Facial surgery – facelift

For face surgery, it is twice as important than everywhere else to find a good timing. We should not have it performed before the facial skin is lax to a significant degree. This most frequently happens in the area of lower cheeks on the edge of the lower jaw line, or on the neck in the area of double chin. The reason is that the facial and neck tissues are no more enough elastic to adjust to the permanent movements of face mimics. Thanks to this, the effect of the intervention is lasting, usually eight to ten years.

If the surgery is performed too early, the effect following the surgery will be good, but the flexible and elastic skin and subcutaneous structures will relatively briefly adjust to usual movements and mimics and the effect of surgery totally disappears within approximately two or three years.

The beautification procedure for face and neck can be certainly repeated, however, this is appropriate no more than once or twice, and always after a period of approximately ten years.

Facelift can be performed for both women and men. However, with men the opportunities to hide scars are not so favourable with regard to their gradually thinning hair and, moreover, as a result of skin stretching, the area where beard grows is shifted close to the auricles or even behind them.

The procedure starts after a general disinfection of face and hair with an incision running from the hairy part of temple area downwards, just next to the auricle. The incision can be made either in front of or behind the trago – i.e. a small cartilage that overhangs the entrance to the ear canal. It then runs around the earlobe and along the fold behind auricle, where, approximately in the middle, it turns into hair. The length of the incision depends on the scope of facelift.

Then the skin on face and neck is loosened from the base and excessive skin is identified and removed. Afterwards SMAS lifting needs to be performed – in other words shifting and tightening of subcutaneous structures of ligaments and muscles. It is accomplished either by application – folding, or by resection – removal of loose subcutaneous structures and a correction by means of absorbable sutures.

Finally it is necessary to carefully secure the skin edges using intradermal stitches on visible locations and separate stitches in hair and behind auricles. Both absorbable and non-absorbable materials are used. In most cases, fine drainage is applied for 24 hours to drain minor bleeding. An overall head dressing is applied when the surgery has been finished.

During the sleep, a position on patient’s back should be always maintained with elevated head. However, the overall head dressing remains applied for three to five days after the surgery as instructed by the surgeon.

Swollen face and eyelids, occasionally even subcutaneous suffusion, belong to a normal post-surgery process in the initial days after the procedure. Also the body temperature may rise temporarily to 38 degrees for a day or two. Therefore it is necessary to avoid strenuous activities and apply cold compress on face and eyelids.

No post-surgery pain usually accompanies the facelift procedure, disagreeable is rather the discomfort caused by the bandage and by restricted possibilities of head positioning. Face swellings and bruises gradually recede and mostly disappear within a week from surgery.

When the bandage has been removed, it is necessary:

• Wash hair repeatedly, further healing usually takes place without bandage.
• Protect the face with a scarf during the night and during any brief stay outdoors.

Further checks and re-dressings after the bandage has been removed depend on instructions by the surgeon and on the healing situation, stitches are normally gradually removed within two weeks. During this period, it is also necessary to avoid strenuous activities and reduce the movements of head and neck. Physical load should be introduced gradually and a normal strain including physical exercise can be resumed in approximately one month from surgery. Making up is possible roughly a week after the removal of stitches, hair should not be dyed with dark shades until six weeks from surgery.

The recovery following a facelift surgery is highly individual and depends on the healing capabilities as well as on the overall approach of every patient.

After the basic healing achieved in ten to fourteen days, it is to be expected that the tissues of the face and neck need several additional weeks to become stabilized. Sensations of tension when moving and a disturbed fine touch sensitivity at the treated areas are a normal accompanying effect and will return to a normal situation in several weeks. Small swellings and skin infiltrations can appear temporarily, particularly in warmer periods of the year. Patient’s face should not be actively exposed to sun for at least two or three months from surgery. When staying on the sun, the face should be protected by means of suitable lotions with a higher sun protection factor.

Subsequent complications may include a reduction or disturbance of facial mimics or the mimics of lips and mouth. This type of complication is relatively rare and it is a consequence of interference with facial nerves. Their recovery is rather long – mostly a number of weeks – and requires a special physiotherapy for facial muscles, as well as a supportive vitamin treatment.

Growing hypertrophic scars may present another problem, mostly behind auricles, sometimes even around earlobes. This depends on the particular healing capability of each individual. Very important is a continuous treatment of scars as instructed by the plastic surgeon. However, healing of facial scars is usually very good, and distinctive or hypertrophied scars are rather rare.

The Esthé clinic can be proud not only because it achieves a very low occurrence of complications, but also because it helps in handling problems of clients from other clinics, who are not satisfied with their results.