PROCEDURE

A facelift is an umbrella term for several techniques which addresses the consequences of ageing in the lower aspect of the face. These address different anatomical layers of the face such as the skin, the underlying layer (called the SMAS), and the plane between the facial bones and the thin layer overlying it (called the periosteum).

The basic principle involves making an incision in front of the ears (this is of variable length depending on the chosen technique and may extend around the earlobe and into the hairline behind the ears). The underlying SMAS muscle layer is lifted, and with it- the overlying skin, the redundant volume of which is trimmed.

As a general rule, the more invasive the technique the more long-lasting the result, but the downside of this is a longer recovery period.

Your options, with the pros and cons of each, will be explained to you during the consultation to help you make the right choice. Adjudicative procedures such as an upper lip lift, fat transfer, or earlobe reduction may also be undertaken to augment your overall result, if this is required.

A neck lift is a procedure to address sagging of the skin and the underlying muscle layer that may cause vertical folds in the neck or sagging tissue under the jawbone. Numerous techniques exist to address this by lifting the underlying superficial muscle layer laterally and fixing it to the area behind the ears, as well as bringing the anterior edges of the muscle together to tighten the entire muscle envelope. If there is too much volume under the chin, then several steps may need to be taken to address this, including removing the fat under the muscle, reducing small glands that help to make saliva, and thinning thickened muscles (if required). As with the facelift, once the muscle layer has been tightened, then any extra skin is trimmed.

RECOVERY

The operation time may vary between 3-6 hours and is usually performed under general anaesthesia. Local anaesthesia with or without sedation (or ‘twilight’ anaesthesia) may be offered with simpler techniques.

Again depending on the technique, you may be able to go home the same day, or the following day.

Recovery times vary depending on the type of procedure you are undergoing, and general health. It is advisable to allow 2 to 4 weeks to recover fully, and preferably 6 weeks before attending a social event.

You may have some bruising and swelling in the first week or two, and you will be asked to sleep with an extra pillow under your shoulders in the first few days to reduce this, as well as use a cooling facial mask.

At around the two- three week mark, the swelling and bruising will usually have resolved or reduced to the point where you can resume social activities.

It is best to avoid saunas for 2-3 weeks and vigorous sport for 6 weeks.

You may feel a tightness when opening the mouth and numbness of the cheeks and ears in the first few weeks. This usually improves with time but you may be left with an area of altered sensitivity of the skin.

RISKS AND POTENTIAL COMPLICATIONS

These will be discussed with you during your consultation, including the risks that may be specific to you if you have a significant medical history.

It is important to take your time and consider them carefully. You will have the opportunity to return for a second consultation to discuss them further, as well as any other queries you may have.

• Risks of anaesthesia (such as allergic reactions, blood clots, chest infections, a heart attack, or stroke)
• Scars
• Bleeding
• Wound breakdown and delayed wound healing
• Loss of blood supply to skin (smokers have a significantly higher risk, so they should avoid this procedure entirely)
• Change of the colour of skin
• Infection
• Weakness of fascial muscles (this is temporary in the majority of cases)
• Asymmetry
• Change in sensation
• Localised hair loss
• A change in the shape of the earlobe
• Overcorrection and under correction
• Collection of saliva under the skin- which may require aspiration with a needle, if the submandibular glands are reduced as part of a neck lift

You can find more information at the BAPRAS site