. The combined effects of these factors result in the characteristic features of an elderly face.
Are there any reasons why I couldn’t have a facelift?
I do not operate on smokers because the risks of horrendous complications are significant if you smoke. I will encourage you to stop smoking for at least 2 months before surgery and will expect you to agree to tests to confirm that you have not been smoking immediately before surgery.
Patients who are on certain medications will have an increased risk of bruising after surgery, and therefore healing problems and complications, so it may be inadvisable to have a facelift in these circumstances – this is something I will assess and discuss with you during your consultation.
What should I expect from my consultation?
Come to your consultation prepared! Before you come, look at yourself in the mirror and list your 3 best and 3 worst facial features. Also dig out pictures of yourself 10 and 20 years ago.
First, I will take a full medical history and examine you completely; then I will focus on your face, brow and neck. I will take standardised photographs with you making several telling facial expressions that will animate your face to help me assess you. These, along with the photos you bring with you, will help us plan and discuss your operation.
How is the surgery performed?
Depending on whether you are having a short scar or a full face and neck lift, your incisions (and thus, final scars) will vary in length. In both procedures, incisions begin above the hairline at the temples and pass down in front of the ear. In a full face and neck lift, the incision continues behind the earlobe to the lower scalp.
Depending on your particular anatomy, a small incision may also be made under the chin to reshape the neck.
The first steps in the operation involve separating the skin from the fat and muscle beneath. Fat can be re-shaped in the neck and under the chin to improve your contour. Next the underlying muscles are tightened which in turn firms up the overlying skin. Finally the skin is re-draped in a tightened, younger orientation, the excess is removed and the incisions are stitched.
What does my operation involve?
Before surgery, you will meet and be assessed by your anaesthetist who will prescribe medications for your comfort and to lessen anxiety if need be.
On the evening before, or the morning of your operation I will review what we have discussed and planned previously and we will both sign your operative consent forms. Then I will measure and draw guidance marks for surgery on your face.
The operation is performed under General Anaesthesia – you will be asleep – and usually takes 3 hours or so, but may be considerably longer if combined with operations on the eyes or brow.
After surgery, you will awake in a recovery area and soon afterwards you will be returned to your room. For the first few nights after your operation I ask you to sleep with your head and chest propped up several pillows to help decrease the swelling.
At the end of the operation a fine surgical drainage tube is placed under the facial skin on each side of your face to drain the normal healing fluid from your wound and then your head, face and neck is bandaged to minimize the swelling. The drains will be removed when the drainage is minimal – usually the following day. Most patients go home a day or two after surgery on simple pain relieving medications and a short course of antibiotics.
What about my recovery and return to normal activities?
You can expect to be up and about a day or so after the operation, but you should take life easy for the next few days.
After face lift surgery the skin of your face and neck will be both swollen, and because sensory nerves have been damaged, somewhat numb. This means you should take especial care to be gentle when touching your face or brushing your hair, because you can hurt yourself unwittingly because you won’t feel pain in the same way initially. The swelling and bruising may mean your features may be distorted and your facial movements awkward, and at these times it is important to remember the pale, bruised and swollen face that looks back at you from the mirror after your face lift will look normal again in a few short weeks.
Most of the stitches in your facial skin will be removed after five days. Your scalp skin takes longer to heal, so the clips in your hairline will be left longer before being removed. Gradually your skin numbness will fade and normal feeling will return over subsequent weeks and months.
In some patients, bruising may persist for 2 – 3 weeks. It is not unusual for patients to tire easily in the weeks after surgery, and to feel low and a little emotional, but this passes for those who experience it.
Avoid strenuous activity (sex, heavy work, aerobic exercise) for 2 – 3 weeks following your surgery, but gentle exercise such as walking would be beneficial.
Generally, you can return to work after 2 – 3 weeks and so long as you can do so with due care and attention, driving too.
The scars from your operation are positioned so as to be hidden by your hair or in the natural creases of your face and ears. Initially, during the inflammatory stages of healing they are red and visible, but ultimately they will fade in colour. That said, new scars benefit from friction-free massage (using vaseline, for instance, to lubricate the massaging process). Beginning to massage scars two to three weeks after surgery, will help them mature, soften and flatten faster than if left to their own devices. New scars should be protected from sunlight for 2 years to avoid them pigmenting differently from the surrounding skin and becoming a different colour permanently. Factor 15 sun block should be applied whenever they are exposed – even to a British winter sun. Finally, it’s worth noting that the hair around your scars may be thinner than elsewhere.
