A facelift (or meloplasty) is part of a comprehensive approach to facial rejuvenation. Often, this is combined with neck lift (platysmaplasty), temporal or brow lift to reposition areas that have descended with age. Further, fat grafting or filler may be used to replace areas of volume loss.
What can I expect?
Facelift surgery aims to:
- reposition the skin and underlying SMAS (the deep layer of muscle and fascia between the subcutaneous fat and underlying bone).
- remove excess or lax skin.
- reposition descended fat compartments.
Initially, there may be some minor contour irregularities and small pleats which usually settle over the first few weeks. Post-operative swelling can take a some months to fully settle, while scars settle after six months or so. The end results should reduce the obvious signs of ageing whilst not creating an ‘operated’ appearance.
What happens before surgery?
The day of your procedure, you will arrive as planned to the hospital where all the staff will be expecting you. They will check your details and ensure all the preliminary paperwork has been done (there’s lots of this, but it’s really important). Before your procedure, your Anaesthetic Specialist will discuss your anaesthetic plan, including any pain medications you may need during your post-operative recovery phase. I will meet you again to make sure everything is taken care of, before drawing my surgical markings and any additional photographs as necessary.
What happens during surgery?
You will be under general anaesthesia, with state-of-the-art monitoring and safety protocols. There will be an incision along the temple hairline, down along the ear crease or just behind the tragus, then sweeping around the back of the ear and sometimes along the hairline behind the ear. Depending on your body and personalised requirements, facelift surgery may be performed as one of many techniques:
- SMAS plication- where the deeper layer of facial supporting tissue is gathered to a less lax position.
- SMASectomy- where the deeper layer of facial supporting tissue is repositioned and excess excised accordingly.
- Deep plane- where dissection takes place beneath this deeper facial supporting tissue plane, allowing release and repositioning of deep retaining ligaments to a less lax position.
- Minimal access cranial suspension (MACS) lift- where the deep layer of facial supporting tissue is lifted by sutures alone and not excised or folded.
Each of the techniques have slightly different advantages and indications which will be discussed with you. Once completed, the excess skin is removed and meticulously sutured closed. Often a small drain may be placed beneath the skin, before a surgical compression garment is applied.
What happens after surgery?
Most patients stay overnight in the hospital before going home the following day. We will review you closely over the coming days and weeks, depending on your individual treatment plan. Any drains are usually removed after a day or so. You will be given a compression garment, which we fit at the time of surgery and you should continue to wear this over the next 2-4 weeks.
While Richard and his team do everything possible to help you achieve the best outcome, there are some things that you can do to be an active participant in your recovery.
- Firstly, read and follow you’re the instructions we give you around surgery.
- Secondly, do not smoke or vape at all and avoid nicotine patches. This can easily cause wound problems ranging from delayed healing to suture line breakdown, and at worst, widespread skin death.
- Possible complications
The decision to undergo facelift surgery is a very personal one, and should only be made after considering if the potential benefits can achieve your aims, and whether the risks are acceptable to you. The possible risks/ complications of facelift surgery include (but are not limited to):
- Cardiac problems, including heart attack or arrythmias.
- Venous thromboembolism (including deep vein thrombosis and pulmonary embolism, which may be fatal).
- Blood loss requiring transfusion.
- Surgical site infection.
- Wound breakdown, delayed healing or protruding sutures.
- Conspicuous scars, including hypertrophic, stretched or migrated scars.
- Loss of hair growth around scars.
- Numbness (temporary or permanent).
- Facial nerve injury (temporary or permanent facial weakness, including paralysis).
- Fluid accumulation.
- Fat necrosis (some fat deep in the surgical field might die)
- Asymmetry, areas of tightness, pleating or contour irregularities.
- You should understand that other people will probably notice you have had facial surgery, and this may draw attention.
- Possible need for revisional surgery.