Facelift

What is a Facelift?

A rejuvenation of the lower face from the temples to the lower neck.

What’s the best age to get a facelift?

No set age. The average patient has their first face-lift between the age of 45 and 55 years of age. These are guidelines and the indications for a face-lift vary, depending on age and facial anatomy. A face-lift will create a more oval shaped face with wider fuller cheek bones. Some patients age prematurely and vice versa. Reasons for premature aging include yo-yo weight change, anorexia, cutis-laxa, smoking, sun exposure, poor life style, abuse of alcohol and drugs and of course genetics. A face-lift can be of benefit to reverse these changes when they occur. Face-lifts address skin excess and muscle laxity primarily. Fat or filler volumization does not correct these issues but are useful to correct the effects of facial fat depletion. Fat injection is often combined with a face-lift.

procedure_facelift_01Facelift technique

: The extra skin is removed. Fat is suctioned from the jowls and under the chin. The muscles in the face and neck are tightened. The cheek fat is elevated to a youthful level recreating the cheek highlights. The incisions are placed inside and behind the ear so that you can wear your hair back. The sideburn is left in its youthful position.

Philosophy

: Aesthetic cosmetic surgery is often maintenance surgery; staying fresh and young looking with regular procedures. However a face-lift can be more about turning the clock back. Generally, sudden age changes, illness or weight loss can make us aware that we no longer look our best. Expressions such as “I am beginning to look like my mother” are common. You may feel you always look angry or tired or that your partner and you have a visual age disparity when other people see you. Or it may be the ‘Mommy-at-the-school-gates Syndrome when you are an older mother and have to wait there with all the other mothers who are 10-15 years younger.

Waiting for face-lifting surgery until you are 65 and then going in for the “works” , expecting to come out looking natural, is often unrealistic. More natural results are usually achievable at a younger age such as between 45-55. But if you already had a facelift at 45 or 50, then you should look natural after a second facelift at 65. Those who ignore this advice and have their first facelift in their sixties may need a secondary facelift within a few years of the first surgery because of the poor elasticity of the skin at this age.

Surgical time and recovery

: Surgery takes about 4-5 hours. Drains are placed and exit behind the ear, one on each side. They are removed the day after surgery. Stitches are dissolvable and do not need to be removed. Staples may be used in the scalp and these are removed progressively between one and nine days. The patient can go back to work at 10-14 days. Light exercise at two weeks (walking), Gym at four weeks (light: heart rate up to 120 pulses per minute). Full exercise at six weeks: heart rate up to 160, except for no inverted positions. It is important not to lift heavy bags, do household work such as making beds or put your head down below your heart (squat instead) for the first three weeks after surgery.

Related Cosmetic Procedures

: The most frequent related procedures are blepharoplasty (eye-lifts) and endoscopic browlift. A chin implant can correct a receding chin as well as a poor neck contour. Lip injections with hyaluronic acid filler or fat can restore a thin aging lip and a nasal tip-plasty can reduce a bulbous nose and elevate the tip.


Adjuncts to facial rejuvenation

Facial aging involves loss of cheek and chin projection due to descent of the fat pads over the cheek and chin regions. Aging is also associated with loss of facial fat, more marked after significant weight loss, illness and in runners. In the chin area, the sagging of the skin in the neck and a pre-existing obtuse angle between the neck and jaw line, contribute to the loss of neck definition. Using a chin implant in these cases can help.

Cheek implants can augment the effects of a facelift and can be used either to elevate the cheek bones alone using a standard malar implant, or they can be used to augment the cheeks as well as any hollowness below. An extended implant is used in this case. Occasionally only the dimple area is treated using a “submalar implant”.

Chin implants are especially helpful in the case of facelift patients with loss of neck definition or a flat contour to the front of the chin. Fat injection has now added a new alternative to implants, especially in the cheek area.

One of the signs of ageing is an enlargement of the nasal tip cartilages and a droop of the tip creating a hooked appearance. As the tip descends, the bridge of the nose then appears more pronounced. Minor refinements of the nose can make a big difference. The tip cartilages can be reduced and the tip can be elevated. At the same time, the bridge of the nose can be shaved without breaking the nasal bones. The effect is subtle but overall a definite boost to the facial appearance.

These procedures can be performed at the same time as face-lift.

1) Cheek Implants

Can be performed at the same time as a facelift or as a separate procedure. An incision is made inside the mouth just above the incisor tooth. A pocket is made along the bone and over the cheek area. An implant is placed in the pocket and sometimes secured with a stitch that comes through the skin or an internal stitch. The incision is closed with absorbable stitches.

After surgery the swelling increase for 2-3 days and then recedes. Most swelling is gone after 7-10 days but the appearance will continue to change for up to 12 months as the tissue reshapes around the implant.

2) Chin Implants

Usually performed at the same time as a facelift or as a separate procedure. A small incision is made under the chin. A pocket is made along the bone. An implant is placed in the pocket and secured with an internal stitch. The incision is closed with stitches which are removed 5 days later.

After surgery the swelling increase for 2-3 days and then recedes. Most swelling is gone after 7-10 days but the appearance will continue to change for up to 12 months as the tissue reshapes around the implant.

Nasal rejuvenation surgery

Usually performed at the same time as a facelift or as a separate procedure. Incisions are made inside the nose and the tip cartilages are visualised and reduced so as to give a more defined tip.

Sometimes an “open” approach is used which means that an additional incision is made in the skin between the nostrils on the under-surface of the nose. This allows more control of the final shape of the nasal tip. The nostrils can be narrowed by excising a wedge of the nostril rim in the crease at the side of the nose leaving a scar which is usually barely visible. The cartilage and bone of the bridge of the nose is shaved either through the internal incisions alone or through the open approach. The incision is closed with stitches which are removed 5 days later. A simple tape dressing is applied and left in place for 2-5 days.

After surgery the swelling increase for 2-3 days and then recedes. Most swelling is gone after 14 days but the appearance will continue to change for at least 12 months. Nasal tips in particular will remain swollen for several months and may take 6-12 months to see the optimal result.

More information for Facial Plastic Surgery procedures.

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