Face & Necklifts

Introduction
Face lift (Facial Rhytidectomy, cervicofacelift) is a term that describes a wide range of surgical procedures aiming to rejuvenate aspects of the face. The SMAS is a layer of the face that may be used to resuspend and rejuvenate the midface, lower face, jowl and neck. SMAS – based facelifts may therefore be specifically tailored to provide a freshening of either the midface and lower face/jowl, or the midface, lower face, jowl and neck, or the neck alone. Very bespoke facelifts are therefore designed to suit the individual, always aiming for a comprehensive result and facial harmony. In combination with blepharoplasty (eyelid rejuvenation), cervicofacial liposuction and/or brow lift procedures, a total facial rejuvenation can be achieved if and when indicated.

The SMAS
Based cervicofacelift scar runs from the temple behind the hairline, along a preauricular crease of the ear, tucked beneath and behind the ear, and up into the hairline behind the ear. Rarely, a small incision under the chin may also be used. The scars remain well hidden, and shorter scars are often used for more the more limited, bespoke SMAS – based midface or neck lifts. A different specialist face lift technique involves a lift in the deepest layer of the face (sub-periosteal or ‘deep plane’, volumetric face lift), and this may involve a combination of incisions in the temple and/or behind the upper lip. We will advise as to which approach best suits your aims, and the risks and benefits of each approach.

The Operation
Face/neck lift procedures take from 3-5 hours depending upon the combination and complexity of the desired aims. General anaesthesia is usually advised. Hospital stay is one to two nights, and the recovering time is characterised by swelling and bruising. Pain is not usually a problem. The surgeon will place a small drain either side, and this will be removed painlessly on the first post operative day. Padded facial dressings are usually used for comfort and support. Cold compresses may be placed on the eyelids if blepharoplasty is undertaken in concert. The hair is washed in the operating theatre, and the patient awakes in a semi-elevated position, with supportive head pillows gently restricting head movement. A ward – based hairwash is undertaken on day two, and drains are removed. Small irregularities and uneven areas in the face are common, and will disappear with the early passage of time. Restriction of physical exercise, neck turning and head bending is prescribed for the first week, to reduce the risk of post operative bleeding. A facelift support garment is commonly used to provide control of facial swelling. Postoperative pain is not usually a problem, but appropriate medications are prescribed. The patients are discharged on the first or second post operative day, and are reviewed in the outpatients at three to five days for removal of an initial set of sutures. These incisions heal extremely well and all sutures/staples are usually removed by 2 weeks.

Recovery Period
Required time off work is usually of the order of three weeks, depending on personal preference thereafter. Swelling and bruising are minimal by the end of this period, depending upon the individual and surgical technique used. By six weeks the majority of the swelling has gone, sensation has returned, and the casual observer would not identify with recent surgery. Return to driving, housework and exercise are individually determined, but a restriction on bending, neck turning and aggressive physical exercise is usual for one month. Application of makeup is deferred for 3 weeks, but gentle hairwashing and moderate hairdrying are permissible at home. Stitches can be made wet and gently dried prior to their removal. Outpatient review is undertaken at 1 week, 3-4 weeks, 3 and 6 months and at one year.
Face lifting (by whichever technique), is associated with an extremely high patient satisfaction, and is usually achieved with the minimum of complication. The specific complication risk for each for each surgical procedure will be discussed on an individual basis by your surgeon. The desired effect of the more youthful cheek, peri-oral, and neck region is the common goal, and is most frequently achieved.