As people age
a number of predictable changes take place in the appearance of their
face. These include sun damage with loss of skin elasticity, which both
lead to, sagging, redundant, wrinkled skin. In addition, the fat over-lying
the cheekbones descends with gravity. This results in loss of volume in
the upper face and gain of volume in lower face, especially the jowl area.
Furthermore, there is a build up of fat deposits in the neck area. These
changes result in the loss of a youthful facial appearance.
Face lift operations aim to reverse these changes by tightening the skin
whilst maintaining a natural look, combined with tightening the deeper
layers of the face to achieve a longer lasting result. Most facelifts
last approximately 10 years. There are two type of facelift: a standard
facelift which addresses the face and neck areas, and a short-scar facelift
which is only suitable for young patients who do not require neck tightening
Facelift operations are often used in conjunction with endobrow procedures
and eyelid surgery- blepharoplasty.
Before the operation
There is nothing
special or complicated to be done by the patient. If you are on HRT you
should continue to keep taking it, and inform the surgeon or anaesthetist
in the hospital. It would be advisable to stop any herbal medicines and
avoid aspirin or ibuprofen-like drugs for 2 weeks before and after the
operation. If you dye your hair it would be advisable to visit the hairdresser
one week before your operation to have tinting/colouring performed. Please
avoid bleach-based colourants on the hair for 6 weeks after surgery.
The operation itself
come into the hospital on the morning of surgery. The operation is performed
under general anaesthetic and takes about 4 hours. A head dressing is
applied at the end of the operation. Patients are required to stay in
overnight, and are discharged home the following day.
Post-operative follow-up and after care.
day your hair will be washed with help from the nursing staff prior to
going home, and the small surgical drains removed. A fresh dressing will
It is important to rest and take it very easy for at least 2 weeks after
the operation and it is essential to avoid all strenuous activity during
this period - this includes all sexual activity. A clinic appointment
will be arranged at one week to check that all is well, and to remove
the stitches You wound be advised to take 14 days off work to allow any
swelling and bruising to settle. It is critical that you do not bend down
and lower your head as this increases the possibility of bleeding and
bruising. Vigorous sport such as jogging or the gym should be avoided
for 4 weeks. A check-up clinic appointment at 3 months after the surgery
will be arranged for you.
carry a risk of complications, although in facelift procedures these are
uncommon. There will be small scars hidden in the temporal hairline, around
the ear, and in the hair behind the ear which heal well and with time
become almost invisible. Occasionally, the scars may be red for a few
months but they usually settle down by themselves without any treatment.
The risk of infection is low, about 1 %, and responds well to antibiotics.
Over-tightening of the skin in order to achieve a superior result may
lead to small areas of wound breakdown and skin necrosis, nearly always
behind the ear. These areas heal with dressings alone, and are much commoner
in smokers. Poor skin healing is usually not a problem in patients who
do not smoke. Troublesome bleeding is a rare, but recognised complication.
This results in a collection of blood under the skin. It can occur at
any time in the first two weeks after surgery and may relate to excess
coughing, bending down, or exercise, or may occur without any identifiable
cause. This occurs in less than 5% of cases and may require a return visit
Since the skin is dissected from the underlying layers, tiny nerves involved
in sensation (feeling) of the skin of the face are disrupted. Thus, for
approximately 6 months after surgery the skin of the face has reduced
sensation. This loss of feeling, which recovers spontaneously, occurs
in all facelift operations.
Branches of the facial nerve, which move the muscles of the face, are
susceptible to damage during surgery. Damage to these motor nerves which
move the muscles of the face, is very rare indeed. Great care is taken
to avoid injuring these nerves during surgery, and long term problems
is a straightforward and safe technique which may be combined with an
endoscopic brow lift or eyelid surgery. After a relatively short recovery
time, the surgery can dramatically improve the appearance face, making
the individual look younger.