As we age, our facial skin and muscle loses some of its elasticity and bulk plus there is a degree of fatty tissue loss which gives a slightly sagging, featureless look to the jaw line and neck.
A common question thus arises: “Surely I can only have a face lift once I am 60?” The answer here is that there is a wide spectrum of facial changes that can occur depending on skin type or previous sun damage etc and as such there is no specific age at which you should undertake this procedure. In other words people are assessed on an individual basis, just as they are for any other facial procedure
Before opting for a face and/or neck lift, it is really important to understand what it does and doesn’t deliver. It is a very useful technique to tighten skin and muscle plus to reposition fat in order to eliminate sagging. What it doesn’t deliver on is the removal of lines and wrinkles which are usually better dealt with by Botox or a skin resurfacing procedure.
Ultimately the aim is to re-establish your natural skin tone plus emphasise the well defined line of the jaw which gives a more refreshed, youthful appearance.
If you are a smoker, quitting 4-6 weeks beforehand will help the blood supply to the skin which will in turn improve the final outcome.
Full face-lifting is usually carried out under a general anaesthetic although some minor lifting or adjusting can be done under a local anaesthetic.
There are many methods employed to deliver a good result but, predictably, the starting point is always the incision which I endeavour to hide in the natural lines of the face. It starts in the hairline of the temple, is carried on down, hugging the contour of the ear and then loops around the ear lobe to travel behind the ear, ending up in the hairline behind the ear. If a neck lift is also being planned, a small incision is made under the chin.
The process now involves separating the skin from the muscle whereupon the muscle is tightened in both the face and neck using non dissolvable stitches. Once the deep tissues are “toned”, the skin is then re-draped with the excess trimmed and stitched using very fine stitches on the face and clips in the hairline. I like to cover the stitch line with chloramphenicol ointment to keep it moist and bug free plus I usually insert a small drain behind the ear that helps the skin the settle down minimising any “blood clot” (haematoma) formation. I remove the drain approximately 24 hours later. A thick pad of cotton wool is then applied and dressed with a firm crepe bandage in order to protect the face and give a degree of support.
• In order to prevent headaches and a feeling of pressure it helps to keep the head up. This will also help reduce any potential swelling and bruising although I would also advise the use of Arnica in the 24 hours pre and post-operatively, cool compresses plus avoidance of hot, steamy food and drink for a while.
• The bandages will usually be removed the following day to check the stitch line and to ensure that there is no haematoma formation. If there are problems these can be dealt with straight away. Once you leave hospital, the bandages should stay in place for 4-5 days and I will remove them in the clinic along with the small stitches in the face. The small clips in the hairline are left for another 5-7 days in order to help the healing process.
• It is not usually a painful procedure but paracetamol with codeine is given routinely (unless of course you have an allergy to either of these analgesics in which case I will supply an alternative).
• Hair washing (with help!) is possible once the bandages and stitches are removed at day 5. Try to avoid steamy baths and saunas for 2 weeks following the operation as this can also precipitate some bleeding.
• Avoiding alcohol consumption and smoking for 2-3 weeks post-operatively gives the best possible chance for a good outcome and will certainly help to avoid complications such as skin necrosis, poor healing and bad scarring.
• Tightness, swelling and numbness will gradually resolve over 2-3 weeks afterwards and avoidance of strenuous activity will help this.
• A shift in the hairline is usually slight but it is important to discuss this before the operation as it can be minimized depending on your hairstyle.
• Injury to nerves that control muscle movement or sensation to the lower ear are (thankfully) very rare but it is important to mention them as part of a fully informed consent process.