With the ageing process the cheeks sag resulting in jowling which causes a loss of the jawline, loss of fullness in the mid cheek region and a deepening of the cheek folds.
The facelift aims to correct these problems and by so doing rejuvenate the face.
Preoperation advice
At the initial outpatient consultation after a full assessment and examination, a long discussion regarding the realistic goals and expectations of the surgery is undertaken.
Aspirin and related anti-inflammatories should be avoided for 2 weeks prior to surgery as they can significantly increase the risk of bruising and bleeding.
Similarly smoking increases the risks of complications such as wound infections, bleeding and poor scarring and should be avoided for at least 2 weeks prior to and 2 weeks following the surgery.
Operation details
Patients are usually admitted on the day of surgery and will be seen by the nursing staff, the surgeon and the anaesthetist.
Preoperative photographs will be taken and markings on the skin may be made. The facelift procedure usually takes between 2 and 4 hours and is usually performed under a general anaesthetic.
The incisions are designed to produce scars that are either concealed or become inconspicuous. The facial tissue is tightened in layers, this produces a more natural effect and prolong the effectiveness of the facelift.
In some patients fatgrafting procedures to correct any depressions or folds may be also be undertaken, in others where there is fat excess, liposuction is performed.
Additional procedures such as a necklift, a browlift, a chemical peel, a lip resurfacing or eyelid corrections may also be undertaken at the time of the facelift.
Following surgery
For the first 24 hours most patients are advised to rest and the swelling is reduced by keeping the head elevated and by applying cold compresses.
Pain is not normally a significant feature although analgesia (pain relief medicine) will be given as required.
Patients are discharged either 1 or 2 days following surgery depending on the exact nature of the procedure.
Some bruising and swelling is inevitable though most of this will usually fade away within 1 or 2 weeks and the “hideaway” period is usually 10-14 days.
Because of the nature of the surgery whilst many of the changes are visible within a fortnight, the full result cannot be fully assessed for at least 3 if not 6 months postoperatively.
Follow up
Arrangements for follow up care will be made prior to discharge. Patients are normally seen between 7 and 10 days postoperatively for removal of stitches and then at 1 month and 4-6 months following the procedure, by the surgeon.
Risks and complications
As with all surgery there are risks of complications. With facelifts the main risk in the first 24 hours is of bleeding resulting in a collection of blood underneath the cheek skin which would necessitate a return to the operating theatre. In the first 2 weeks following surgery wound infections can occur though these are usually easily treated with either topical (applied to the skin) or oral antibiotics. In some patients lumpiness and facial swelling can persist for several weeks. The most significant risk however of facelift procedures is of injury to the facial nerve which can result in one side of the mouth or eyebrow region not moving appropriately. Fortunately in most cases this is a temporary problem which usually resolves within a few weeks of surgery.
Your new look
Healing is a gradual process and the full result really cannot be assessed for between 3 and 6 months. Although the ageing process cannot be stopped, the effect of the facelift will last for many years and a lot of patients will never require any further facial rejuvenation procedures. However some patients may elect to go to secondary facelifts but these are not usually required for at least 8-10 years following the original procedure.
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