Facial Rejuvenation – Facelift (conventional) and “mini” Facelift / Necklift / Brow Lift

A “Facelift” is actually a bit of a misnomer as a conventional facelift actually rejuvenates the lower jawline (“jowl” area) and neck area (“necklift”) with some improvement of the cheek and lines descending from the side of the nose (nasolabial creases). Depending on what your concerns are we may discuss procedures ranging from a classic facelift, more of a neck-lift (often with some liposuction) or combine these with some upper face rejuvenation – either eyelid lift (blepharoplasty), some fat-filling or a subtle brow-lift

A facelift (rhytidectomy) cannot stop the ageing process, but it can help remove the most visible signs of ageing. By trimming or repositioning excess fat, tightening the underlying muscles, and re-draping the skin of your face and neck, a facelift can make you look younger and fresher. In the process, it may enhance your self-confidence and self-esteem.

Contrary to popular misconception, a facelift should not give you a totally different look and nor can it restore the health and vitality of your youth. Before you decide to proceed, think carefully about your expectations and discuss them with your surgeon

A facelift operation is good for removing wrinkles, excess fat and excess skin from your lower face and neck area. It does not usually significantly address forehead lines, crow’s feet wrinkles, deep naso-labial folds (the lines that run from the nose to the mouth) or down lines from the mouth to the chin (“Marionette” lines).

Who is suitable for a facelift?

You may be suitable for a facelift if your face and neck have begun to sag but your skin still has some elasticity and your bone structure is strong and well defined. Most people will complain about jowl formation and sagging neck skin. Most patients are in their forties to sixties, but facelifts can be successful at any age.

A number of facelift operations exist and some patients are better suited for one type of facelift while others may be better suited to a different operation. It is important to define your specific requirements and expectations prior to deciding what procedure to opt for with your plastic surgeon.

The first steps are to define your needs and gather information. Speak to people, read and find out what you can about the procedure. The better informed you are at the time of consultation, the more meaningful that consultation will be. The next step is to consult with a plastic surgeon.

What to expect at the initial consultation

At a first consultation, I will ask you to tell me in your own words what it is that you wish to change about the appearance of your face. It is important to be honest and forthright as surgery is tailored to your specific needs and expectations. Do bear in mind, however, that it is not possible to achieve unrealistic expectations.

In addition, I will take a full medical history including any previous surgery, cosmetic or non-cosmetic, previous hospitalisation, chronic medical problems, medication and allergies, whether you smoke or not, your personal circumstances, the reasons for wanting the procedure and your goals and aspirations.

The examination will concentrate on your facial features, but also assess your general fitness and suitability for surgery. Routine photographs will be taken.

Following the assessment, I will discuss all available options and formulate an operative plan, including type of surgery and anaesthesia to be used, venue for surgery and costs. Any risks and possible complications will also be discussed with you.

It is important that you are clear what your surgery will entail. Well informed patients cope better with surgery and you have a right to ask any question you want and expect your surgeon to answer with honesty and without the use of jargon. Consent for surgery will also be taken.

Where does the treatment take place?

We can arrange for you to be admitted as an inpatient to either:

  • Parkside Hospital, Wimbledon, SW19
  • St Anthony’s Hospital, Cheam, Surrey
  • The New Victoria Hospital, Kingston

A Consultant Anaesthetist will meet you prior to surgery.  A facelift usually takes about three to six hours to perform.   Normally patients spend one-two nights in hospital following the surgery. You will often need to wear a pressure garment under your chin and round your lower face for a week or 2 post-operatively.

What can go wrong?

If performed by a fully qualified and accredited Plastic Surgeon in a proper operating theatre under sterile conditions on a relatively fit and healthy patient, a facelift is a safe procedure.  In general, complications are rare.  However, as with any surgical procedure, there are certain risks and complications, and these will be explained to you at your consultation. These complications may include:

  • Bleeding and haematoma
  • Infection
  • Wound healing problems
  • Poor or absent sensation of the facial skin in front of the scars
  • Injury to small branches of the facial nerve
  • Poor scars including hypertrophic and keloid scars
  • Asymmetry
  • DVT and pulmonary embolism
  • Emotional lability in the weeks after surgery

Do I need to make any preparations?

You should cease smoking at least 2 weeks prior to surgery and not start again until the wounds have healed, usually 3 weeks after the operation.  Although nicotine replacement products such as spray, patch or gum are of great assistance, these products also adversely affect wound healing and should be avoided for the same period.

You will be unable to drive for a day or two following the procedure, so you should arrange for someone to collect you from the hospital.

If your hair is very short, you might want to let it grow before surgery, so that it is long enough to cover scars while they heal.  Alternatively it is a good idea to bring a scarf to wear when you leave hospital

How long does it take to recover?

Following the operation you should be pain free or experience only minimal pain.  Painkillers will, nevertheless, be prescribed.

Bandages are usually taken off the next day and any small drains left after surgery removed.  If stitches/staples require removal, this will be done at an outpatient appointment one week later by me.

Some numbness of the skin is normal after surgery and will disappear in a few weeks or months.  Most of the scars will be hidden within your hairline and in the normal creases of your skin.

Recovery periods vary between patients, depending on factors such as your general health and the complexity of the operation.  In general, you should be up and about in a day or two, but plan on taking it easy for the first week after surgery.  You will need to be especially gentle with your face and hair since your skin will be both tender and numb at first.

Each patient will differ, but in general strenuous activity, including sex and heavy housework, should be avoided for at least two weeks, although, walking and other very mild exercise is allowed.  You should aim to get plenty of rest for at least two weeks after the procedure to allow your body to heal. You should be able to drive about a week after surgery but please check with your car insurer for your specific conditions of cover.

In the days immediately after surgery, 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 will probably be self-conscious about your scars and appearance.  Some bruising may persist for 2 or 3 weeks and you may tire easily.  By the third week, you will look and feel much better.

Most patients are back at work about 14 days after surgery.  If necessary, special camouflage makeup can help to mask any bruising that remains.

How satisfied will you be with the results?

The vast majority of patients are delighted with their facelift – often with results exceeding expectations.  However, you should remember that the results may not be immediately apparent.  Even after the swelling and bruises are gone, your skin may be thin and might feel dry and rough for several months.

Having a facelift does leave scars, but these scars are usually well hidden in the natural creases of your face and ears.  Scars go through various phases in their healing, but after about 6 – 12 months they should be settling down to be thin, inconspicuous lines.  If necessary, your hair can be styled to hide the scars. Men may find they have to shave in new places – behind the neck and ears – where areas of beard-growing skin have been repositioned.

Although having a facelift can turn back the clock, it cannot stop the clock.  Your face will continue to age with time, but, the effects of facelift are lasting and you will continue to look younger and fresher for years following treatment.

The information included here is provided for general guidance only. I will discuss the exact nature of your treatment, including procedure details, recovery times and any possible side-effects at your consultation.

Brow Lift

If the outer brow is tending to sag, and this concerns you, I may suggest adding in a lateral brow-lift as part of your facial rejuvenation. I used to do endoscopic brow-lift but have abandoned this procedure in favour of a small lateral skin excision plus suture suspension lift. This is a low-risk procedure which will however leave a small scar up in the hairline above your brow.

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