Facelift

If you are bothered by the signs of aging in your face, a facelift may be right for you. Technically known as rhytidectomy, facelift is a surgical procedure to improve visible signs of aging in the face and neck, such as:

• Sagging in the mid-face
• Deep creases below the lower eyelids
• Deep creases along the nose extending to the corner of the mouth
• Fat on the face that has fallen or is displaced
• Loss of muscle tone in the lower face may create jowls

Rejuvenating Procedures

Other rejuvenating procedures typically performed in conjunction with a facelift are:

• Brow lift, to correct a sagging or deeply furrowed brow
• Eyelid surgery (Blepharoplasty) to rejuvenate aging eyes
• Neck Lift, to correct the excess fat and hanging of loose skin under the chin and neck area
• Non-Surgical Rejuvenation, to complement a facelift and address not-so-severe problematic areas that cannot be addressed by a facelift such as Botox for forehead wrinkles and frown lines between the eyebrows; or Dermal Fillers for thin lips and deep nasal grooves.

What it won’t do: As a restorative surgery, a facelift does not change your fundamental appearance and cannot stop the aging process.

A facelift can only be performed surgically; non-surgical rejuvenation treatments such as Botox^® and Dermal Fillers on their own cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate and complement the results of surgery.

The procedure - What happens during facelift surgery?

Anaesthesia
Dr Vrtik performs all her Facelift procedures under General Anaesthesia. This ensures your comfort during the procedure and allows optimal blood pressure control. This is important as high blood pressure is associated with increased risk of bleeding.

The incisions & soft tissue manipulation
Depending on the degree of change you’d like to see, your facelift choices include a traditional facelift or a limited incision facelift. A traditional facelift incision often begins in the hairline at the temples, continues around the ear and ends behind the ear in the lower hairline at the nape. Fat may be sculpted or redistributed from the face, jowls and neck, and underlying tissue is repositioned, commonly the deeper layers of the face. Repositioning is down by sutures which hitch or tightens this deep layer. The facial skin is then re-draped over the uplifted contours and excess skin is trimmed away. Deep sutures are often placed under the skin to ensure that the skin stay taut over the lifted facial soft tissues.

Incisions for a traditional facelift

An alternative to a traditional facelift uses shorter incisions at the temples and around the earlobe. This method is only effective if your face doesn’t have much loose skin and only some repositioning of the underlying fat and soft tissues is required. This technique does not allow much excision of excess skin. Access to and amount of suturing and hitching of soft tissues can be limited. Results are often not as dramatic as a traditional facelift.

Closing the Incisions
Sutures or skin adhesives are used to close the incisions. Once healed, the incision lines from a facelift are well concealed within the hairline and in the natural contours of the face and ear.

Watch an animated demonstration of a facelift.

Specific risks of facelift surgery

The decision to have a facelift is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Dr Vrtik and our staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.

The risks include:

• Unfavourable scarring
• Bleeding (hematoma)
• Infection
• Poor wound healing
• Anaesthesia risks
• Temporary or permanent hair loss at the incisions
• Facial nerve injury with weakness
• Facial asymmetry
• Skin loss (skin necrosis)
• Numbness or other changes in skin sensation in the ear and on the face
• Fatty tissue found deep in the skin might die (fat necrosis)
• Fluid accumulation (seroma)
• Pain, which may persist
• Skin contour irregularities
• Skin discoloration, sensitivity or swelling
• Deep sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
• Unsatisfactory results may include asymmetry, unsatisfactory surgical scar location, unacceptable visible deformities at the ends of the incisions
• Possibility of revision surgery - It may be necessary to perform additional surgery to improve your results or correct any unsatisfactory areas
• Deep vein thrombosis, cardiac and pulmonary complications

Most of the above-mentioned risks are very uncommon, and some people (with particular health problems or distinct facial characteristics), may be at higher risk for specific complications. Dr Vrtik will discuss this with you during your consultation if any of these risks are specifically pertinent to you.

Although Facelift is an effective procedure where the benefits significantly outweigh the risks, the degree of surgical success can be altered by how each individual’s body responds to surgery and healing. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure. Revision surgery may be necessary.

Be sure to ask questions: It’s very important to ask questions about your facelift procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings or concerns with Dr Vrtik or any of our staff members.

Use of fibrin sealants or tissue glue (Tissel®)

Fibrin sealants (made from heat-treated human blood components to inactivate virus transmission) are used to hold tissue layers together at surgery and to diminish post-operative bruising, bleeding and fluid accumulation following surgery.

This product has been carefully produced from screened donor blood plasma for hepatitis, syphilis, and human immunodeficiency virus (HIV). These products have been used safely for many years as sealants in cardiovascular and general surgery. This product is thought to be of help in diminishing complications and promote healing by adhering layers of tissue together.

Postoperative recovery

When your procedure is completed, a bandage is gently placed around your face to minimize swelling and bruising. You will be encouraged to sleep in a semi up-right position and icepacks may be applied to your face immediately after your operation.

A thin tube on each side may be present around the earlobe to drain any excess blood or fluid that may collect under the skin. These tubes and the bandages are usually removed before you go home. Once removed, you will be able to wash your face and hair in the shower; then a facial garment is placed, providing firm pressure and support on the suture lines and around your neck to prevent bleeding, fluid collection and provide protection to your wounds.

More information on postoperative instructions.

Expections and results

In contrast to non-surgical facial rejuvenation such as Botox® and some Dermal Fillers, the results from a facelift will be long-lasting. The visible improvements of a facelift appear when the swelling and bruising settle. The bruising often dissipate within 2-3 weeks, but it may take several months for swelling to fully subside and up to 6 months for incision lines to mature. Often, the full long-term effect of a facelift is not visible for at least 3-4 months after surgery.

You can expect that your final result should not only restore a more youthful and rested appearance, but also help you feel more confident about yourself.

The results of a Facelift can last from 5 to 15 years (or longer). This is dependent on your skin and tissue quality, as well as the type of facelift. Some people’s skin and soft tissue are more lax, thus respond to gravity more readily and therefore their results do not last as long as others. These are usually people who tend to develop stretch marks and have significant ‘sagging’ of soft tissues elsewhere on their body (e.g. breasts, tummies, buttocks). As for technique, limited incision facelifts do not allow as much ‘lift’ nor skin excision, thus results may have variable endurance. A repeat facelift can be done on suitable patients if required.

Enhancing your facelift

A variety of other procedures can further enhance the outcome of a facelift. They include:

• Dermal Filler augmentation or Fat Grafting to re-contour the facial structure or to support sagging, deflated soft tissue associated with aging
• Resurfacing techniques (such as chemical peel and microdermabrasion) to improve the tone and texture of facial skin
• Wrinkle reduction and prevention by Botox® injection

Please check with Dr Vrtik or our Practice Nurse if you would like to consider these options, as adequate time for recovery from your surgery is essential before any adjuvant treatment. Check out our non-surgical services at Creare Clinic for more information.

How to maintain and prolong the effects of your facelift?

Good Skin Care, life-long sun protection will help to maintain your rejuvenated appearance by minimizing photo-aging or sun damage. In addition, a healthy lifestyle will also help extend the results of your rejuvenated, more youthful appearance.

Vocabulary to know

• General anaesthesia: Drugs and/or gases are used during an operation to relieve pain and put you in a deep sleep.
• Haematoma: Blood pooling beneath the skin, usually due to bleeding under the skin.
• Tear trough: Deep creases below the lower eyelids.
• Nasolabial fold: Deep creases between the nose and cheek
• Jowls: A jaw line that sags into the neck, usually caused by loss of muscle tone in the lower face.
• Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
• Rhytidectomy: A surgical procedure also known as facelift, to reduce sagging of the mid-face, jowls and neck.

(Some Information & Illustrations are courtesy of the American Society of Plastic Surgeons).