For the correction of facial ageing, particularly the neck and jaw line. As the face ages the skin and underlying muscles become lax with loss of skin tone and elasticity. This with the effects of sun and gravity result in the drooping of the facial tissues. There is also loss of fat volume and descent of fat in the face. Facelift can partly reverse these changes. This procedure can sometimes be done with removal of neck fat, blepharoplasty (eye-lid tuck), fat injection to help fill out the middle of the face and forehead lift.
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Procedure in brief
The full-facelift and short scar facelift are differing extents of the same operation. The most commonly performed is the full-facelift. This entails lifting the skin and fat layer away from the underlying muscles. This is done in the cheek, jaw-line and down into the neck. An incision from above the ear in the hair runs then in front of and finally behind the ear. Sometimes the incision is placed along the sideburn hair- line instead of up into the hair itself. These options will be discussed at consultation. The underlying muscle layer (SMAS layer) is then tightened. This is an important stage in the operation as this layer takes up much of the ‘lift’. The excess skin from the face and neck is then removed and carefully stitched in its new elevated and tightened position.
A short scar facelift involves a smaller incision that is in front of and not behind the ear. Although working on similar principles the extent of skin elevation is less and it treats predominantly the jaw-line and less so the neck.
Length of surgery
Operation takes 3 to 4 hours depending upon technique used.
Nights in hospital
Usually one night, occasionally two.
Dressings and stitches
You will wake up with dressings on the wounds and a head bandage. The bandaging is usually removed before your discharge home and exchanged for a compression garment. Any stitches will be removed at the day 5 visit.
Time off work and socializing
Allow 2 weeks. People vary in recovery. Most patients are very comfortable at one week and although feel they could return to work it is preferable to wait. You will be a little swollen and bruised in the first week but this is less marked than most patients expected. Most of this will have settled by the end of the second week.
Time to exercise
Walking a distance at 5-7 days, swimming by 10-14 days (if fully healed). Strenuous exercise (aerobics etc) should be avoided for 4 weeks.
Postoperative instructions
Day 1-4 You should be taking it very easy! Day 5-14 You will be feeling much better from here onwards. The swelling will be settling and much of the bruising will subside. You can start exercising gently and build it up over the next 10 days. Week 3-6 Should be back to work and doing anything you wish by 6 weeks.
Follow up
Wound check and dressing change a day 5. Then see Dr Deepak Kalia at 3 months. NB There are no charges for any follow up appointment relating to your surgery.
Complications
This is a routine operation that is a great success for the vast majority of patients. However, it is very important you understand what can go wrong as well as right with an operation. With facelift the potential problems are listed.
Skin loss:This is extremely uncommon and occurs if the blood supply to the skin is insufficient. The risks are if the skin is pulled too tight (therefore always avoided) and in patients that are heavy smokers.
Altered skin sensation: This is common initially but returns to normal in all areas in the vast majority.
Altered ear sensation: Again very uncommon but can occur if a nerve to the ear is damaged.
Small areas of asymmetry: The same operation will be performed both sides. There is a small risk of minor irregularities in the skin surface on one side and not the other. Similarly the lobe of the ear can subtly change position.
Scars: Patients can vary in the quality of scars they produce.
Wound breakdown: Although uncommon this can result in delay in wound healing and poorer scar quality.
Bleeding: A blood clot can collect under the skin flaps needing you to go back to theatre for its removal. If this occurs it will be within the first 24 hours. Occurs in approximately 1%.
Infection: Quite uncommon but if occurs you will need a course of antibiotics.
Nerve injury: Injury to the facial nerve is very uncommonbut can result in palsy of the facial muscles. The most common areas affected are to the eyebrow and corner of the mouth. If it occurs it resolves itself in the majority of cases over 2-3 months. There are some cases with permanent injury.
