Surgical Face Lift

"Face Lift" or Rhytidectomy are the general terms applied to a variety of procedure that involve raising the facial skin so that hanging fold are reduced.

Ordinarily they involve the skin of the neck, the region under the chin, the cheeks and temple regions. Surgical correction of these facial conditions may be directed to several different areas in sometimes different ways. It must be sad that while the forgoing description deals in generalities, the individual must be studied carefully to determine which specific areas may require direct attention. In the absence of notable lower facial change, attraction is frequently directed entirely to the eyelids or brow area, since these are the earliest to show fullness or redundancy. Under some circumstances, elevation of the nasal tip as a modified nasal procedure will create a sufficiently youthful appearance so that the treatment of other areas may be deferred. The removal, or more often, the camouflaging of frown lines just above the nose may also have similar effects.

Classically, the basic operation is designed to lift, stretch, and remove the sagging skin while supporting the underlying facial musculature. There are various modifications in the basic procedure, all of which are designed to concentrate upon the most prominent deformities. the incision may also be changed if the hair pattern is high, low, sparse or full in the temple region. Male facelift incisions are planned to avoid or minimise interference with the normal beard pattern at the sideburn area. The varieties are infinite and each has it's own purpose or set of conditions, which may change even during the course of an already planned operation.

Surgical treatment of facial sagging will result in limited benefit where very fine skin wrinkles are the most prominent problem/ There are other means to achieve improvement of this condition that may be employed at the same time as the major face lift, or possibly during a secondary procedure. Sometimes it is not possible to correct everything at the one time; the risk jeopardising the final result can be increased of overenthusiastic attempts are made.

Along with the development of better surgical methods, there has been significant change in opinion concerning the optimum time for facial surgery. There is no need to wait until hanging folds or almost irreversible changes have taken place; while correction is perfectly possible in the late 60's or 70's. However, overstretched muscles with lack of tone, particularly in the eyelid region, can become more difficult to repair. Preference has shifted to the early 40's, or perhaps earlier under some circumstances, when limited corrections can often be made to maintain youthful appearances for an extended time. The selection of patients in the earlier age group must be based upon the character of tissue ageing and the degree of improvements that might be anticipated.

Finally there are several misconceptions regarding the face lift and eyelid operation, as well as the general ageing process that require additions explanations.

  1. There are no medications, creams, cosmetics or exercise that can significantly affect the ageing changes described here. Skin softening creams may be employed to some benefit to keep the skin in a healthy condition, but the structural changes are not affected. So-called chin supports or facial muscle exercises are worthless; the latter may, in fact, be harmful. Constant vibration massage may result in more rapid shrinkage of the underlying delicate fatty tissue and produce the opposite result from that which was intended.
  2. The result from a properly performed face lift can be lasting. The procedure cannot stop the ageing process; unfavourable appearances can however, be altered and delayed sufficiently to be helpful for many individuals in their adjustment to various social pressures.
  3. There are no substitutes for the face lift operation if sagging is predominant and muscle tone is poor. Tightening the skin alone in small areas without separating and stretching it over the underlying structures will be of limited value. The "mini face lift" performed in 15 days. An adequately performed operation requires two or three hours, sometime a bit longer, depending upon the individual circumstance.
  4. Over correction with restriction of facial motion is indeed a rare phenomenon, perhaps only apparent to limited degree during the early post-operative period when tissue swelling may still be present.

The normal course of events after this operation is perhaps best understood if you understand some of the technical details. As noted before, the customer incisions are placed in front of and behind the ear. As the skin is separated from the underlying tissues, the many small bleeding points are controlled by electro coagulation or surgical suture ties. Most of the bleeding is immediately reduced by the use of very small amount od adrenalin in the anesthetic solution. This part of the procedure is the most important and requires meticulous attention as the facial skin of muscles are elevated and stretched backward and upward. The remaining skin is removed and the edges are sutured at the incision lines.

It should be easy to understand now why the surgeon's instructions are primarily directed to elimination of undue facial motions (heavy chewing, excessive talking and laughing) immediately after the operation. Activity of the kind may produce undesirable bleeding under the skin, which may jeopardise final results. Any circumstances, which might lead to unusual blood pressure elevation, could have a similar effect upon bleeding, various medication may be employed to counteract this possibility. The reader should recognised that the forgoing description is simplified and that post-operative instructions will be modified as the individual circumstances dictate.

What are some of the risk?
In a well-performed and controlled operation, there may still be some limited blood collection under the skin. This can be treated during the follow-up office examination and will not affect the overall results. Larger collections require earlier and more vigorous treatment and possibly the reopening of part of the surgical incision to remove clotted blood or to close small bleeding points. This complication is unusual, however. There may also be some temporary las in the normal activity of facial muscles. Most often, this delay is due to swelling in front of and slightly behind the ear and will disappear gradually. The surgical incisions will require special modification when the hair is thin and when some spontaneous loss has taken place earlier.

A number of other conditions must also be anticipated in the early post-operative period. There will be a feeling of numbness and tension in the neck and cheek areas as well as around the ear. This is the result of separating the small sensory nerve fibres in the skin during the operation, and will usually disappear within the first four to six post-operative weeks. Swelling and bruising of the skin (particularly the lower face and neck) subsides gradually during the early post-operative period leaving no ill effects. Temporary swelling around the eyes is also not uncommon shortly after the face lift operation. It usually takes four weeks to get back on top of things.

What will I look like immediately after the procedure?
When will I look good?
Your face will be swollen and perhaps bruised for two to three weeks. Five to eight days after the procedure you will visit the clinic and have the stitches removed. About two weeks after he operation you will be able to do back to work, socialise etc.

When can I use makeup?
As soon as the wounds are well healed - this usually takes about two weeks, you ma wear full makeup. You may use eye makeup or lipstick if that area has not been involved in the face lift. New makeup techniques may have to be adapted to accentuate your facial features.

For further information and an initial complimentary consultation with a counselor, please contact your nearest Australian Aesthetic Surgery Centre.