Facelift and Necklift
Due to the ageing process, there a number of important changes that occur in our face, affecting volume, amount of skin and laxity of soft tissue attachments to our bony skeleton.
After examining you, I will advise you which of these components require repositioning (commonly referred to as tightening), addition of volume or indeed, reduction of volume. I will need to address to some extent 3 main components namely, the skin laxity/amount, a tightening to the support layer under the skin called the SMAS (Subcutaneous Muscular Aponeurotic System), or the platysma muscle in the neck, as well as the soft tissues.
With facial rejuvenation, a combination of techniques are used to obtain the best results, and this may include treatments to the eyes, brow, neck, and soft tissue augmentation to the cheeks, lips and folds. Together, we will plan the most appropriate form of treatment to address your specific concerns.
How the operation is performed
Depending on the type of facelift performed, the operation can be performed either under local anaesthetic or a general anaesthetic, as a day case procedure or with a planned overnight stay.
Types of facelift surgery:
1. “Hitch lifts” – this is a minimally invasive, short scar procedure ideal for younger patients that require additional volume along the cheekbones only. This can be done under local anaesthetic as a day case.
2. “SMAS tightening type” facelifts – these are performed under general anaesthetic, with the aim to address cheek and jowl areas.
3. Frequently, the neck also slackens with age, leading to unsightly creases and ‘platysmal bands’, formed by thinning of the muscle and separation of the muscles from the midline.
I often perform full facelifts in combination with fat transfer to certain parts of the face (‘lift and fill’). Fat can be safely harvested from the tummy/hips/inner thighs and injected into the parts of the face where volume has been lost. This fat is permanent and unlike injectable fillers, do not require annual top-up.
Face and necklifts are not skin tightening operations. The tissues underlying the skin (SMAS in the face and platysma muscle in the neck) are freed from the skin and tightened in an upward and outward vector using strong sutures. The skin is then draped over these layers so that there is no tension on the skin when closed. There is often an excess of skin that is trimmed off.
After 2 weeks
Start returning to your normal activities of living. Be sensitive to your body and try not to do too much too soon. Therefore, if you experience any pain, stop and try again another day.
You can drive and start lifting light objects from 2 weeks. You may start lower leg exercise after 4 weeks. Strenuous Gym activities, aerobics or sports should be avoided for six weeks.
Skin care do not be scared to gently rub massage the face after the first 2 weeks as this will help with swelling in the tissues. From 6 weeks on gentle massage along the scar in circular motions will help with scar softening.
Sleeping: Sleep on your back with one or two extra pillows during the first 2 weeks, as this will help to reduce swelling.
Pain: It will be uncomfortable over the first few days; this varies from person to person. Analgesia (painkillers) will be prescribed to take home.
Work / Sport / Leisure: It is recommended that you take 2 to 3 weeks off work. If you have an active hobby / leisure interest, please ask the surgeon or nurse for advice. It is also advisable to avoid bending forward too much at first.
Bathing: Please keep the wounds dry for the first week. You may take a shallow bath. After you first post-operative check with the nurse at 1 week, you will be advised if you can then shower.
Sun Bathing: Do not sit out in strong sun for the first 2 weeks after surgery.
Diet: Maintain a healthy nutritious diet with plenty of fruit and vegetables, as this is important for wound healing and bowels.
Bowels: As you are inactive and due to use of painkillers, you may become constipated. For your own comfort and wellbeing, prevent this from happening. Purchase an aperient such as Senokot® or what ever has suited you in the past.
Flying: If possible avoid flying for the first six weeks, wear flight socks and take low dose aspirin before flying.