Face Lift or Neck Lift
A facelift is an operation performed to improve your face and neck to a natural, more youthful looking state. The procedure is best suited to treating the lower half of the face. It addresses the deepening folds running from the corner of your nose to your mouth (the nasolabial folds), sagging jowls, wrinkles and a sagging neck.
A neck lift is a similar procedure but the scars are shorter and located behind the ear and under the chin. In extreme cases a scar can be placed directly over the loose skin in the chin area. The neck lift only addresses the neck itself and not the soft tissues of the lower face.
What does the surgery involve?
I perform two types of facelift depending on what you want to address and how much you would like to achieve. Shorter procedures have less potential complications and recovery time. However, the results are very subtle and do not last for as long as the full procedure.
A one-stitch facelift is a less invasive alternative to the full facelift. You can return to work the next day and the hair easily covers scars as they are healing. Small scars are hidden in the hairline at the sideburn area and occasionally there is a small incision under the earlobe. The incisions are closed with dissolvable sutures that do not need to be removed. The procedure takes 45 minutes to perform and is carried out under local anaesthetic. No overnight stay is necessary.
This form of facelift carries minimal risk and will last for approximately 1year, at which stage it can be repeated. It does not improve the neck at all. The cost of the repeat lift at a year is included in your quote so there are no extra fees. I often perform fat grafting and chin liposuction at the same time as the one stitch facelift and I believe a tailor made rejuvenation plan is essential to getting the best result. Most patients choose to have a very short general anaesthetic if we combine a one-stitch facelift with these additional procedures.
A MACS (minimal access craniofacial suspension) facelift/ necklift goes beyond just tightening the skin. It extends below the skin to the deeper more fibrous layers. Tightening this deeper SMAS layer (superficial musculo-aponeurotic system) allows the underlying facial muscles to also be lifted. These muscles, just like the skin, droop with age. During the same operation, I often perform fat grafting to fill in wrinkles or grooves and to replace volume from areas where it is desirable (such as lips or cheeks).
A small area of liposuction can also be performed to remove the fat pad at the chin. In general, incisions are made inside the hairline at the temple, extending down along the natural crease in front of the ear, curve behind the ear under the earlobe and horizontally back into the hairline. In a less extensive lift, a shorter incision can sometimes be made. If surgery is required around the jaw line and neck, a small incision under the chin may be needed.
Once the deeper layers have been lifted, the skin is re-draped, carefully removing any surplus before closing the incisions. Dissolvable sutures are used in the hairline, while the scars around the ears are stitched with a suture that needs removing after 6 days.
MACS facelifts are most commonly performed under a general anaesthetic (you will be completely asleep). The operation takes between three to five hours to perform depending on the area(s) to be treated and whether or not other procedures are carried out at the same time. You are likely to stay in hospital for one to two nights.
What are the risks and side effects of surgery?
Having cosmetic surgery can be a very positive experience. Complications are infrequent and usually minor. However, facelift surgery is a moderately big procedure and not without risk. It is important that you have a clear understanding of this.
Your face will be swollen, numb, tender and bruised following surgery. This will quickly improve and bruises can be concealed with makeup, as long as incisions are avoided whilst the wound is fresh.
Scar – scars on the face tend to settle remarkably well, so that they are barely perceptible. However, some patients heal with thick scars and this can make them more noticeable.
Bruising and swelling – this is very common and bruising may take a couple of weeks to settle.
Haematoma – a large blood clot can sometimes form if bleeding collects under the skin. If this does occur, it is likely to happen within four to six hours of surgery. Any increase in swelling or pain around the face should be reported immediately so that treatment can be given. Sometimes it is necessary for patients to have this blood removed with another short operation.
Infection – this is rare as the face has good circulation.
Wound healing problems – this problem is rare but more likely to happen to smokers, as nicotine reduces the blood supply. There is a risk that a small patch of skin behind the ear may form a black scab that falls off after a few weeks. This leaves behind an open wound that heals quickly but may result in a less than satisfactory scar. It is for this reason that you must stop smoking in a MACS facelift or the optimum result for you will at risk. It is very unlikely to occur in a one-stitch facelift, as the skin is not lifted beyond the area excised.
Nerve injury (the facial nerve) – weakness in parts of the face can occur. This is a very rare complication and usually, but not always, corrects itself in a few weeks once the injured nerve has had chance to recover.
Numbness – injury to sensory nerves can occur which can leave areas of numbness. A common area is the earlobe. This gradually improves as the nerves recover but permanent deficit is possible.
DVT/PE – following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and move to your lungs. If the blood clot is large enough it could prove fatal. In order to reduce any risks of this we give you special stockings to wear in bed and a blood thinning injection if you are not mobile.
All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss these with me.
What happens after the operation?
If you have had a one-stitch facelift under local anaesthetic you can go home straight after the procedure.
If you had a general anaesthetic procedure then you may be able to go home the same day or recommended to stay 1-2 nights depending on the extent of the procedure.
You will have non-absorbable sutures that require removing in 5-7 days. You will be able to have a shower and wash your hair once the sutures are removed. You will need to wear a support strap to help shape your chin and allow the tissue layers to heal in the best way. This should be worn for 2 weeks, although you can remove it to shower and apply cream to your incisions. Before you leave the hospital, you will receive a follow up appointment with the nurse for 1 week and an appointment with me for 4-6 weeks.
What is the estimated time for recovery, absence from work and return to usual activities?
Recovery times vary from one person to another and depending on which procedure you have had. A one-stitch facelift will routinely heal within 2 weeks and you can return to work the next day.
A full facelift is likely to require a minimum of 2 weeks off work and complete rest. If you have any concerns during this period, you must contact me or the hospital team for advice. In the unlikely event of an emergency, you are to visit your local NHS Accident and Emergency Department.
Remember to wear a high factor sunscreen over the scars (minimum factor of 15) when you go outside. This prevents pigmentation of the scars.
How much does the surgery cost?
Facelift / Neck Lift Compression Garments (PDF)
Pre and Post-Operation Instructions (PDF)
I hope you find this information useful. If you have any questions or require a little more information then please do not hesitate to contact me.