FACE LIFT
Will a facelift correct skin folds running down from the sides of my nose towards my mouth? (The naso-labial folds)
Modern facelifts have been specifically designed to address this very difficult problem which was not corrected by older types of facelift. The indication and choice of procedure will vary from patient to patient depending on the skin type that they have.
Will this operation correct my jowls?
The jowls are usually caused by loose ligaments in the facial support mechanism and an accumulation of fat. The modern facelift is very good for restoring the natural youthful angle of the lower jaw.
Will a facelift help my neck?
There are usually two problems with the neck. Firstly any excess fat can be removed and secondly, the loose platysma muscle can be tightened to restore the natural angle as well as tightening the loose skin.
Will a facelift help my wrinkles?
In general wrinkles are best treated by resurfacing the skin with either a laser or chemical peel. However, if there are underlying structural problems such as marked jowls or redundant skin in the neck, then it is better to try and combine a facelift procedure with a resurfacing operation.
Can a facelift restore my youthful cheek bones?
A facelift, by repositioning the fat which has slipped off the cheeks towards the mouth creating folds, can be replaced by an extended SMAS dissection.
Are there any patients who are not suitable for a facelift?
Patients who have sun damage resulting in creases without little structural changes to the face are best treated by resurfacing. Overweight patients are best advised to try and lose weight before surgery. Smokers carry an increased risk with wounds healing.
There are a number of medical conditions which may influence the outcome of surgery and these would be best discussed individually with your surgeon.
Psychological Considerations
Personal reasons for desiring surgery are very important. If there are any doubts or conflicts about the operation, then we have a Clinical Psychologist (Louise de Haro) who would be more than happy to talk through with you the motivation for the surgery.
Consultation
1. What would be the best operation for me?
The subcutaneous facelift which is the original operation sometimes now described as a MACS lift can often be done as a day case procedure. This is mostly used on older patients who have either undergone a facelift previously or have a very thin SMAS layer in the face which is not amenable to dissection and lifting.
2. The extended SMAS plication
This is now the standard procedure for a facelift procedure in our unit. It lifts the neck and the mid face by pulling on the deeper structures in the face and cheeks and gives a very consistent result.
3. The composite facelift
This is a more extensive dissection involving not only a SMAS lift, but a brow lift and the lower eyelids as well. It gives the whole face rejuvenation but the disadvantage is that there can be quite prolonged swelling associated with this and therefore the recovery time is longer.
4. Sub-Periosteal facelift
This is a deep plain dissection of the face which can be performed in younger patients who don't have a lot of loose skin and are looking to enhance the cheek bones in particular.
5. Endoscopic facelift
This is really a variation of the sub-periosteal facelift using small incisions and keyhole surgery.
6. Do I require a general anaesthetic?
Most surgery of this type is done under general anaesthetic. The sub-cutaneous facelift may be done under local anaesthetic with intravenous sedation as a day case procedure and in specific, selected cases for various reasons, a more extensive facelift can be performed under IV sedation rather than a general anaesthetic.
Preparation for surgery
1. Do I need to stop smoking?
Most definitely the answer is yes. There is good evidence that people who smoke have more problems with wound healing and bruising. Therefore it is a very good idea if you can, to stop smoking at least a week before surgery and to cut down the number of cigarettes smoked a month before.
2. Is there any medication which will help with bruising?
We are big believers in the use of the homeopathic preparation 'ARNICA' and we prescribe this for our patients for a week before surgery to continue through into the post operative period in tablet form.
3. Are there any drugs I should stop taking before my surgery?
In general any drug which you take normally should be continued through the operative period. This should be closely discussed with your anaesthetist. The one drug however that you MUST stop is Aspirin. This must be stopped at least two weeks before your surgery.
