HMT Sancta Maria Hospital, Swansea

Facelift

As a natural part of the ageing process, our skin loses elasticity and begins to sag and wrinkle. Other factors such as smoking, sun-exposure and gravity also play a part. Substantial weight loss can result in excessively loose skin around the face, just as in other areas of the body.

Initially, a person may notice the appearance of fine lines and wrinkles around the mouth and eyes. Eventually, the lines and folds become deeper, leading to sagging around the cheeks, jawline, chin and neck. Other treatments, such as injectable dermal fillers, are no longer effective. The rate at which this happens varies between individuals. Many people have a facelift in their 40’s, whilst others may be in their 70’s or older.

Treatment

A facelift is a surgical procedure to tauten the skin and to remove any excess. Often, the underlying muscles also need lifting. The treatment improves the tone of the cheeks, jowls, chin and neck area. Heavy, drooping brows and wrinkles of the forehead require a separate technique, known as a brow lift. Often, the brow area can be improved with wrinkle relaxing injections, dermal fillers, or chemical peels, without the need for surgery.

Procedure

The incisions are made within the hairline, starting at the temples, and continuing down the front of the ear, around and behind the earlobe, and into the lower scalp.

Occasionally, only the skin is lifted and tightened, but usually, the underlying muscle also needs to be lifted and sutured into a tighter position. The direction of the lift is upwards and backwards. The surgeon may also use liposuction to remove excess fat along the jawline and/or chin.

Sometimes, an additional incision is required under the chin, to achieve sufficient tightening of the platysma muscle in the neck and chin area.

The deeper tissues are sutured into position, but staples are often used to secure the superficial skin layer. Two wound drains will usually be inserted to reduce the collection of blood and fluid around the wound area.

Bandages and padding are applied firmly, to reduce swelling and bruising around the area. 

Limitations

A facelift should look natural, and it should not be obvious that you have had surgery. The object is to achieve a more toned and youthful appearance, but you may still have fine lines, for instance, around the mouth.

Any lines or sagging in the upper face would require other treatments, such as wrinkle relaxing injections, or a browlift.

The ageing process continues, and in time, further sagging and drooping will occur. However, even then, the effect of the facelift means that you will not look as old as you would have done without having had the procedure.

A small number of people may have unrealistic expectations, and may be disappointed with the result. A qualified, experienced plastic surgeon will explain what can and cannot be achieved in each individual case.

 What to expect following surgery

You will have some degree of bruising and swelling in the first few days following surgery.  In women, it is easier to disguise with makeup, and the incisions are largely hidden behind the hairline. In men it may be more difficult to disguise the scars in the early days.

 It is normal to experience some numbness of the skin around the cheeks and ears.  It can persist for weeks or months, and in some people, there is permanent numbness of some skin areas.

You will be up and about with the help of the nurses the day following surgery. Most people can return to work after one to two weeks. Heavy lifting and strenuous activity should be avoided for at least three weeks. Before you leave hospital, you will be given details of your first follow-up appointment, and any specific instructions your surgeon may want you to follow.

Risks

All surgery carries potential risks, such as pain, bleeding, infection and delayed wound healing. These risks are increased if a person is overweight, diabetic, smokes, or is on certain medications such as aspirin.

In addition, potential risks specific to a facelift procedure include nerve damage, resulting in drooping of part of the face, and asymmetry, where the result does not appear equal on both sides.

The information contained in this website is not exhaustive. A full consultation with a suitably qualified plastic surgeon is essential to ensure that your individual risks are assessed, and to ensure that this type of surgery is suitable for you.

Sources/Further Information

· British Association of Aesthetic Plastic Surgeons (BAAPS)

· British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

· Department of Health  Cosmetic Surgery: Information for Patients (August 2006)

· NICE  Surgical Site Infection Prevention and Treatment of Surgical Site Infection (October 2008)