Face Lift

With age, there are some facial bony structural, soft tissues and skin changes in the face and neck. These changes often result in skin wrinkles and creases, progressive volume changes and soft tissue ptosis and general structural atrophy. Commonly, these visible signs of aging are characterized by:

  • Sagging skin in the midface
  • Prominent nasolabial folds or deep creases at nasolabial region
  • Deep creases below the lower eyelids
  • Displacement or loosening of facial fats
  • Prominent jowls due to loss of muscle tone in the lower face
  • Increased skin laxity and fat deposition under the chin and jaw giving rise to double chin appearance

Facelift or rhytidectomy is a cosmetic surgical procedure to reduce the visible signs of aging in the face and neck. The approach to face lift often begins with skin incisions in front of ear canal, extending upward to the hairline at the temples and continues below and behind the ear. Following the exposure of facial soft tissues, fat tissues from the face, jowls and neck are sculpted and redistributed. Its underlying tissues namely the deeper layers of facial tissues and muscles are also lifted and repositioned. The facial skin is then redraped over the uplifted contours and excess skin is trimmed. At the end of the surgery, drains (tubes to remove fluid from the wounds) are often inserted and incisional wounds are closed with sutures.

Facelift surgery can be done as a single procedure or combined with other cosmetic surgical procedures for facial rejuvenation purposes:

  • Brow lift (to correct the sagging eyebrow)
  • Blepharoplasty (to rejuvenate aging periorbital region)
  • Liposuction (to remove excess fat in lower face or neck to improve the jaw line and neck contour)
  • Fat grafting (to augment or recontour certain areas of the face)
  • Facial implants
  • Laser resurfacing or chemical peel (to improve tone and texture of facial skin)

Ideal candidates for facelift

  • Patient who has a positive outlook and realistic expectations in mind for the improvement of appearance
  • Physically healthy
  • Non-smoker

Preoperative evaluation for facelift

Communication is vital in order to achieve the patient’s goals. During the initial consultation, patients will have the opportunity to discuss their goals and desirable results with the plastic surgeon. The plastic surgeon will work closely with the patients to reach an agreement about the expectations from the surgical procedures involved and their long term benefits.  Every patient is different, therefore a specific treatment regimen is planned to suit an individual’s need.

The preoperative assessment for facelift may involve:

  • Discussion about patients’ expectations and desired outcome
  • Medical conditions, drug allergies and previous medical or surgical treatment
  • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
  • Examination of the face and its soft tissues
  • Discuss the options available for facelift and facial rejuvenation
  • Preoperative evaluation for types of anaesthesia
  • Photography for preoperative and postoperative evaluation

Preparation for facelift

  • Preoperative medical evaluation including blood investigations
  • Avoid certain medications or adjust your current medications
  • Stop smoking or alcohol for about 2-3 weeks prior to the scheduled surgery
  • Avoid taking aspirin and certain anti-inflammatory drugs and herbal supplements as they can increase bleeding and bruises

The risks and safety information on facelift

It is important for patients to understand that every surgical procedure has its own complications and down time. However, if a patient is assessed properly before the surgery and postoperative care is given adequately, these risks can be eliminated or reduced. The risks involved in facelift surgery may vary depending upon the nature of the surgical procedure.

Some of the risks of facelift include:

  • Wound infection
  • Poor wound healing (higher risks in chronic smokers)
  • Unfavorable scarring
  • Bleeding (hematoma)
  • Anaesthesia risks
  • Hair loss at the incisions
  • Facial nerve injury resulting in facial muscle weakness
  • Facial asymmetry
  • Numbness or other changes in skin sensation
  • Fat necrosis
  • Fluid accumulation
  • Skin contour irregularities
  • Skin discoloration, sensitivity or swelling
  • Possibility of revision surgery

Postoperative expectations

During the initial healing phase, patient may experience swelling, numbness, discomfort, bruises and discoloration around the face. These symptoms vary from each patient and they usually last for about 2-3 weeks. A compressive bandage or facial garment and ice compression are usually placed around the face for 3-5 days to minimize swelling and bruises. Drains to remove any excess blood or fluid from the operative field will be removed 1-2 days after the surgery. Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively. Stitches will be removed after 7-10 days.

Postoperative care

  • Follow the postoperative instructions given carefully
  • Head elevation especially when sleeping for 1-2 weeks
  • Take the prescribed medications as instructed
  • Compressive bandage or facial garment may be used for 3-5 days
  • Ice compression on the face for 3-5 days
  • Regular wound cleaning with antiseptic solution and antibiotic ointment
  • Allow gentle hair washing from second day post surgery
  • Avoid strenuous physical activities for 3-4 weeks
  • Make up to cover the bruises and discoloration may be allowed from third day post surgery
  • Regular use of sunblock for 3-6 months after the surgery

How much will a facelift surgery cost?

Cost is always a consideration in elective surgery. The cost for facelift can vary widely. Cost may include:

    • Surgeon’s fee
    • Hospital or surgical facility costs
    • Medical tests (blood investigations)
    • Anaesthesia fees
    • Prescriptions for medication
    • Post-surgery garment (facial garment)

Facelift surgery is a cosmetic surgical procedure. Therefore, most of the health insurance companies do not cover cosmetic surgeries or their complications.