Our faces change as we grow older, usually as we enter our 30′s. As we age the skin begins to loosen on the face and neck. The wrinkles known as crow’s feet or laughter lines on the outside of our eyes begin to appear. Our jaw lines may soften into jowls and vertical folds appear under our chin. The aging process and the changes in our facial appearances are influenced by a number of things including personal habits, genetics, the pull of gravity, sun exposure and smoking.
A facelift involves the tightening of facial and neck skin tissues, re-orientation of muscles and repositioning of fat with re-draping of the skin. A facelift is sometimes performed in conjunction with other facial aesthetic procedures, such as a brow lift, forehead lift or eyelid surgery. Also, a facelift is a basis for other non-surgical treatments such as dermal filler and/or botox treatment. A facelift is a delicate procedure that tries to recreate the beauty and harmony of young facial contours.
Through discreet facelift incisions, Mr Meagher can free the skin from the underlying tissues. After the skin has been pulled up and back, the excess is removed. In many instances, the deeper tissues may also need to be repositioned to restore a more youthful contour to your face. Sometimes a small incision beneath the chin lets us remove fatty tissue in that area and smooth the cord-like structures of the underlying muscle in the neck.
Deciding on a facelift
A facelift cannot stop aging nor turn back the clock. What it can do is help your face look its best and give you a healthy, more youthful appearance. It can also increase your self-confidence. A facelift is usually an option for people in their 40s, 50s, or 60s, but the procedure may also be performed successfully on people in their 70s and 80s. Plastic surgery helps to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, aesthetic cosmetic surgery can help change how you feel about yourself.
Understanding the limitations of a facelift is crucial and psychological stability is vital. There is no ideal in a facelift and the goal is to improve the overall facial appearance. Skin type and thickness, degree of skin elasticity, individual healing, bone structure, ethnic background, as well as a realistic attitude are factors that will be discussed prior to surgery. If you’re considering a facelift, you will need to discuss your full medical history with Mr Meagher.
Successful plastic surgery is a result of good rapport between patient and Mr Meagher. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery is performed.
Before the operation
The most important thing to do is to talk with Mr Meagher so that there is a clear understanding of your desires and expectations, in light of any biological prerequisites. We want you to be well informed and have realistic expectations of the results.
Mr Meagher will describe the type of facelift and technique he will use, the type of anaesthesia, the hospital, any additional surgery, the pros and cons, benefits, potential complications, possible risks and the costs of the procedure.
You will be asked to discuss your medical history, including information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries and medications that you currently take. Mr Meagher will also examine the structure of your face, skin texture, skin elasticity, soft tissue structure and underlying bone framework. You will have to stop taking medication which alters blood viscosity, e.g. aspirin. As for all surgery, patients are requested to stop smoking at least 6 weeks prior to the operation.
Specific individual risks will also be explored especially those related to medical situations such as high blood pressure, a tendency to scar, smoking, medications and any deficiency in blood clotting. As well as assessing your general health and facial appearance, Mr Meagher will assess your mental and emotional attitudes toward the surgery.
If several flaws need correction, more than one procedure may be necessary for the best overall result. Other procedures include surgery on the eyelids, forehead, neck and chin as well as non-surgical treatments such as wrinkle treatments, dermal fillers and laser treatments.
Mr Meagher will examine your face, taking measurements and photographs for your medical record.
If you decide to proceed with the operation you will be required to confirm your understanding of all aspects of the surgery and agreement to proceed by signing a consent form.
Mr Meagher begins the incision near the temple hair, just above and in front of the ear, and then continues around the lobe, circling the ear before returning to the point of origin in the scalp. The skin is raised outward before Mr Meagher repositions and tightens the underlying muscle and connective tissue. Some fat may be removed as well as excess skin. These incisions are designed to be easily concealed by your hair or with makeup. There may also be a small incision hidden underneath your chin.
There are other types of facelifts that we can use, especially in younger patients with less skin laxity but with sagging soft tissues such as cheek jowls and fat pad descent on the cheeks. These facelifts are called ‘MACS’ (Minimal Access Cranial Suspension), ‘Quicklifts’, ‘S-lifts’ and ‘minilifts’. With these minimal access facelifts, less intrusive incisions may be used often avoiding incisions behind the ear and lower scalp.
For men, the incision is aligned with natural beard lines. The incision is placed where it will fall in a natural crease of the skin to help reduce the risk of the scar being noticed. After trimming the excess skin, Mr Meagher closes the incisions with fine sutures and/or surgical metal clips which permit surgery without shaving hair from the incision site.
During the operation
Your surgery will be performed in a major hospital under a general anaesthetic. It can take between 2 and 4 hours for the operation and, for your safety, the attending anaesthetist will use various monitors to check your heart, blood pressure, pulse and the amount of oxygen circulating in your blood.
After the operation
Even though most patients experience very little pain after surgery, Mr Meagher will still prescribe pain killers. You will have some swelling but you can use cold compresses to keep swelling to a minimum. If a dressing has been applied, it will be removed within one to two days. You should also keep your head elevated when lying down, avoid as much activity as possible and report any undue discomfort. Though there are few risks in facelift surgery and thousands are performed every year, some risk exists in any surgery.
After the facelift is complete, Mr Meagher will close the incision and apply bandages for a day or two. You will need to stay in hospital overnight.
In some cases, a drainage tube may have been inserted during surgery. This will be removed on the first or second day after surgery. Mr Meagher generally recommend that patients avoid vigorous activity and organise support from family and friends, especially with transport home after your discharge from hospital.
For several days after a facelift, it is perfectly normal to experience some pain, discomfort, swelling and bruising. Usually you can wash your hair within a few days of surgery after the dressings are removed. Most bruising will disappear within 2 weeks, but it takes a little longer for the swelling to completely subside. It’s also quite normal to experience some numbness in the face. If you notice any signs of infection or experience any bleeding or sudden increase in pain, contact Mr Meagher immediately.
Recovery usually takes 2 to 3 weeks, though many patients go back to work in 2 weeks. Scars are usually not noticeable after enough time has passed for them to mature and they are easily disguised in natural skin creases, by the hair, or, in persistent cases, by makeup until totally healed.
Mr Meagher will remove sutures and stitches in a follow-up visit between 4 and 14 days after surgery. Following this, most people are able to resume their normal daily activities (working, food shopping, going out to dinner, limited exercise) without any difficulty.
After a facelift, it is important to follow Mr Meagher’s instructions carefully and we recommend you:
- Arrange to have someone to take you home and stay with you for at least 24 hours after the facelift
- Keep your head propped up to help reduce swelling – sitting up against pillows may be the most comfortable position
- Get your pain medicine prescription in advance and use as directed
- Try to avoid irritating your stitches – Mr Meagher may suggest that you use a gentle baby shampoo or antiseptic shampoo and that you avoid styling products that may cause irritation
- Return for your follow-up visit to have your stitches or sutures removed
- Avoid strenuous exercise for at least 2 weeks following surgery
- Don’t have facials and other skin treatments for 6 weeks
- Use a high-factor sunscreen (minimum 30+ SPF)
Naturally, there are risks associated with any type of operation and this surgery is no exception. Mr Meagher will explain the possible risks, which are rare, but may include:
1. Infection: Infection does not happen very often and you will be given an antibiotic at the time of your surgery to prevent this. If you do develop an infection, see Mr Meagher as soon as possible. Most infections can be treated with an antibiotic but they can cause serious problems and increased scarring.
2. Pain: As with any surgical procedure, pain of varying intensity may occur following facelift surgery. You will be prescribed some pain medicine to take in hospital and at home after your discharge, if you need it.
3. Poor wound healing: Healing can take longer in cases of:
- Fluid accumulation
- Overly tight stitches
- Improper support during healing
- Pressure against the scar tissue
Wound healing may also take longer in patients who have diabetes, or other medical conditions, or who smoke
4. Haematomas: Haematomas are a solid swelling of clotted blood within the tissue and they can happen after any surgery. The risk of infection is higher if a large haematoma or seroma (a collection of watery fluid within the tissue) collects immediately after surgery. Mr Meagher may use a surgical drain to help prevent small haematomas but, in some cases, Mr Meagher may need to re-operate to remove a large haematoma after face lift surgery.
5. Nerve damage: It’s possible, but highly unlikely, that you could suffer nerve damage after a general anaesthetic. The area may vary from a very small patch of numbness, tingling, or pain, to most of a limb. The pain can be a continuous, aching pain or a sharp, shooting pain. You may also get warm or cold sensations. If motor nerves are damaged, there may be weakness or paralysis (loss of movement) of muscles in that area. The risk of a significant peripheral nerve injury lasting more than three months is estimated to be less than one in 2,000 patients having a general anaesthetic. Permanent damage, lasting more than a year, is estimated to occur in less than one case in 5,000.
Other potential issues
The risks associated specifically with a facelift procedure include:
- Hair loss around the incisions (usually not permanent)
- Scarring – most scars can usually be hidden by the hair (especially for women) or natural creases of the skin and they fade over time
- Rough skin
- Asymmetry – uneven results in different parts of the face. Some slight asymmetry is common, uncommon cases of profound asymmetry may need corrective surgery
- With a facelift, there is some risk of injury to the outer branches of the facial nerve, but permanent nerve damage is extremely rare and can be dealt with by a surgeon who specialises in nerve repair
Because of the very nature of cosmetic surgery, sometimes patients can be dissatisfied with the results.
The reason many people have a facelift is to look younger and, generally, the procedure makes people look about 10 years younger. During the first few weeks after a facelift, there will be some relaxation of facial tissue as your body heals and swelling diminishes.
Normally, the younger you are at the time of surgery, the longer the results will last. For a woman in her 40s, the effects may last up to 10 years. For a woman in her 60s, results may last anywhere from 5 to 7 years. It is also important to remember that the way you look after a facelift and how long the results last depends on your:
- Bone structure
- Skin type
- Exposure to the sun
- Lifestyle e.g. diet, exercise, rest, refraining from smoking and substance abuse, etc.
Most people who undergo facelift surgery are happy with the results. But some people are still concerned about the signs of ageing that facelift surgery does not fix: sagging eyebrows, deep facial lines and fine wrinkles around the eyes or lips. But there are other ways we can address these problems, including muscle-relaxing treatments, dermal fillers or laser treatments to treat fine lines and wrinkles that remain after a facelift.