What Is A Face-Lift (Rhytidectomy)?

Facelift

A face lift, or rhytidectomy, is a popular cosmetic surgery treatment for smoothing sagging facial skin. A face lift tackles skin that has lost elasticity with age, and is ideal for men or women who are concerned with deep wrinkles and loose skin on the lower two-thirds of the face. While the procedure can be expensive and leave you a little sore, the results can dramatically rejuvenate your face by tightening the skin and smoothing out wrinkles. To achieve the best results, you may also need to combine a face lift with a brow lift or neck lift. For those under 40, most cosmetic practitioners would recommend less invasive options to help you achieve the results you want without the need for surgery. The only way to discover if the procedure is suitable for you is to consult with a surgeon.

Only a qualified cosmetic surgeon can determine whether a face-lift is right for you, but providing you are fit and healthy and have realistic expectations of what can be achieved then surgery can be a great way of giving you more confidence in the way you look.

Face-lifts are popular with both men and women and can be used to erase the signs of ageing such as wrinkles and saggy skin. Most people who have the surgery are over 40, although the surgery is performed on younger people if they are suitable.

Although the procedure is relatively simple, not everyone is suitable for a face-lift. The ideal candidate for this type of surgery will have good skin elasticity, a strong bone structure and loose skin on their face or neck. Because face-lifts stretch the facial skin to remove wrinkles having supple, flexible skin will allow you to heal better. A good bone structure will also help you achieve a better result because the underlying structure provides support to the skin. If you have ‘weak’ facial features, you may also want to consider having dermal fillers or facial implants to improve your underlying structure. If you have loose skin on your face and neck, then this can be trimmed and tightened during the procedure.

You may not be suitable for this procedure if you suffer from certain medical conditions. Heavy smokers are also not ideal candidates for any type of surgery as they are at more risk when undergoing general anaesthetic. If you do smoke, you’ll be asked to stop at least two months before the procedure, as smoking can also delay the healing process.

Having a thorough consultation with a qualified face-lift surgeon is the only way to discover if the procedure is suitable for you.

A face-lift can turn the clock back 10 or 15 years, giving you a younger more rejuvenated look. It can address concerns associated with ageing such as sagging skin, wrinkles, loose facial muscles and loss of definition of facial contours. Having a face-lift can give you much more confidence in the way you look. Like all surgery, a face-lift procedure does carry some risk, so it’s important you weigh this up against the benefits before making your decision to undergo surgery.

A face-lift is generally a very safe procedure, which provides very good long-term results, however although there are many benefits there are also a number of risks and potential complications associated with the procedure, which should be carefully considered before you make the decision whether or not to go ahead with surgery.

Most of the side effects are temporary, and could include blood or fluid retention under the skin, crusting of scars, problems with skin healing, skin or hair loss (this is very rare) and numbness. There is also a low risk of nerve damage.

Other complications and side effects of a face-lift include infection, swelling, scarring, bruising, hematoma, and reaction to the anesthesia. The risks of these complications occurring can be minimized by carefully picking your surgeon and following the post-surgery recovery instructions.

Infection

Infection can occur with any type of surgery. It usually happens within one to six weeks of surgery. In the majority of cases an infection can just be treated with antibiotics. Symptoms of infection include fever as well as severe tenderness, redness, and swelling.

Swelling

Swelling is very common following facial surgery. It is usually at its worst 24 to 48 hours after surgery. Swelling is simply the body’s natural reaction to an injury, and it will subside as the body begins to heal itself. Swelling will probably start to subside after just a few days, though you will probably still notice some swelling several weeks after your face-lift surgery. You can help reduce the swelling by keeping your head elevated as much as possible and avoiding excessive or strenuous activities that increase blood flow.

Scarring

Scarring will occur with any kind of surgery. Your scars will usually remain pink for a few months before turning a less noticeable white. The locations of your scars will depend on the technique used by your surgeon. In most cases scars will fade over time and will not be noticeable as they are usually hidden in the hairline. More skilled surgeons are able to keep scarring to a minimum, so it’s important you choose a surgeon that has proven experience in performing face-lifts.

Bruising

Bruising is fairly common after any surgery although not everyone will experience it. The amount of bruising you get will depend on the skill of the surgeon and the individual patient. Bruising tends to be at its worst in the first few days of recovery after face-lift surgery, and is usually more visible around the eyes. While bruising is usually very minimal, if you have any large, firm, painful areas of bruising, contact your surgeon immediately as there is the possibility of developing a hematoma, which is a more serious type of bruise that will need treatment. However normal bruising should subside in one to two weeks. Hematoma is a serious complication involving blood accumulation beneath the skin. It can leave the area painfully swollen and additional surgery may be required to stop the flow and remove the blood. A Hematoma is a serious risk after having a face-lift so make sure you follow your surgeon’s instructions carefully.

If you have had your face-lift under general anesthetic, then you also need to consider the risk associated with this. You can experience side effects from anesthesia, such as a sore throat, headache, dizziness, nausea, vomiting, shivering, or muscle pain but these are usually temporary. It is very important that you let your surgeon know if you have experienced any reactions to anesthesia in the past.

Most people experience some pain and discomfort following face-lift surgery however severe or sudden pain should be reported to your surgeon immediately.

The likelihood of serious complications arising from the procedure is typically influenced by the surgeon’s skill as well as your individual response to the surgery. However, these severe risks can be avoided by following your surgeon’s advice and instructions.

Before making the decision to have a face-lift, you should find out as much information as possible about the procedure, the surgeon and hospital you are being treated at.

You should also have a consultation of at least an hour with your surgeon before going ahead. Do not be afraid to ask any questions and make sure all of your concerns are addressed before you sign on the dotted line. It is also a good idea to ask the surgeon if you can see before and after pictures of the previous work so you can see what results they have achieved with other patients. The most important thing is to make an informed decision that you feel confident about.

During your consultation your surgeon should take a thorough medical history and give you a consent form to sign to make sure you fully understand the possible risks and complications. It is very important that you read this form carefully. It is also important to make sure your surgeon is aware of any medical conditions you may be suffering from such as high blood pressure, heart disease, and bleeding disorders, as these can increase the risks associated with surgery.

After examining you your surgeon will explain your options and recommend what type of procedure(s) you may need to achieve the best result. They may recommend combining your face-lift with a brow-lift or neck-lift or facial implants.

To prepare for your surgery you should:

  • Avoid taking aspirin or anti-inflammatory drugs for a period of 10 days before your surgery, because they cause the blood to thin and make surgery more dangerous
  • Give up smoking at least two months before the procedure, as it increases the risks and can delay the healing process.
  • Avoid drinking alcohol
  • Continue to take prescription and daily medicines as long as they have been approved by your surgeon It is advisable to wash your hair thoroughly the day before your surgery to minimise the risk of infection and make sure you get a good night’s sleep. You should also not drink any alcohol before having surgery.

How long your face-lift takes, where it is done and whether or not you have a general anesthetic or not will be determined by the extent of surgery you are having done.

Face-lifts are usually performed under a general anesthetic, although some types of face-lift can be performed under local anesthetic so you are sedated but awake during the surgery. One of the biggest risks of any surgery is going under general anesthetic so discuss your options carefully with your surgeon.

During surgery the surgeon will make incisions, usually in the hairline, to enable him/her to remove excess fatty tissue and tighten the underlying facial muscles. The skin will then be pulled back and tightened to smooth out wrinkles before it is stitched and stapled back up. Exactly how the surgery is done and where the scarring will depend on the type of face-lift you are having.

A face-lift typically takes between 1 ½ – 2 hours but may take 3 or 4 hours if you are having a brow-lift or neck lift at the same time. If the two procedures are going to take a long time, then your surgeon may decide to perform them on separate occasions.

Depending on the type of face-lift, your face-lift recovery may require you to stay overnight in hospital. After your surgery your face will be very swollen and you will feel drowsy from the anaesthetic so it is important to arrange for someone to take you home.

Your head will be bandaged to help reduce swelling and bruising and a drainage tube may be inserted to prevent blood and fluid from collecting under the skin. You will experience some postoperative swelling, numbness, and skin discoloration for about two weeks. Your skin may also feel very dry and tight. Pain medication can be taken to make you feel more comfortable.

You will need to take it easy for at least a week after surgery and even get someone to help you with everyday activities such as cooking and cleaning as it will make your recovery easier. You will also need to take time off work.

You should be able to go out in public after two weeks as most of the swelling and bruising will have subsided after this period of time. However, the length of recovery time will depend on the type of face-lift you have had. Full recovery can be expected to take up to six weeks.

You should be able to return to work after 10-14 days after a deep plane or mid-face lift. If you have had an endoscopic face-lift, thread face-lift or mini face-lift you may be able to return to work in as little as a day or two.

You should avoid showering or bathing until your surgeon says it is OK to ensure that the incisions and dressings are kept dry and to minimize the risk of infection. You should keep your head elevated for the first few days after surgery and try not to move too much to minimize swelling. You should also avoid blow-drying your hair, wearing earrings, drinking alcohol while you are recovering. Vigorous exercise, heavy housework and sexual activity should be avoided for at least the initial two weeks after surgery and saunas and steam rooms should be avoided for several months.

To ensure a speedy recovery make sure you follow your surgeon’s instructions closely during this healing period. Contact your surgeon immediately if you notice any signs of infection or if you experience bleeding or a sudden increase in pain.

There are many different types of face-lift surgery. These procedures differ in the type of incision used, the area of the face being treated and how invasive they are. The type you have will depend on your individual needs and will be discussed with your surgeon at your consultation. It is important to consider the specific areas that you want to improve, how long you want to spend recovering from treatment, and what your expectations are when making this decision with your surgeon.

Deep plane face-lift or SMAS lift

The deep plane face-lift has long-lasting benefits as it treats the underlying tissue layers and muscles improving nose to mouth lines (nasolabial folds) and giving you a more defined jaw and chin. It is the most invasive face-lift procedure but can give quite dramatic results with the effects lasting for 10-15 years. It is the most common type of face-lift performed and is particularly good for older people with severe facial sagging and laxity.

During the procedure, tissue in the mid facial region and the cheekbones is lifted and repositioned. The skin and tissue lifted is thicker, so there is less interruption of the blood supply to the area. The procedure often requires incisions along the hairline so that the facial muscles and upper fatty tissue layers can be easily lifted and repositioned in the area of the cheekbone and mid face. The facial muscles are lifted and repositioned along with the fatty layer above them; these are then secured to achieve a more youthful appearance. This is often a better technique to use for smokers.

Mid Face-lift

By the time we reach our mid-30s the soft tissue from around the cheekbones starts to lax and sag slightly, creating nasolabial folds. This flattens the mid face area and may make a woman’s face look slightly masculine.

People between the ages of 40 and 50 are the most ideal candidates for a mid face-lift or if you have cheeks that appear to be sagging and the nasolabial area has skin folds or laxity.

The procedure often requires several small incisions along the hairline and inside the mouth so that the fatty tissue layer(s) in the affected areas can be lifted and easily repositioned. This also means that scars are practically non-existent. The natural fatty layer over your cheekbones is lifted and repositioned. The benefits of a mid face-lift include the improvement of nose-to-mouth lines and the roundness over the cheekbones, restoring a more youthful appearance.

Mini face-lift or ‘S’ lift

The least invasive type of face-lift, the mini lift offers a more temporary solution to facial ageing with less downtime. It is sometimes known as the ‘S’ lift because of the type and shape of incision used or the ‘short-scar’ face-lift. The incisions will usually be made from the hairline around the ear with the scars hidden in the natural crease of the skin. The mini-lift is used to reposition the skin and soft tissues of the face and can often be performed with an endoscope. Once this has been achieved, the surgeon carefully repositions the skin using small sutures. This type of face-lift is particularly suitable for younger patients with premature ageing who are not ready to have a full face-lift. Because it is less invasive it involves a shorter recovery period.

Thread Lift

A thread lift or feather lift as it is sometimes known is a less invasive option to surgery, which is popular with people in their late 30s to early 40s who seek minimal improvements to treat sagging or laxity in the eye area, forehead, and nasolabial folds.

The thread lift can be performed under local anaesthesia. The doctor uses a barb suture technique. In this technique, barbs that act as a hook are used with threads to gather skin layers in an upward direction thereby tightening the skin. The thread itself, which has small barbs to hold the skin in place, is not reabsorbed or dissolved and remains in place. No skin is cut away and only the barbs on the threads give the lifting effect.

Complications may include the appearance of lumps, puckering skin, or the visibility of threads. Treatment for complications can range from oral medications to surgical intervention. A thread lift may provide a benefit for up to five years.

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