Frequently asked questions about Facelift and Neck Lift Surgery

 

What is facelift surgery?
What is neck lift surgery?
What does facelift and neck lift surgery involve?
What should I expect in the recovery period after facelift or neck lift surgery
Is facelift and neck lift surgery safe?
How long does facelift or neck lift surgery last?
How do I arrange a consultation about facelift or neck lift surgery with Mr Hamilton in London, UK?

 

What is facelift surgery?

Facelift is probably a poor term for this facial rejuvenation surgery and no longer refers to a single procedure but to a wide variety of procedures which have been designed to address the various changes seen in the ageing face. These procedures are intended not only to correct skin laxity but also, more importantly, to reposition the deeper supporting structures of the face which contribute to a well-rounded, youthful appearance. The procedure chosen must be tailored to the individual patient and will be discussed in detail at consultation. Mr Hamilton will be happy to recommend the best procedure for you and will give an honest opinion of your suitability for surgery.

Skin only facelift

The original type of facelift, only the skin of the face is tightened. This can be suitable for some patients but will usually not give a very long-lasting improvement in appearance.

Deep plane (SMAS) lift

Below the skin of the face is a deeper layer called the SMAS (Superficial Musculo-Aponeurotic System) to which the skin of the face and many of the muscles are attached. Tightening this layer can often give rise to significant facial rejuvenation and increase the longevity of the improvement.

Subperiosteal facelift (Mask Lift)

In some (often younger) patients where the main problem is loss of volume in the middle of the face and over the cheekbones, the fat can be repositioned higher by means of incisions hidden in the hairline and mouth. This restores the gentle curvature over the cheekbone seen in the young face.

Endoscopic facelift

The subperiosteal lift can, in some cases be performed using a surgical telescope to reduce the length of scars required. That said, in many cases highly acceptable short scars can be employed without the use of a telescope.

Short scar facelift / MACS Lift (Minimal Access Cranial Suspension)

In the short scar or MACS lift, a smaller incision is made in front of the ear without extending up behind the ear and a series of sutures are placed in the SMAS layer (see above) to tighten the tissues of the cheek and neck. This type of lift can be helpful where there is little loss of elasticity in the neck and the majority of correction required is in the middle of the face and around the sides of the mouth. 

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What is neck lift surgery?

A neck lift is a procedure intended to tighten the tissues of the neck, improving the jawline, reducing the appearance of jowls and softening the bands of muscle which often run down from the jaw to the neck as the tissues age. It is sometimes called Platysmaplasty. Neck lifts are usually carried out as part of a facelift and many can be carried out through the same incision used for the facelift without additional scarring. Occasionally, a small hidden scar is required just under the chin, particularly where extensive muscle “bands” are present.

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What does facelift and neck lift surgery involve?

What happens when I come into hospital for facelift surgery?

You will be admitted to the hospital on the day of surgery and be seen in the ward by Mr Hamilton and the anaesthetist. The areas intended for correction will be re-discussed and some pen marks placed on your skin to guide the surgery.

What type of anaesthetic is used in facelift surgery?

Facelifting and necklifting are usually carried out under general anaesthetic administered by an experienced consultant anaesthetist. Patients have the opportunity to discuss the anaesthetic with the anaesthetist prior to the surgery.

What does the operation involve?

In theatre, after the anaesthetic has been given, Mr Hamilton will prepare you for surgery, initially tying your hair out of the way (no hair is cut during the procedure). The skin incision is marked then a mixture of saline and local anaesthetic is placed in the cheek to reduce bleeding and the amount of general anaesthetic required thus improving the safety of the procedure and the speed of recovery. The skin is then lifted from the cheek and, depending on the individual procedure, the deep SMAS layer is lifted and tightened. The neck is then adjusted and any excess skin or fat removed. Sometimes a small amount of fat may be sucked out (liposuction) and indeed a small amount may be re-injected in areas which need more. The skin is closed using very fine sutures which are designed to be very easy to remove and a soft bandage is placed on the cheeks without covering the eyes, nose or mouth. In some patients, additional procedures such as forehead lifting or eyelid adjustment (blepharoplasty) may have been planned and can be carried out under the same anaesthetic. The anaesthetic is then reversed very gently and you will be returned to the recovery area and then to the ward.

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What happens after facelift or neck lift surgery? What should I expect?

Usually, after a gentle night in hospital, you will be able to go home the following morning, after your hair has been washed. It is best to take things easy, avoiding bending down too much and exercising for several days. The swelling experienced tends to increase on the first and second postoperative day before setting over the next week or two.

Depending on the exact procedure, you will be seen back at the consultation room 5 to 7 days after surgery when the sutures will be removed and general advice on recovery and scar management to speed up your progress will be given.

Typically, another review appointment will be made thereafter to see the final result.

Most of the bruising and swelling settles in the first 2 weeks and many patients are able to return to normal activities at that stage. Sometimes, things can take a little longer to settle (particularly in patients undergoing more extensive procedures) and it may be wise to allow a little longer just in case.

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Is facelift and neck lift surgery safe? What are the risks?

Fortunately, the risk of significant, long lasting complications in facelift and neck lift surgery is very small. There are some problems which can develop though these tend to be temporary and short term.

• Bleeding under the skin (haematoma) – due to different local anaesthetic solutions and careful anaesthetic technique, this problem is seen less frequently in modern facial rejuvenation. It is seen more commonly in men undergoing surgery and in patients taking blood-thinning medication such as aspirin and other non-steroidal painkillers such as ibuprofen (Brufen) or diclofenac (Voltarol). These medications are therefore best avoided pre and postoperatively. When a haematoma does occur, it may be simply removed by aspiration though very occasionally some sutures need to be removed to wash the area out and the wound reclosed. It does not usually affect the eventual result.

• Numbness and nerve damage – some numbness in the area of the lifted skin and on the ear is normal after this type of surgery and will usually slowly return to normal after surgery. A feeling of “pins and needles” is normal as this sensation recovers. The motor nerves which move the face must be carefully protected in facelift surgery. Cases of damage to these nerves have been described in the medical literature though it is exceedingly rare. In the vast majority of these, recovery was complete over a period of 2 to 3 months following surgery.

• Hair loss – Hair loss is rare with careful technique and more common in smokers. Where is does occur it is typically seen on the scar itself or in the region of the temple and settles slowly over a few months.

• Infection – Infection is rarely seen in facelift surgery and routine antibiotics are not required post-operatively. However, as with all surgical procedures, infection occasionally occurs and antibiotics are sometimes needed.

• Slow healing – Scars from facial rejuvenation surgery usually heal very well and quickly. Occasionally the wound may be slow to heal, usually in the delicate skin behind the ear. This is fortunately rare even in smokers who are the patients at slightly higher risk of this problem.

• Scars - The scars resulting from face and necklifting are usually very well hidden and the patient can, after they settle, wear any hairstyle he or she wishes. In a small proportion of patients the scars can thicken somewhat usually in the first couple of months (hypertrophic scars) and may need some additional treatment to encourage them to settle.

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How long does facelift or necklift surgery last?

This is a very sensible and common question. In truth, many factors affect this, including the genetic makeup of the patient, the quality of the skin and the surgery performed. It is fair to say that the benefits typically last 7 to 10 years. Although the surgery “turns back the clock” by improving the freshness and youthfulness of the appearance, aging still continues and further change with time is inevitable. Rejuvenation surgery, however, gives long-lasting benefit which persists despite the ageing process.

Summary

For the appropriate patient, facelifting and necklifting can give very pleasing, long-term results. With careful planning and attention to detail a less tired, more youthful appearance can be achieved. Mr Hamilton will be happy to discuss your suitability for these procedures at you consultation and to give an honest and friendly opinion on the results which might be achieved.

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