Christopher Thomson F.R.A.C.S
Ear, Nose and Throat & Facial Plastic Surgery
Phone: +64 (03) 356 0274
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Patient Information on Face Lift Surgery

Facelift surgery is designed to reverse the inevitable ageing changes experienced as a result of gravity acting on the structures of the face and due to the effects of sun exposure.

Facelift surgery is not one operation but often a variable combination of procedures reflecting the degree of descent of individual areas of the face and neck. In some patients elevation of structures in the forehead, mid face and neck are necessary whereas in others this may simply be limited to surgery to address the neck structures. Often it is difficult to treat one area in isolation as this can lead to an irregular appearance at the interface between these regions.

The general principles of facelift surgery involve careful placement of incisions to disguise these and to allow natural hair styles and to preserve natural hairlines. The facial and neck skin is undermined to a variable degree following which the layer deep to this, the so called SMAS (superficial musculoaponeurotic system) is identified, mobilised and elevated either by excising portions of SMAS or using sutures to hitch this layer up onto fixed points around the facial tissues. Repositioning of these tissues assists in the return of a more youthful appearance. It results in an excess of skin which needs to be redraped and trimmed appropriately to fit the contours of the incisions.

Typically incisions are placed in front of the ear, often in the crease immediately anterior to this extending superiorly (if necessary) into the temporal hairline and inferiorly around the back of the ear up into the hair bearing scalp. Frequently surgery in the neck in the form of liposuction is required to assist with redraping and defatting of neck tissues and it is also often necessary to plicate the platysma muscle in the midline in the neck through a small incision under the chin. This is a thin sheet of muscle which extends across the anterior neck and is continuous with the SMAS layer in the face.

Typically facelift surgery takes 2-4 hours. Because of the extensive undermining and the length of the procedure, antibiotics are advisable and are routinely used. Suction drains are usually placed at the end of the procedure and light pressure dressings are applied. Both the pressure dressings and the drains are removed the following day and frequently a lighter dressing is used by the patient for the following week.

Following your surgery you should expect a variable degree of bruising and swelling, a feeling of tightness in the facial tissues and a moderate degree of discomfort. Bruising typically takes about 2 weeks to fully clear and the swelling may take a month to finally settle. Makeup can be applied within a few days to help disguise incisions and bruising. Typically patients should expect to look about 10 years younger as the result of a successful facelift and this "time shift" should be sustained for the life of the patient.

Facelift surgery is not minor surgery and patients should be aware of the following issues:

  • The possibility of visible or broad incisions
  • Slight disparity in hair line alignment
  • Superior shifting of the tuff of hair in front of the ear
  • The risk of infection
  • The risk of haematoma formation requiring a return to theatre and drainage (2-3%).
  • Most of the above problems can be avoided by careful planning and meticulous closure without tension. Patients should avoid taking any form of anticoagulant medication for two weeks preoperatively and should advise of any homeopathic medications that they may be taking as some of these may have an anticlotting effect.
At the consultation, preoperative photography will be taken and close examination will be made regarding the thickness of skin, the presence of subcutaneous fat, the areas of the face or neck which are most aged and the pattern of the patient's hairline. You should take an opportunity to discuss freely with Mr Thomson the key issues that you wish to be dealt with at surgery. He will help you develop realistic expectations of what can be achieved by surgery based upon an explanation of the anatomy and a demonstration of the procedure.

Facelift surgery is an excellent operation to rejuvenate the ageing face.

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