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With time, gravity, sun exposure, and the stresses of our environment, take their toll on our faces and necks. Deep creases appear beside the mouth (nasolabial folds), the jaw line becomes jowly, and the neck develops loose folds and fat deposits. A facelift can counteract these signs of ageing by tightening muscle, repositioning or removing fat and trimming excess skin to give your face a fresher look. Facelifts are most effective for patients who want to correct: Midface sagging; Deep creases between the nose and mouth; Jowls due to loss of muscle tone; Sagging areas of fat; and Loose skin and fat under the chin and jaw.

The spectrum of procedures to restore a youthful appearance to the ageing face has advanced considerably in the last few years. This is due to a better understanding of the changes that take place during ageing in the soft tissues and muscles of the face and has resulted in the development of a range of procedures that are applied on an individual basis depending upon an analysis of your specific requirements. The aim of a selected procedure(s) should be to produce a brighter, fresher more youthful appearance without a 'windswept' or 'operated' look.

If you are considering a facelift, it is important to understand that the texture of your skin will not be modified by the facelift procedure. Wrinkles, acne scars, age spots or creases around the lips will not be resolved by a facelift. Therefore, preconditioning with advanced skin care products or skin resurfacing with a chemical peel before or in conjunction with a face lift procedure to improve the skin and to improve wrinkles, age spots, etc., may be recommended. Furthermore, eyelid surgery or fat grafting is often combined with a facelift to help recontour the face and to help rejuvenate the skin through adipose derived stem cells. This will be discussed at your consultations.

The Surgery

You will come into the hospital on the morning of surgery. The operation is performed under general anaesthetic and usually takes between 3-4 hours, although this can be shorter or longer depending upon which type of facelift or additional procedures you are having performed. Drains may be placed which are usually removed the following day. When you wake up you will have a bandage/compression garment around your face and head. There are several types of facelift which have been developed to perform depending upon requirements. These include:

A "Full" facelift for rejuvenating the face, jowls and neck, including fat sculpting, lifting and repositioning of muscle and deeper tissues, and skin trimming and redraping. The incision begins at the temples and travels down in front of the ear, around the earlobe, and behind the ear to the lower scalp at the hairline:

"Short Scar" facelift for limited rejuvenation around the eyes and mouth, including nasolabial folds and other deep creases. The incisions are made at the temples and around the earlobe:

"Necklift" which concentrates on jowls, loose skin of the neck, and fat under the chin. The incision is made around the ear lobe and behind the ear to the lower scalp at the hairline:

"Midface Lift" which is performed through lower eyelid incisions often in combination with eyelid (blepharoplasty) surgery and is aimed at lifting the sagging fat of the cheek back to a more youthful position over the cheekbones, This operation also improve the creases around the mouth and nose but is not effective at improving jowls or sagging neck and chin tissue. This technique may also be indicated where previous eyelid surgery has resulted in excess exposure of the white of your eye below the coloured iris (Scleral Show).

Post-operative follow-up and after care.

You will need to stay in hospital overnight and possibly two nights and you will be discharged home with some painkillers. If drains are placed they will be removed the day following surgery. An appointment will be made for you to be seen one week after surgery, when the stitches or surgical clips will be removed. At first, you may experience swelling, bruising, altered sensation or numbness and a feeling of tightness in the face and neck. Your face may look uneven or a little distorted and your facial muscles may feel stiff. Most of these usually resolve within 2-6 weeks, and sensation typically returns to normal within a few months. Your scars will gradually become paler and less raised, lumpy or itchy with time.

Possible complications

Serious complications after facelifts are rare. The commonest problem is bleeding in the first few hours after surgery, which usually requires treatment by a prompt return to the operating theatre for a short time. This occurs in about 3% - 5% of all patients having a facelift. All procedures result in scars placed optimally in the hairline and skin creases. These are usually well hidden although they can be less than ideal if you have had any other complication such as skin edge necrosis or infection (both of which are more common in smokers). Some numbness in front of the ears as described above is usual but normally disappears after a few months. Rarely, nerves which work the muscles of the face can be damaged causing muscle weakness and reduction in facial movement although this often resolves after a few months.

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