Mr Neil Toft

Consultant Plastic Surgeon

BSc MBChB MD FRCS (Plast)

 

0845 094 5657

 

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FACELIFT INFORMATION


General Background

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

Patients normally 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.

The following 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 be applied.
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.

Complications

All operations 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 to theatre.
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 are exceptional.


Summary

Facelift surgery 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.

 

Operation Time 4 hours
Anaesthetic General
Nights in hospital 1
Time off work 14 days
Return to normality/exercise 4 weeks