The facelift operation is technically known as "rhytidectomy". It is directed at lifting, tightening and smoothing out tissues of the face which have descended due to gravity and ageing over the years. It essentially addresses the jaw line (jowl area), cheeks and neck. It can be extended to lift the midface and can be combined with procedures for the eyebrows and forehead as well. In the past the same operation was used for everyone. Today we have a profusion of techniques which are able to address different problems.
Today a wide variety of face lifts operations are available giving more choice to the surgeon and patient. To name a few: MACS lift, endoscopic brow lift/full face lift, trans-blepharoplasty mid-face lift, thread-lift, composite lift etc. Fat grafting may be added to any of these. Just as no single key fits every lock, same facelift will not be applicable to every patient. The appropriate mix of techniques to rejuvenate the face will be decided after consultation.
Your consultation will involve a full medical history and examination to determine the individual features and tissue status of your face. You need to disclose your full medical history and all the drugs you are taking, including herbals. Use of Aspirin (even baby aspirin) and other blood thinners should especially be disclosed, as these drugs increase bleeding after face-lift (see preoperative instructions). Life-style, smoking, sun-exposure, hair styles preferred and social commitments all need to be discussed. Because of the numerous variables, not everyone will achieve the same results from a facelift.
The traditional facelift incision generally starts in the temple area of the scalp, runs in the fold in front of the ear, then around the earlobe and into the scalp behind the ear again. In the newer MACS lift the scar is much shorter and need not go behind the ear, however not everyone is a candidate for MACS lift. There may also be a small incision concealed under the chin. All these incisions can be hidden with the hairstyling and some makeup, and are generally not a problem. The skin is then undermined [lifted off] over a large area of the face and neck to expose a deeper structure called the SMAS. This structure is then lifted and fixed to the strong tissues of the upper face. This gives a lift to the sagging tissues. The skin is then re-draped over this new contour, excess skin is trimmed and the wounds closed. A drain tube or strip may be kept under the skin for a day to remove any excess tissue fluids. A bulky bandage may be applied.
After the operation, the face will be swollen and there will be some bruising. The postoperative course is not generally painful. Fortunately, significant complications from facelifts are infrequent but there are some issues that every patient must be aware of. The subject of risks and potential complications of surgery, however, are best discussed on a personal basis between you and your plastic surgeon.
It is important to realize that the time taken for recovery varies from individual to individual. Generally, the greatest amount of swelling occurs after 48-72 hours after surgery, but it may take several weeks before all the puffiness has resolved. The bruising may take up to two weeks to resolve completely, make-up can be applied before this time. There will be some numbness experienced on the face for several weeks after the operation, but this will resolve. You will be able to resume most all of your activities after a fortnight, and exercise in a month. You should be cautious about exposure to sunlight and become used to wearing a regular sunblock cream. Some of the side effects which you should be aware of include anesthetic reactions, hematoma (collection of blood underneath the skin), seroma and healing problems. Complications are more in smokers. In the MACS lift variant, the recovery is much quicker and complications are less.
The results of facelift surgery generally last for many years but will again be dependent on individual genetics and life-style factors. The changes may be subtle or dramatic depending on the goals you and your plastic surgeon have established prior to surgery, as well as of course how you look before surgery. Even though the aging process continues, people remain happy with their results and may opt for further procedures at a later date.
Refinements: Combining MACS lift and fat grafting as well as special barbed threads [Quill TM sutures] gives further refinements in the results while decreasing down-time. Simultaneous endoscopic forehead lift or blepharoplasty or endoscopy assisted neck lifts and liposculpture are also used if necessary, to provide a truly comprehensive make-over. Maximum attention to safety and prevention of complications make for safe outcome.
For minor sagging of the face, where a full face lift is not required a quick recovery procedure called the S-lift is available. This can be done under local anesthesia and the person can recover under a week.
All these refinements are available at our center.