Face lift surgery
If you are considering face lift surgery, you may wish to have several questions answered. Face lift surgery, technically known as a "rhytidectomy", can effectively re-drape the skin of your face and neck to soften the effects of ageing and give you a more youthful, 'refreshed' look.
Other techniques are often used in conjunction with a standard 'face lift' to enhance your natural looks and emphasise the result. For example, volume can be restored in the cheeks using fat grafts taken from your thighs or abdomen, deep lines on the upper lip can be softened, and the lips may be rejuvenated to look fuller and more youthful. Although face lift surgery cannot stop the ageing process, it helps 'turn back the clock'.
Newer face lift surgery techniques are used in our London practice, that are tailored to the individual patient's desires and requirements. The over-stretched, 'pulled face' look is due to over-zealous surgical compensation of the effects of ageing on skin, and should not be seen following a modern face lift. Careful manipulation of the deeper tissues in the face allow for a more natural repositioning of facial elements, with a relaxed, healthy looking patient as a result.
You may wish to consider face lift surgery to improve the most visible signs of ageing such as:
- A slack and 'jowly' jaw line
- Folds and fat deposits around the neck.
- Deep creases between the nose and mouth
- Cheekbones that have flattened with age
The following frequently asked questions (FAQs) and answers should help give you a basic understanding of the face lift surgery procedure, how it is performed, and what results you can expect. These probably won't answer all of your questions, since a lot depends on your individual circumstances. However, your surgeon will be happy to answer any further concerns you may have regarding face lift surgery.
What should I consider before having face lift surgery?
A face lift can make you look younger and fresher, and it may enhance your self- confidence in the process. But it can't give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have face lift surgery, think carefully about your expectations and discuss them with your surgeon.
The best candidate for face lift surgery is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well defined. Most patients are in their forties to sixties, but face lifts can be done successfully on people in their seventies as well. If you're physically healthy and realistic in your expectations, you may be a good candidate.
How do I plan my face lift surgery?
The procedure for a face lift surgery is highly personalised. At your initial consultation with LPSA your surgeon will evaluate your face, including the skin, underlying muscle, fat and bone layers, and discuss your surgical options and personal goals for the surgery.
He will also check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars. Be sure to let him know if you smoke or drink excessively, are taking any drugs or medications, especially aspirin or other drugs that affect clotting. Smoking has a major impact on skin circulation, and raises the chance of a complication occurring after surgery. It therefore reduces the range of surgical options significantly, and in many cases is not compatible with surgery.
If you decide to have face lift surgery, your surgeon will also provide explanations about general anaesthesia, the hospital where the surgery will be performed, and the Practice manager will go over the costs involved. Don't hesitate to bring your surgeon any questions you may have written down beforehand, especially those regarding your expectations and concerns about the results.
How do I prepare for my surgery?
Your surgeon will give you specific instructions on how to prepare for your face lift. These may include guidelines on eating and drinking, stopping smoking, and taking or avoiding certain vitamins and medications. LPSA will give you a pre-surgical kit to boost your healing capacity, including a range of homeopathic medicines such as Arnica, and massage oil that is particularly effective in softening your scars postoperatively.
Whilst making preparations for surgery, you should arrange for someone to pick you up on discharge from the hospital and be available to drive you home. It is also advisable to have someone help you around the house for a few days, to plan a soft diet for the first week and to get ready to sleep using a couple of pillows.
If your hair is very short, you might want to let it grow out before face lift surgery, so that it's long enough to hide the scars while they heal. Make sure you wash your hair thoroughly the day before surgery, and do not book any hairdressing appointments until at least a fortnight after surgery.
Where will my face lift be performed?
Your face lift will be performed at one of several of London's best private hospitals, according to your preference and the availability of operating time.
You will usually be admitted on the day of surgery. An overnight stay in hospital is generally advised and you will be discharged home the following day at about 10:00am. If you have the surgery as a day case you will be discharged later that day.
What type of anaesthetic will be used?
Face lifts at LPSA are usually performed under a general anaesthetic, so you'll sleep through the entire operation. Newer types of anaesthetic that reduce the risk of nausea after surgery are used at LPSA, and the experience is usually safe and comfortable.
What takes place during the face lift surgery?
Every surgeon approaches the procedure in his or her own way. Some complete one side of the face at a time, and others move back and forth between the sides. The exact placement of incisions and sequence of events depends on your facial structure and your surgeon's preferred technique.
Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin. Tiny incisions may be required to place fat grafts into the cheeks or lips, which heal rapidly and are not conspicuous.
In general, the surgeon separates the skin from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The surgeon then tightens the underlying muscle and membrane, pulls the skin back, and removes the excess. Stitches secure the layers of tissue and close the incisions; metal clips may be used on the scalp.
Following surgery, a small, thin tube may be temporarily placed behind your ear, under the skin, to drain any blood that collects there. This tube is called a drain, and is usually removed the day after surgery. Another, very small drain may be kept in your neck for a little longer, to prevent fluid accumulating and expedite your healing. The surgeons may also wrap your head loosely in bandages, or apply a facial garment, to minimize bruising and swelling.
How long will the surgery take?
A face lift usually takes several hours and can take somewhat longer if you're having more than one procedure done. For extensive procedures, some surgeons may schedule two separate sessions.
What can I expect after the surgery?
Any discomfort experienced post operatively can be controlled with medication prescribed by your surgeon, but a face lift is usually a surprisingly painless operation.
Your surgeon may ask you to keep your head elevated and as still as possible for a couple of days after surgery, to keep the swelling down. Bandages, or facial garments, if used, are usually removed after one to five days. Don't be surprised at the pale, bruised and puffy face you will see at this stage post operatively, just bear in mind that it will soon have subsided considerably.
Most of your stitches will be removed after about five days. Your scalp may take longer to heal, and the stitches or metal clips in your hairline will usually be left in a few days longer.
How long will it take for life to return to normal?
You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. This includes refraining from household chores. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first.
Your surgeon will give more specific guidelines for gradually resuming your normal activities. They're likely to include these suggestions: avoid strenuous activity for at least two weeks (walking and mild stretching are fine) and avoid alcohol, steam baths, and saunas for up to three months. Above all, get plenty of rest and allow your body to spend its energy on healing.
At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff and you'll probably be self-conscious about your scars. Some bruising may persist for two or three weeks, and you may tire easily.
By the third week, you'll look and feel much better. Most patients are back at work about ten days to two weeks after surgery. If you need it, special camouflage makeup can mask most bruising that remains temporarily.
How will I feel about my new look?
The chances are high that you'll be happy with your face lift, even though the results may not be immediately apparent. After the swelling and bruises are gone, the hair around your temples may be thin and your skin may feel dry and a little rough for several months. Daily moisturising and skin care is essential. Men may find they have to shave in new places where areas of beard-growing skin have been repositioned.
You will have some scars from your face lift, but they're usually hidden by your hair or in the natural creases of your face and ears. In any case, they'll fade with time and should be inconspicuous with time.
Having a face lift doesn't stop the clock. Your face will continue to age with time, and you may wish to repeat the procedure, perhaps five or ten years down the line. But the effects of even one face lift are lasting as, years later, you'll continue to look better than if you'd never had a face lift at all.
Does a face lift carry any risk?
Complications after face lifts are infrequent and usually minor. Still, people vary greatly in their anatomy, physical reactions, and healing abilities so the outcome is never completely predictable.
Complications that can occur include haematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles (usually temporary), delayed skin healing, minor infection, and reactions to the anaesthetic. Poor healing of the skin is most likely to affect smokers. You can reduce your risks by closely following your surgeon's advice both before and after surgery.
Most patients are delighted with their results following a face lift, and in trained hands it remains a highly satisfying and rewarding cosmetic operation.