As we grow older, the effects of gravity, sun exposure and everyday life stress become more noticeable on our faces. Deep creases appear between the nose and mouth; our cheeks drop; wrinkles and fat accumulate around our neck. A cervical facial lift cannot stop the process, but it can stop the clock, improving the most visible ageing signs, tightening facial muscles, getting rid of excess fat and repositioning the skin in the face and the neck. The facelift can be performed alone or together with other procedures such as a blepharoplasty or a rhinoplasty. A brow lift corrects the sagginess in eyebrows and the wrinkles on the brow and eyebrows. If you are thinking of undergoing a facelift, you will be informed about the basic details of the procedure, about when it is indicated, how it is carried out and what results to expect. However, it is unlikely that you get answers to all your questions, as they mostly depend both on personal factors and the plastic surgeon’s preferences. Should you have any doubt, talk to your plastic surgeon.
The ideal candidates for a facelift are men or women whose face and neck start “dropping” but whose skin still has some elasticity. Most patients are aged between 40 and 60 years old, but it can also be performed successfully on patients aged between 70 and 80. A facelift can make you look younger and improve your self-confidence, but it will not provide you with a completely different appearance, nor will it restore your health or vitality. Before deciding to undergo this surgery, ponder what results you would like to obtain and discuss them with your plastic surgeon.
Good communication between you and your plastic surgeon is essential. In the first appointment, your face will be assessed including your skin and the underlying bone structures. The different surgical possibilities will be discussed. Your health state will be tested including those conditions that can complicate the procedure such as high blood pressure, blood clotting or scarring problems. You must tell your surgeon if you smoke or take any medication, especially aspirin®. If you decide to undergo a facelift, you will be informed about the techniques and the type of anaesthetics that will be used, about where the surgery will take place, and about the risks and cost of the procedure. The procedures covered by the National Health Care do not include facelifts. Do not hesitate to ask your surgeon any doubt you may have, above all those regarding your expectations and the results.
Your plastic surgeon will give you specific instructions about how to prepare for the surgery, including some rules about food and liquid intakes, smoking and medicine intake or suppression and face cleaning. It is important to refrain from smoking at least one or two weeks before the surgery. If you have short hair, you might want to let it grow a little longer before the surgery to conceal the scars while they are healing. Following the instructions carefully will improve the conditions under which the procedure will be performed. Make sure as well a relation or a chaperon can take you home when you are discharged and there is somebody who can help you out for a few days if necessary.
The facelift is always carried out in an operating room in a clinic or hospital. Normally, after the surgery the patient stays overnight in the clinic, being discharged the following day.
The facelift can be performed under local anaesthetics with sedation, or, more frequently under general anaesthetics. This depends on the complexity of the surgery and the surgeon’s preferences. When performed under local anaesthetics and sedation, the patient feels relaxed and the face is numb to pain; under general anaesthetics the patient is asleep during the procedure.
A cervical facial lift normally lasts several hours or maybe more when it is associated to other procedures. The exact location of the incisions and the steps of the procedure can vary a lot depending on the structure of your face and the surgeon’s choice of technique. The incisions normally begin in the temples area and follow a natural line that runs just in front of the ears and goes on behind the earlobe and towards the back part of the scalp. If some work on the neck is required, a small incision can be made behind the chin. Generally, the skin is separated from the underlying fat and muscles. The fat around the neck and chin can be removed or liposuctioned in order to improve the facial contour. The underlying muscles and skin are then tightened and all excess skin is removed. After the surgery, a small tube can be placed behind the ears for a few days to drain any accumulation of liquid. A light bandage is also normally applied.
In brow lifts, the incision is placed on the forehead, concealed behind the hair or, in some cases, on the hairline. The skin in this area is separated from the underlying structures, drying up the muscles responsible for wrinkles and excess skin.
Normally, there is not much discomfort after the surgery. If there were, it could be easily relieved with the medication prescribed by your surgeon (if there were severe or persistent pain, you must inform your surgeon). It is usual to have some numb skin areas; this sensation vanishes after a few weeks or months. You must keep your head elevated for a few days after the surgery in order to reduce the swelling. Drainage tubes, if used, are removed after a couple of days; bandages are removed between the first and the fifth day after the lifting. Do not be surprised by the swollen and bruised appearance of the first days; remember that in a few weeks your appearance will go back to normal. Most of the stitches are removed within five days; the stitches and the staples in the hair are removed later. Most of the patients that undergo a facelift feel well after a couple of days, but you must rest for the first week. You must be especially careful with your face and hair, as they will be more sensitive for some time. Although your plastic surgeon will give you specific instructions, here are some recommendations: avoid strenuous activity for at least 2 weeks, avoid steam baths and saunas for several weeks and limit sun exposure for several months. Above all, you must rest and allow your body to use all its energy on a proper healing. In the beginning, your face may look a little strange due to swelling and your facial movements may seem a little slow. Some bruises may last for 2 or 3 weeks, and you might get more easily tired. By the third week, your appearance will be much better. Most patients resume work within 10 days and 2 weeks after the surgery. If necessary, you can use make up to cover the bruises.
When the facelift is performed by a qualified plastic surgery, the complications are rare and minor. However, each person has a specific anatomy, and different physical reactions and healing capacity, therefore the results are not completely predictable. There might be some complications such as bruising, the normally temporary injury of the nerves that control the facial muscles, infections or reactions to anaesthetics. Scarring difficulties are more frequent among smokers. Risks can be minimized by strictly following your plastic surgeon’s instructions, both before and after the surgery.
Results are very satisfactory and you will feel happy with them as long as you understand that the results are not immediate. Even after the swelling and the bruising are gone, the hair around the temples might be thin and the skin might be somehow dry and rough for a few months. The lifting scars will be concealed behind the hair and the natural skin folds of the face; they will, anyway, tone down with time until becoming barely visible.
A facelift cannot stop the clock; your face will keep on ageing with time, and you might even wish to undergo a new facelift after 5 or 10 years. However, the results are long-lasting; after several years you will still look younger.
– Information obtained from www.secpre.org