Getting older, we all start to notice the changes in our faces. Ageing may start with a few fine lines around the eyes as skin starts to lose elasticity and will eventually lead to loss of volume in the mid face with nose-to-mouth (nasolabial lines) becoming more prominent, and ultimately jowl formation and marionette or mouth-to-chin lines in later life.
Getting older, we all start to notice the changes in our faces. Ageing may start with a few fine lines around the eyes as skin starts to lose elasticity and will eventually lead to loss of volume in the mid face with nose-to-mouth (nasolabial lines) becoming more prominent, and ultimately jowl formation and marionette or mouth-to-chin lines in later life.
These age-related changes can be corrected with cosmetic surgery through a surgical face lift or rhytidectomy.
Both natural or intrinsic ageing – our genes – and extrinsic ageing – our lifestyles and environment – play a part in how our faces age, but all in gravity as well will be mean that we lose fat in the cheeks, skin starts to wrinkle and sag and create loose areas of skin, most noticeably in the low face around the jawline.
A rhytidectomy gets its name from the word rhytid which means wrinkles, so technically the procedure is more than a face lift as such but is a wrinkle-removing operation.
A face lift can be done as a full-face lift procedure or a mini facelift and this will depend on the severity of correction needed for loose, sagging skin.
The operation involves making minimal incisions in the skin to lift and reposition both the overlying skin and the underlying soft tissue and musculature framework so that it can be supported in its new place.
This results in a tighter, smoother, and more youthful appearance with a restoration of the jawline and removal of excess lax skin. The aim of face lift surgery is to improve the visible signs of ageing on the face, and often the neck as well.
Face lift surgery involves making incisions or cuts into the skin on the face, usually starting from above the hairline at the temples and running downwards along the front of the ear, then going under the earlobe and finishing behind the ear. By using this technique, it makes it much easier to hide any scarring from the incisions around the ear. If the jawline and neck is also being lifted, then further incisions will be made in the lower face, under the chin.
Once the skin and soft tissue has been exposed, the surgeon is able to pull the tissues into a new position by going backwards towards the ears and upwards at the same time. Excess skin can then be removed, and the skin stitched back around the ears. Depending on the extent of the face lift, the surgeon may also reposition and stitch in place some of the underlying fat pads or facial fat pockets to help with volume restoration and achieving a more youthful appearance. Once all is position, the face lift is complete and can be bandaged, sometimes using special support bandaging which helps to minimise swelling and bruising, whilst also helping to keep the tissue secure in its new position.
Face lift surgery is usually considered for men and women over the age of 40 and is more common in those aged 50 to 60+. You will be particularly suitable for surgical face lifting if you have a considerable amount of excess skin which will not respond well to minimally invasive or non-surgical face lifting options such as radiofrequency tightening, thread lifts etc.
A consultation will be held with our surgeon who will take a full medical history to discuss your suitability for the operation. Photographs will also be taken, and your expectations and concerns discussed. A decision to undergo surgery must not be taken lightly so you will be given time to think things through and reflect on all the information provided before you can book and schedule any surgery.
Face lift surgery is usually performed under general anaesthesia but can also be done under local anaesthesia and sedation, depending on the extent of the surgical intervention.
You can expect some discomfort post-surgery, especially as the original anaesthesia wears off, but you will be prescribed pain medication or advised on over-the-counter options that you can take to ease any pain.
A surgical face lift operation usually takes 2 to 3 hours depending on the extent of the surgery required.
As this is a surgical procedure, you will need to plan for time to recover from the operation. Generally, it can take 2 to 4 weeks to fully recover from the face lift surgery, during which time you will usually be off work and not engaging in your normal activities. Although you will not usually need to stay overnight after your operation, it is important that you make arrangements for someone to take you home and look after you initially as you will not be able to drive.
Post-surgery you can expect pain, tenderness, swelling (especially around the eyes and cheeks) and bruising, which may move down the face and develop further over several days. Some people also report a feeling of stiffness, tightness or having a numb face which is related to the swelling. Your head and sides of your face will be bandaged due to the incisions and stitches in place. Most pain can be managed with over-the-counter pain medication, and full aftercare advice will be given.
This will include not showering for 48 hours to avoid getting the area wet and sleeping in an upright position with your head propped up on pillows to aid healing and reduce swelling in the first few days. If you have non-dissolving sutures or stitches, these are usually removed after a week during a follow-up appointment.
Bruising is likely to last up to a fortnight, with redness at the incision points and scars fading after several weeks or months. Usually, these can be effectively hidden by your hair at the ears and should eventually disappear completely.
The full and final effects of face lift surgery can take up to 6 months to be visible as the body heals and adjusts to the lifting and tightening carried out during the procedure.
As with all surgical procedures, there are some possible risks with a rhytidectomy which may need further revision or cause additional pain. These side effects include a haematoma or build-up of blood under the skin which will require draining, as well as excessive bleeding or blood clot formation. Other notifiable risks include infection or an allergic reaction to the anaesthesia. In rare cases, there have been reports of nerve damage following surgery which results in a loss of sensation in the face or difficulties with facial movement.
Results from a face lift procedure are generally expected to last for approximately ten years, before further revision is needed. This varies by individual and is depending on your age at time of the operation, your lifestyle, including whether you smoke, and the rate of your natural ageing. You can expect to have a smoother, tighter skin appearance to your face and a more youthful restoration of your facial contours with loose skin and wrinkles removed.
Rarely patients may experience an asymmetry, most often in the positioning of the earlobe after the facial skin has been tightened back to the ear. This can be adjusted with further surgery.
