Facelift

A facelift can improve the most visible signs of ageing by removing excess fat, tightening underlying muscles, and redraping the skin of your face and neck. A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.

If you’re considering a facelift

As people age, the effects of gravity, exposure to the sun and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jaw line grows slack and jowly; folds and fat deposits appear around the neck.

This part of the website will give you a basic understanding of the procedure, when it can help, how it’s performed and what results you can expect. It can’t answer all of your questions, since a lot depends on your individual needs. So please ask us about anything you don’t understand.
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The best candidates for a facelift

If your face and neck have begun to sag but your skin still has some elasticity and your bone structure is strong and well-defined, you could be well placed for this procedure. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties.

A facelift can make you look younger and fresher, and it may enhance your self- confidence in the process. But it can’t give you a totally different look, nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with us.

A facelift can improve the deep cheek folds, jowls and loose, sagging skin around the neck that come with age.
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All surgery carries some uncertainty and risk

When a facelift is performed by a qualified plastic surgeon, complications are infrequent and usually minor. However, your anatomy, physical reactions and healing abilities are unique; the outcome is never completely predictable.

Complications that can occur include haematoma (a collection of blood under the skin that must be removed by the surgeon), injury to the nerves that control facial muscles (usually temporary), infection, and reactions to the anaesthesia. Poor healing of the skin is most likely to affect smokers, requiring modifications to the operation. You can reduce your risks by following closely your surgeon’s advice both before and after surgery.
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Planning your surgery

Every facelift is individual. In our initial consultation, I will evaluate your face, including the skin and underlying bone, and discuss your goals for the surgery. I will also check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, blood clotting problems, or the tendency to form excessive scars.

If you decide to have a facelift, I’ll explain the techniques and anaesthesia I will use, the type of facility where the surgery will be performed, and the risks involved. Please ask me any questions you may have, especially those regarding your expectations and concerns about the results.
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Preparing for your surgery

You will be given specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding medication. These will help your surgery go more smoothly.

If you smoke, you should consider stopping at least a week or two before and after surgery; smoking inhibits blood flow to the skin, and can interfere considerably with healing. If your hair is very short, you might want to let it grow out before surgery, so that it’s long enough to hide the scars while they heal.

You should arrange for someone to drive you home after your surgery, and to help you out for a day or two if needed.

A facelift is performed as an in-patient in hospital under general anaesthetic for most patients. A five day course of Arnica tablets is recommended immediately prior to surgery.

Clinical photographs will be taken before your operation.
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The surgery

A facelift usually takes several hours – or longer if you’re having more than one procedure.

Most patients have a full face lift, but some have only a temporal lift which tightens the skin above the temples and over the cheekbones. Sometimes this is carried out more extensively and is then known as an upper face lift. Skin is mobilised and tightened as above but the muscles of the cheek are also tightened at the same time. For a temporal lift, scars remain in the hairline extending just down to the ear; in an upper face lift, the scars are sculpted round the front of the ear to disguise them as much as possible and usually pass round to the back of the earlobe.

The exact placement of incisions and the sequence of events depend on your facial structure. Incisions usually begin above the hairline at the temples, extend in a natural line in front of the ear (or just inside the cartilage at the front of the ear), and continue behind the earlobe to the lower scalp. If the neck needs work, a small incision may also be made under the chin.

In general, the skin is separated from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. The underlying muscles are then tightened and the excess skin removed. Stitches secure the layers of tissue and close the incisions.

After deep tissues are tightened, the excess skin is pulled up and back, trimmed and sutured into place. Most patients have dressings and bandages for 24 hours.
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After your surgery

Pain following surgery is usually mild and it can be lessened with the medication prescribed. Some numbness of the skin is quite normal; it will disappear in a few weeks or months.

You will be advised to keep your head elevated and as still as possible for a couple of days after surgery, to reduce the swelling.

If you’ve had a drainage tube inserted, it will be removed one or two days after surgery. Bandages, when used, are usually removed after one or two days. Don’t be surprised at the pale, bruised, and puffy face you see. Just keep in mind that in a few weeks you’ll be looking normal.

Most of your stitches will be removed between one and two weeks. Your hair will be shampooed before you leave hospital and you will be able to wash your hair regularly once you get home.

Most of the scars will be hidden within your hair and in the normal creases of your skin.
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Getting back to normal

You should be up and about in a day or two, but plan on taking it easy for the first week after surgery. Be especially gentle with your face and hair, since your skin will be both tender and numb, and may not respond normally at first.

You will be given more specific guidelines for gradually resuming your normal activities. They’re likely to include avoiding strenuous activity including sex and heavy housework for at least two weeks and avoiding vigorous exercise for two months. Above all, get plenty of rest and allow your body to spend its energy on healing.

At the beginning, your face may look and feel rather strange. Your features may be distorted from the swelling, your facial movements may be slightly stiff and you’ll probably be self-conscious about your scars. Some bruising may persist for two or three weeks, and you may tire easily. It’s not surprising that some patients are initially disappointed, but I will prepare you by telling you what to expect.

By the third week, you’ll look and feel much better. Most patients are back at work about two to three weeks after surgery. If you need it, special camouflage makeup can mask most bruising that remains.
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Your new look

The chances are excellent that you’ll be happy with your facelift – especially if you realise that the results may not be immediately apparent. Even after the swelling and bruises have settled, your skin may feel dry and rough for several months. Men may find they have to shave in new places such as behind the neck and ears, where areas of beard-growing skin have been repositioned.

You’ll have some scars from your facelift, but they’re usually hidden by your hair or in the natural creases of your face and ears. In any case, they’ll fade within time and should be scarcely visible. After surgery, you’ll present a fresher, more youthful face to the world.

Having a facelift doesn’t stop the clock. Your face will continue to age, and you may want to repeat the procedure after some years. However, the effects of even one facelift are long lasting, and even years later you’ll continue to look better than if you’d never had a facelift.
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