Facelift

Short summary

  • sagging tissues, volume depletion and excess skin can only be addressed with surgery
  • our goal is to obtain refreshed, natural and rested, rather than plastic, operated and overdone appearance
  • we select a type of facelift according to detailed preoperative analysis and patient’s wishes and concerns
  • face lift is usually performed under general anesthetic, however smaller lifts can be performed under local anesthesia
  • the procedure takes 1-3 hours
  • stiches are removed after a week
  • you should expect some swelling and bruising on the face to last for a month

What is a facelift?

Traditional facelifts consisted of pulling the skin, which often resulted in a distorted unnatural appearance and not very long lasting results. A modern facelift surgery is usually part of surgical facial rejuvenation. The concept is based on facial soft tissue augmentation by structural fat replacement, removal of excess skin, three dimensional lifting and tightening and redraping of underlying tissues. The goal is to obtain refreshed, natural and rested, rather than plastic, operated and overdone appearance.

Who is a good candidate for facelift surgery?

Men or women who are healthy, physically active, without multiple or untreated medical problems. Most patients are in their 40′s to 60′s, but facelifts can be performed successfully even on older people. With different modifications facelift namely addresses descended facial volume with sagging of the jowls and the neck. Excess fat and skin that accumulate in the lower half of the face are removed to restore the youthful contour of the neck and jaw line. It is the only way to successfully treat deeper skin folds, tissue bulging and sagging skin. Patients with receding chins are less likely to get a good neckline with a face lift, but this can be improved by combining the facelift with chin enlargement. Midface lift is used to rejuvenate a depressed and descended cheek area.

Can facelift be combined with other procedures?

With advanced signs of aging a comprehensive approach is needed, to obtain satisfactorily results. All other procedures for facial rejuvenation can be combined with a facelift. Most commonly facelift is complimented and further enhanced by skin resurfacing and correction of periorbital region with blepharoplasty and brow lift. After comprehensive examination, we will be able to recommend a surgical option, to safely achieve your goals.

What type of anesthesia s used for facelifts?

Most surgeons and patients prefer a general anesthesia for optimal comfort, control and safety. Facelift can also be performed in local anesthesia with intravenous sedation. In both cases, experienced anesthesiologist should be present and patients should spend the night in the clinic.

How is a facelift performed? Where are the scars?

Detailed planning and three dimensional analysis of photographs taken before the procedure is essential for predictable and reliable outcomes. Incisions for facelift run from the hairline at the temple region, in front of the ear (in a natural fold), around the earlobe, to the lower scalp behind the ear. Another incision beneath the chin may be used for reshaping of the chin and neck. The incision behind the ear can be drawn out to a length of choice to suit the conditions, needs and requirements. Scars are shortened whenever circumstances allow. The skin overlying the face and neck is gently elevated off the deeper layers. The underlying connective tissue with fine muscles (SMAS-superficial musculo aponeurotic system) is lifted, repositioned and tightened. Excess fat is removed and degenerated fat compartments reshaped and augmented to create a more youthful appearance. The excess skin is removed and wound closed without tension Fat along the jaw line and under the chin is removed by liposuction. The neck muscles are drawn and sutured together at the midline, forming a strong support for the entire neck.  small thin drains may be placed under the skin behind the ear for a day or two to remove any blood that might collect. The head is wrapped in bandages to minimize the swelling.

What is mid-facelift, upper face and endoscopic facelift?

A midface lift is a vertical lift of tissues in the middle of the face to make cheek area more prominent and youthful. To reposition the soft tissues over the cheekbones the skin is incised in the hairline or on the lower eyelids or inside of the mouth . The scars are not visible. A midface lift can be performed on its own or in conjunction with other facial procedures, most commonly eyelid surgery (blepharoplasty). It can be designed to be an extension of the brow (forehead) lift which rejuvenates the upper region of the face by opening and lifting the outer angle of the eyes. The combined procedure is also called upper face lift. An endoscope, rigid pencil-shaped probe with a small camera attached can be used for this procedure. Endoscope enables the surgeon to see deep structures on a video screen. Camera is inserted in the temple region through small skin incisions and tunneled beneath the skin of the scalp. Only relatively young individuals with a very limited amount of skin sagging are candidates for this approach also named endoscopic facelift.

What is the recovery after facelift?

After surgery, you will need to rest until the effects of the anesthetic have passed. You may need pain relief to help with any discomfort as the anesthetic wears off. You will usually be advised to spend a night in the clinic. Immediately after the procedure your face will look a little puffy and may feel rather strange and stiff. During the first 24 hours, a fairly mild analgesic is usually sufficient. After this, some patients manage without any medication while others may take mild painkillers during the first week at home. The bandages and drain will be removed after a day or two. The sutures are removed in 7 to 8 days. The scars after a facelift and neck lift tend to heal very well, because of the excellent blood supply of the face and avoidance of tension on the skin closure. Swelling in the first days after the procedure disappears as healing progresses and visible improvements of the facelift procedure appear. Minor swelling and bruising can be concealed with special camouflage make-up. Elevating the head with a few extra pillows while sleeping will facilitate the resolution of swelling. Although patients can return to work, they should limit strenuous physical activity for several weeks. Prolonged heat and sun exposure should be avoided for several months. Sun avoidance and the regular use of sunblock at least two months after the procedure are vital to prevent permanent hyperpigmentation. Hair coloring should be avoided for at least three weeks after surgery. After a midface lift, a sense of dumbness in the cheek region and difficulty chewing are common during the first week. A common experience is that the tissues have been lifted too extensively, but after 2-3, weeks this usually disappears.

How long does a facelift last? What is a secondary facelift?

A facelift puts the lock back, but it does not stop it. Aging continues as appropriate after any type of aesthetic procedure, but the benefit of the operation remains. The effect of the face lift is likely to always be there. You will not look as old as you would have if it had not been carried out. Over a long period of time, additional aging may bring about recurrent signs of aging, and it is not uncommon for patients to desire another face lift after about ten years. A secondary facelift is more challenging and requires more experience and judgment. Basically is performed the same way as the first one, and there are no additional scars.

What are the alternatives to facelift surgery?

There are no alternatives to correctly indicated and precisely executed facelift. Non-surgical rejuvenation treatments are sometimes labeled as face lifts, but they are not. Fillers and Botox may temporarily reduce some superficial signs of aging, and are frequently used in conjunction with facelift, but sagging tissues, volume depletion and excess skin can only be addressed with surgery. Creams, gels and beauty treatments may help tighten your skin. However, there is no scientific proof of their effectiveness.