Facelift

About Procedure
Forum
Before/After Photos

Facelift ranks among the most frequent aesthetic surgeries. Thanks to new methods in cosmetology and corrective dermatology the effects of aging on face can be successfully moderated and delayed. Facelift can be performed in women and men. In men the chances to hide scars are not so good (thinning hair) and, in addition, by pulling the skin the area where beard grows is moved close to and even behind the auricles.

Timing and method

The most frequent age group is between 50 and 60. It stands for facelift more than anything else that the surgery should be timed correctly. The surgery should be performed when facial skin is significantly lax (usually in the lower part of cheeks, on the edge of lower jaw and on neck in the area of double chin) and the elasticity of face tissue is widely reduced. In this case the effect will be a long-term one (8 to 10 years in average) because the face and neck tissues are not elastic enough to adjust to permanent moves of face mimics. If the surgery is performed too early, the effect after the surgery is good but elastic skin and subcutaneous structures will shortly adjust to usual moves and mimics and the effect of surgery disappears within approximately 2 or 3 years.

The face and neck lift can be, of course, repeated, however it is suitable only once or twice at most and always after a longer time period (approx. 10 years). If the surgery is repeated more times, in a 3-to-4 year interval, the result will be a stiff, mask-like face with thinned skin and risk of large tense scars.

The amount of slack skin on face and neck is rather individual as well as the amount of wrinkles. Therefore the surgery concentrates on particular areas on individual basis. Sometimes it is necessary to focus more on the neck area and the lower jaw angle, sometimes more attention is paid to cheeks and temples etc.

The amount and depth of wrinkles are also rather different. It is necessary to realize that wrinkles only reflect our usual mimics and the ability of skin to balance the tension of mimic muscles more or less. When skin is treated by facelift, it is stretched out and mimic wrinkles are smoothed and reduced. The surgery does not interfere with the mimics of facial muscles and therefore it is necessary to expect that the wrinkles will subsequently re-appear or grow deeper.

Nasolabial folds running from each side of the nose to the corners of the mouth, creating a natural border between the group of facial muscles and the muscle around the mouth, are always present at a face. The surgery can soften and smooth the folds but never remove. Also the fine vertical wrinkles on the upper and lower lip are not affected or removed by the surgery.

Generally, the effect is always better and longer-lasting in a face which is slimmer, with fine skin. In the round face type with thicker layer of subcutaneous fat the skin cannot be so well stretched; however there is the advantage that there are not usually fine mimic wrinkles in this face.

If there is a thicker layer of subcutaneous fat in the neck, especially in the area of double chin, the liposuction of double chin can be added to the face and neck lift resulting in a better effect.

Preparation:

If a patient decides to undergo facelift, it is necessary to know that the stress related to the surgery as well as the post-operative process are rather extensive although the healing and recovery of face tissues is always very good and rather fast.

A comprehensive preoperative examination must be done; good and stable health condition is presumed for the surgery. No acute and inflammatory illness, or a skin problem, should occur within 3 weeks before the surgery. Drugs that increase bleeding (aspirin etc.) should not be taken 2-3 weeks before the surgery.

Operation:

The surgery is done under the combination of local and general anaesthesia. General anaesthesia can be also in the form of so-called analgosedation (anaesthesia under intravenous control).

The surgery starts after the general disinfection of the face and hair with an incision running from the hairy part of temple area downwards, tight in front of the auricle (the incision can be done either in front of or behind trago – i.e. small cartilage that overhangs the entrance to the ear canal) around the earlobe and along the fold behind the auricle in the middle of which it turns into the hair. The length of the incision depends on the scope of the facelift.

Then the skin on face and neck is loosened from the base and the excessive skin is measured and removed.

Afterwards SMAS lifting needs to be performed – i. e. the shift and fortification of subcutaneous structures of ligaments and muscles.

It is done either by plication – folding, or by resection – removal of loose subcutaneous structure; resorbable suture is applied.

In the end it is necessary to secure the skin edges using intradermal suture in visible places and separate stitches in the hair and behind auricles. Both resorbable and non-resorbable suture materials are used. In most cases fine drainage is applied for 24 hours to drain minor bleeding. A total head dressing is applied at the end of the surgery.

Post-operative process:

After the surgery, patient must be hospitalized at least until the second day when the first re-dressing is performed. If the recovery process is standard, drainage is removed during this re-dressing and the patient can go home. It is necessary to maintain the body position on back with elevated head. The total head dressing remains for 3 to 5 days after the surgery as instructed by the surgeon.

Swollen face and eyelids, sometimes even subcutaneous suffusion, belong to the normal post-operative process in the first days after the surgery. The body temperature can rise to 38ºC for a day or two.

Therefore it is necessary to stay at home and apply cold compress on face and eyelids.

There is usually no pain after facelift; it is rather the discomfort of the bandage and limited possibilities of head positions.

When the bandage is removed it is necessary to wash hair several times; further healing is usually without bandage.

The face is protected by scarf only at night or during a short stay outside. The swelling and bruises gradually disappear within 7 to 10 days after the surgery.

Further checks and re-dressing after the bandage is removed depends on instructions by the surgeon and on healing conditions; stitches are gradually removed within 10 to 14 days. In this period it is necessary to rest and reduce the movements of head and neck. Physical load must be introduced gradually and the normal load including exercise etc. can be started approx. after one month from the surgery.

Make-up may be applied approximately a week after the stitches are removed, hair may be dyed by dark colours within 4 to 6 weeks after the surgery.

The recovery is individual and depends on the healing process as well as on the overall approach of every individual.

After the immediate healing (within 10 to 14 days) it is necessary to expect that the tissues of the face and neck need several weeks to get stabilized. The feelings of tension when moving and the disturbance of fine touch sensitivity in the operated areas are usual concomitant effects and will get normal within several weeks. Also small swellings and skin infiltration can appear temporarily for a couple of weeks, especially in warmer weather. The face should not be actively exposed to the sun at least 2 to 3 months after the surgery; when staying on the sun, the face should be protected by creams with a higher sun protection factor.

Complications:

Possible complications most often include the post-operative bleeding which can extend the healing period and the absorption of swellings and bruises by weeks. Another complication is infection and inflammatory troubles which are usually prevented by antibiotics. The minor temporary reduction of skin sensitivity in the face disappears within several weeks.

Later complications include reduction or disturbance of face mimics or the mimics of lips and mouth.

These complications are rather rare. They are the result of the interference with facial nerves. The recovery is rather long – mostly many weeks – and requires special physiotherapy for the facial muscles and a supportive vitamin treatment.

Growing hypertrophic scars can be another problem, mostly behind auricles, sometimes even around earlobes. It depends on particular healing abilities of each individual. The long-term care of scars is very important, as instructed by the plastic surgeon.

The healing of scars in the face is usually very good and distinctive and hypertrophic scars are rather rare.

operace obličeje

Please contact us if you have any questions.

You can send two photos with your question.

Your question

Wrinkles on the face – what to do with them?

Have you noticed the first wrinkles in your face, forcing you to admit that the years are already showing on your face and you are looking for a solution?

full article

2010-06-15