Face Lift

A facelift is an operation to lift up the facial skin & tighten the underlying facial muscles to leave the face tighter, smoother & younger looking. This may be combined with surgery around the eye to correct the bagginess of the lower eyelid or droopiness of the upper eyelids (blepharoplasties). It is used to correct some of the effects of the ageing process (loss of skin elasticity) made worse by sun exposure, gravity & smoking. It is also used in treating people with facial weakness.

Preparation: Before the operation it is best to get to a more ideal weight because continual weight loss following the operation will still cause looseness of skin. During the consultation the surgeon will usually address issues such as fine wrinkles around the corners of the eyes (crow’s feet) or wrinkles on the lips which are not necessarily addressed by face lift operation & may require non-surgical techniques such as anti-wrinkle injections, filler injections etc. Stop smoking at least two weeks but preferably six weeks before surgery. Inform your doctor if you take Aspirin as this can worsen the bleeding.

Anaesthetic: Usually a general anaesthetic which requires fasting for more than six hours before surgery. This means no food or drink for six hours. This can also be done under a local anaesthetic with intravenous sedation. Time in hospital: 1 - 2 days.

Techniques: The incision usually starts from behind the hairline at the temple, extends down to the front of the ear & into the hairline around the back of the ear. This may be combined with incisions behind the hairline whereby the brow is lifted using fine telescopic instruments (endoscopic facelift). At the end of the operation the face is fitted with a pressure garment designed for facelifts. This usually runs underneath the chin, around the ears & over the head. Fine drains may be used which will be taken out usually the following day. Painkillers & antibiotics are usually prescribed while in hospital. Duration of operation: 3 to 4 hours This is longer when combined with other procedures for e.g. correction of bagginess under the eyes.

Post-Op care: Before discharge, instructions about how to care for the wounds are given & a follow up appointment is then made with the surgeon. The patient may be advised to apply cold compresses to help ease the swelling. These are usually applied in the form of a bag of frozen peas wrapped in a towel or a bag of ice wrapped in the towel. The ice should not be placed directly on the skin as this may cause cold burns. While at home the patient will be advised to sleep with their head higher than the body by lying on pillows & avoid bending over. This is to reduce increasing pressure in the head area that will increase swelling & bruising. Vigorous activity is restricted. Exposure to the sun is restricted for a few weeks as well. After about five days usual makeup can be applied. The sutures are removed in six days. The scars are initially red & they feel lumpy initially when pressed. They gradually soften as time passes. Bruising & swelling may take up to two weeks to settle.

Risks/Complications: Many patients are pleased with the results of the facelift. However, there are problems that can arise from this operation including bruising & swelling so it is advisable not to embark on a facelift procedure close to a major event in which one would like to be present such as a wedding, because the swelling & bruising may take longer to settle. Other general risks such as excessive bleeding, infection, wound breakdown, a general reaction to anaesthetic & blood clot in the legs can occur with this operation. More specific problems include damage to the facial nerve which can cause numbness & weakness of the face which will become apparent when the patient is asked to smile. These are usually transient & occasionally may become permanent. Bleeding underneath the skin & a collection of blood called an haematoma can occur. If significant it will require a return to theatre for evacuation. Infection is not common but it can occur. It is usually prevented by the use of antibiotics. Wound healing problems can occur especially in smokers so it is advisable to give up smoking six weeks before operation. The scars may become raised. The scars are initially red but they fade with time but this may take several months. The hairline may become raised and the beard a little closer to the ear in men.