Facelift

Introduction

A facelift has always been regarded as a major surgical procedure but recent advances in technique both surgical and anaesthetic have made it a much safer and comfortable experience. It is important to remember however, that although a facelift can wind the clock back by reversing the effects of gravity, it will not erase permanent creases, particularly around the lips, eyes and in the neck. At your consultation you should provide all your general medical/psychological history, together with details of any previous facial surgery.

Slight differences in facial symmetry are normal and will have been pointed out as they often go unnoticed by the patient. By gently lifting the facial skin, Anthony is able to assess what could be expected post operatively.

Over the years the classical (skin only) operation has undergone a number of modifications aimed at improving the overall results. Each of these modifications can be tailor-made to suit individual needs. It is possible to undergo correction of eye bags (see notes regarding blepharoplasty) as well as other procedures at the same time as the facelift. Free fat transfer from other parts of the body is very often used to restore the lost volumes of the central part of the face.

Procedure Details

A facelift is carried out under general anaesthetic and a 2 night stay in hospital is usually required. Starting high in the temple area (hidden by the hair at this point) the incision courses down following the curves in front of the ear round the earlobe and up behind the ear before curving gently back into the hair again. Using these incisions on both sides, the skin and deep tissues are remodelled and re-draped. The incisions are closed with stitches in front of the ear and surgical clips in the hair. Small drainage tubes are inserted underneath the skin during the operation and they are removed the day after the surgery. It is also usual to apply a head bandage in order to gently pressurise the incisions during the first post-operative night.

Summary

A facelift redefines the jaw line by lifting and smoothing out the sagging jowl. This is an extremely popular procedure, which refreshes the face. Some swelling and slight bruising should be expected for approximately seven days. Infection with this procedure is rare, but if it did occur a course of antibiotics is precribed.

Aftercare

Bandages are removed on the second morning after the surgery. The hair will be washed and then you can return home. Over the subsequent few days, you can gently wash your hair with a mild shampoo, obviously exercising care in the suture area. It is important not to stoop or carry out vigorous activities for the first five days after the surgery otherwise post-operative bleeding can result.

Any discomfort can be controlled by taking a mild analgesic such as Paracetamol (Aspirin must not be taken). Sutures are usually removed 7 days post-operatively. Scars are usually very faint after a facelift. However, a period of thickening and reddening of the scars can be expected to last for a few months before returning to more natural skin colour and texture. The scars in the hairline may stretch a little, as this is where the tension is carried.

Bruising, swelling and numbness are temporary following a facelift and are mostly resolved after two weeks. Complications after facelift are rare as great care is taken at the time of the operation to protect the Facial (VII) nerves and meticulous attention to detail is observed. If a haematoma (a collection of blood under the skin) should occur, a revisit to the operating theatre may be necessary. However, if dealt with promptly this does not affect the long-term results. Occasionally, delayed wound healing may occur, mainly in diabetic patients or patients who smoke. Please discuss your smoking habit with your Anthony as smoking is not compatible with facelift surgery, or any cosmetic procedure, especially under general anaesthesia.

Damage to the nerves, which control the facial muscles, is an extremely rare event, which may be associated with a facelift. Even if this should occur, in the majority of cases, there is a full recovery.In addition you should expect some relaxation of the facxial tissues post-operatively and this can be difficult to predict from one patient to the next.

A facelift is NOT a necklift and the tightening of the facial tissues is seen more over the jawline than the central/main part of the anterior neck, here laxity of the skin and wrinkles may persist. Mr Armstrong will point out these aspects at the time of your pre-operative consultation.

General advice

You should arrange for someone to drive you home from hospital.

You will experience mild discomfort after your surgery and it is recommended that you take one or two pain relieving tablets (such as Paracetamol) on a regular basis for the first week. DO NOT TAKE ASPIRIN OR ANY PRODUCTS CONTAINING ASPIRIN as this may prolong or cause bleeding in the early post operative period.

There may be some swelling and bruising following surgery, though this should settle over the first 2-4 weeks. To minimise swelling you are advised to sit up right throughout the day and prop yourself up with 2 extra extra pillows at night for the first two weeks post operatively.

Do not do anything that would raise the blood pressure in your head, eg bending forward, straining, heaving lifting etc.

It is important to rest as much as possible for the first 48 hours after surgery, after which you can recommence gentle activities and household chores, but should refrain from strenuos exercising for at least 2 weeks. You should move around as much as possible and not lie in bed for protracted periods. You should take extra pillows in bed for 3 weeks post-operatively to allow any swelling to drain away with gravity overnight.

Bathing

Your hair should be washed with a mild shampoo (eg baby shampoo), but do not touch the suture line or surgical clips. It is important to blowdry the hair after washing, but ensure that the temperature of the air is not too ot as some areas of scalp may initially be slightly numb.

You should avoid using make up for at least one week post operatively.

Post surgery meeting

About a week after the operation you will be seen in the Dressing Clinic by our specialist cosmetic nurse and Anthony, who will remove the stitches and at 2 weeks the surgical clips.

Exercise

For the first week post operatively you should avoid doing heavy household chores and you may return to swimming two weeks post operatively. You can recommence gentle gym work one month post operatively I would have advised that it is important to stop smoking prior to your operation in order to reduce the risks of complications.

Smoking

You should not smoke pre or post-operatively.

Driving

You should avoid driving for 72 hours after your operation. After this you may recommence driving once you feel confident to undertake an emergency stop. Until you feel confident to do this you should refrain from driving.

Returning to work

Following surgery, the type of job that you do determines when you can return to work. If you mainly confined to deskwork, you may feel able to return to work after two weeks.

Skin care

Your facial tissues will initially be soft but may become firmer over the following weeks before softening again. During this period patience is called for. Massage and moisturise the external scars from 3 weeks with a good facial moisturiser. The scars will take time to mature, but will do so. The delicate scar tissue is at greater risk of sunburn if exposed to the sun, therefore, you are advised to avoid sun exposure to any scar tissue for the first 6-12 weeks of healing, after this if the area is to be exposed to sunlight you should apply sun protection factor 50 sun block to exposed scar tissue.

Complications

Though most people experience uneventful post operative recovery, if you develop any of the following you should contact the ward:

  • Temperature greater than 38.5°
  • Severe pain not alleviated by simple painkillers
  • Fresh bleeding from the wound, other than a minor ooze Excessive swelling
Helpful Statistics

General Anaesthetic

Limited mobility: 1-2 days

Hospital stay: 1 night

Washing: Straight away with care

Surgery time: 2-4 hours

Driving: 2-4 weeks

No smoking 2 weeks before and after any surgery

Off work: 3-4 weeks

Exercise: 4 weeks

Patient Journeys

  • I feel completely refreshed and although some people did not see why I wanted to have it done I did and it has made me feel renewed. Well done to Anthony and his team for their support and care. So recommended.

  • I feel so appreciative of my surgery and I would like to highly recommend the expertise of Mr. Armstrong and his professional and caring team.

  • Once the bandages came off my ears, I was able to see just what a fantastic job Mr Armstrong had done.