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General informationA facelift is a procedure that involves removing facial folds and wrinkles by tightening the skin, and usually the underlying tissue as well. If there is excess fatty tissue under the chin or deep folds in the neck, it may be necessary to lift this region as well. A facelift is performed by a plastic surgeon. The procedure does not address wrinkles on the forehead, round the mouth or on the eyelids. If you wish to have these wrinkles removed, you will need to undergo other forms of plastic surgery.
The different types of facelift
S-lift / mini faceliftThis procedure involves lifting only the central part of the face and, to a lesser extent, the neck. It is a less extensive procedure than a full facelift, and can therefore be carried out under local anaesthetic. The procedure is referred to as an S-lift because it entails removal of the S-shaped areas of skin immediately in front of the ears. Hence, the scars caused by the surgery are located in front of the ears. Generally speaking, an S-lift involves less risk than a full face lift.
Neck liftAs the name suggests, a neck lift involves lifting the skin in the neck region. This procedure is normally carried out under general anaesthetic, but can sometimes be performed under local anaesthetic. A neck lift leaves scars that are further back than S-lift scars, i.e. behind the ears and around the neck-hair line. The incisions are made in this area in order to maximise the effect on the neck. In some cases, a cut is also made under the chin so that the fatty tissue beneath the skin can be removed and stitches inserted to make the subcutaneous connective tissue and muscle tighter.
Full faceliftA full facelift is a more extensive surgical procedure that effectively combines an S-lift and a neck lift.
Brow lift / forehead liftIn this procedure, drooping eyebrows and forehead skin are lifted. Although the eyebrows and forehead connect directly to the face, brow and forehead lifts are often performed separately and do not form part of a full facelift. However, it is quite common to combine brow and forehead lifts with upper and lower eyelid correction.
Prior to the procedureShortly before admission for a facelift, your general health is checked and blood tests are performed. If you are taking any medicines, you should inform your doctor. Certain medicines (such as aspirin, APC and such like) should be avoided for ten days prior to the procedure. Furthermore, you must not smoke in the four weeks prior to the procedure, since smoking constricts the blood vessels and can impair the healing of wounds.
The procedureFor a full facelift, you are normally given a general anaesthetic. Mini facelifts, S-lifts and neck lifts, on the other hand, can usually be carried out under local anaesthetic. If you need a general anaesthetic, you should definitely stay overnight, and it is a good idea to do so even after a local anaesthetic. The surgery itself takes two to four hours. The skin of the neck and cheeks, together with the tissues beneath the skin, is freed across a large area, then pulled towards the ear. Any excess fatty tissue in the neck area can be removed via an incision made under the chin. At the end of the procedure, the surgeon fits two drains (thin tubes) to allow blood and fluid from the wound to run out. These are then removed the next day. The stitches are not dissolvable.
AfterwardsAfter a facelift, you need to wear a supportive elastic hat for between five and seven days. If drains are fitted, the doctor will normally remove them the day after surgery. Following the procedure, your face and neck will be swollen and discoloured. This will take about two weeks to subside. You are unlikely to suffer significant pain, however. The stitches are removed one to two weeks after the procedure.
RisksA facelift entails the risks associated with any form of surgery. Postoperative bleeding and infection are both possible. Sometimes, a facial nerve can be temporarily disabled, leading to short-term local paralysis (e.g. a mouth corner that droops or an eyelid that cannot be fully closed). In serious cases, skin tissue necrosis can occur. Fortunately, such serious complications are rare in the extreme. Other complications that sometimes follow a facelift include the collection of fluid at certain points and the development of stiff patches on the face. These should disappear of their own accord, but you can also have them treated by a beautician or a skin therapist. The scars left by a facelift are more likely to be visible on a dark-skinned person, necessitating permanent camouflage.
OutcomeThe final outcome of a facelift is not apparent for several weeks. The scars always remain visible on close inspection, but are not usually noticeable in day-to-day life. They start under the hair at the temples, and continue down in front of the ear. At the ear lobe, they turn back up behind the ear before disappearing under the hairline. With more extensive procedures, there may also be a small scar under the chin as well. The effect of a facelift generally lasts five to ten years, after which time further surgery may be needed.
FinallyThe purpose of a facelift is to remove loose skin and make the face smooth again; it will not remove facial wrinkles caused by the way you laugh or talk, for instance. Such wrinkles are inherent to your face and cannot be eradicated. Nor will a facelift completely take away fine lines around your mouth and eyelids. Removal of these lines requires additional treatment. You can discuss such treatment with the plastic surgeon, who will advise you on the best course of action. It is also important to recognise that the natural ageing process of your skin cannot be halted by a facelift; the gradual loss of elasticity will continue after the surgery.
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Plastic surgery
