Face-lift (Rhytidectomy)

Face-lift (Rhytidectomy)

What is a face-lift?

Before and after portrait of a woman (cosmetic surgery).Medically known as a rhytidectomy, a face-lift is a cosmetic surgical procedure (performed under general anaesthetic) whereby the soft tissue of the face is lifted (through an incision made into the skin) and excess skin and tissue is removed. Underlying tissues can also be tightened. Facial skin is then gently draped back over newly repositioned contours in an effort to aesthetically improve the face and neck, providing a smoother, more youthful effect. Incisions (usually made along the hairline) are stitched (sutured) closed and the healing process can begin.

It is not uncommon for a face-lift to be done in conjunction with another procedure, most notably a platysmaplasty (neck-lift), and sometimes an eyelid surgery (blepharoplasty) or brow-lift (also known as a forehead lift). Other additional procedures to improve the face and neck can include liposuction, the removal of buccal fat pads (in the cheeks), a forehead lift, an autologous fat injection (using one’s own fat to plump up sunken areas of the face), chemical or laser peels, or malar (cheek) and submalar (chin) implants.

The primary aim of a face-lift is to achieve a more youthful facial appearance, especially if signs of aging (loss of fat or muscle tone and skin elasticity) are already in motion. Facial skin that begins to droop or sag can thus be corrected with this cosmetic procedure, with the effects resulting in not only aesthetic improvement but also a self-confidence boost.

A face-lift doesn’t typically correct the quality of a person’s skin. Wrinkles and sun damage may be better off treated with skin-resurfacing or facial filler methods instead. It can, however, tighten loose, hanging skin around the jawline (or ‘jowls’), remove excess skin and fat (especially in the neck and around the chin), as well as remove creases around the nose and mouth. The procedure can also tighten underlying tissues to improve the forehead, brows, eyelids and cheeks.

The correcting of creases, tightening of tissues and removal of skin and fat effectively reshapes the lower half of the face for an improved appearance.

A traditional face-lift procedure can take anywhere between 2 and 5 hours to complete. A person can generally return home the same day (when the procedure is done on an outpatient basis) or stay overnight if monitoring is required for any reason.

Did you know? Face-lifts were more commonly performed on women until recent years. Plastic surgeons have noted a dramatic increase in male candidates of late. Face-lifts are now the fifth most common type of plastic (cosmetic) surgery among men, but still very much a favoured procedure for women too.

Are there different types of face-lift procedures?

Depending on a person’s aesthetic goals and result preferences, a surgeon will assess various applicable risks and a person’s facial anatomy before agreeing to perform any of the below types of face-lift procedures.

The type of incision used generally differentiates the various options for surgery, as well as the number of treatable tissue layers, the degree of surgical invasiveness necessary to achieve the desired result, as well as the specific area of the face in which a person desires an aesthetic change.

Some of the most popular face-lift types (techniques) are:

  • The deep plane lift: Considered the gold standard for most surgeons, this option often produces the most lasting results, and fewer necessary revisions or further corrective procedures. It is mostly recommended for those with severe facial sagging. This option is a more technical procedure where incisions are made along the hairline allowing for easier lifting and repositioning of facial muscles and upper fatty tissue layers (superficial musculoaponeurotic system or SMAS). The SMAS area is just beneath the skin, and surrounding the muscles responsible for facial expression (smiling or frowning). Incisions are extended in a downward direction along the natural creases of the face along the ear lobe and ending in the crease behind the ears. A surgeon will separate the skin from the SMAS layer, before cutting into what is referred to as the ‘deep plane’ beneath. The surgeon will then release any tissue attachments, allowing for easier movement to reposition the SMAS layer and skin. Once this is done, the SMAS layer will be repositioned and any excess skin is then removed in the process. From there, a surgeon will stitch (using sutures) or staple the skin back in place along the hairline incisions. The results of this procedure can be incredibly dramatic, especially around the cheeks, jawline, chin and nasolabial folds or ‘smile lines’, and last between 10 and 15 years.
  • The SMAS (superficial musculoaponeurotic system) lift: This option is ideal for tissues around the face and neck which have begun to droop with age, especially where mild-sagging has occurred. The procedure works with the superficial (top) layers of skin and tissues beneath once an incision is made at the temple, just above the hairline. Further incisions are made downwards following the natural crease ending at the edge of the top of the ear, below the ear lobe or behind the ear. A surgeon will then tighten the SMAS using sutures and remove any excess skin before making the final stitches. The greatest difference between this lift technique and the deep plane option is that the surgeon does not release any tissue attachments beneath the SMAS layer.
  • Short scar lifts: This option involves several abbreviated scars (incisions) which do not end behind the ear. Examples of short scar lifts include an S-shaped incision (made at the temple or in front of the ear), or a minimal access cranial suspension lift / MACS (in which an incision ends at the ear lobe). Either option is often preferred for those in their 40s and 50s who do not have too much excess skin, or for those with very few signs of aging around the neck. This option is quite effective in tightening moderate amounts of sagging skin, and re-adjusting tissues that support smile lines or jowls.
  • The endoscopic face-lift: A surgeon uses an endoscope (a pencil-shaped probe with a small camera attached at the end) to view clear video images of the internal facial structures, and transmit theses visuals to a monitor or screen. Three or more incisions are made to insert the endoscope and perform a face-lift procedure. This option is not as popular as some of the other methods due to results that aren’t as effective, but it may be considered for sagging in the cheeks (where the best results of endoscopically done lifts have been achieved).
  • The mid-face or cheek lift: A surgeon will make incisions in the hairline, as well as the inside of the mouth. This option targets the middle third of the face and allows for easier lifting and repositioning of the fatty layers covering the cheekbones. The objective of this method is to improve lines between the nose and the mouth, as well as to lift dropping cheeks. Subtle freshening with minimal risk can also be done endoscopically with an isolated mid-face-lift or through the lower eyelid (along with eyelid surgery).
  • The thread lift (also known as the feather lift or aptos lift): This method is often used in combination with other face-lift options as a way to provide additional tissue support in the face. A surgeon makes use of small suture barbs attached to a thread which act like a hook to tighten the skin (gathering layers of skin upward). For this method, no removal of skin or tissue generally takes place.
  • The stem cell face-lift: Although called a ‘face-lift’, this option is technically not a surgical procedure. A surgeon, however, performs this method with fat injections in a two-step process. Fat cells and the stem cells within them are harvested through a liposuction procedure (often in the buttocks, thighs or tummy area where they are plentiful) and then processed. The cells are then injected into various areas around the face to contour and fill trouble spots such as the cheeks, temples, under-eye hollows, or lips.

Reasons a face-lift is considered?

Aging can have the effect of making a person’s face a little more rectangular in shape. Face-lifts, as a cosmetic procedure offer people the opportunity to achieve a more youthful appearance to the lower portions of their face (making it appear more heart-like).

As we age, our faces can become ‘hollowed’ (hollow-looking) or appear to be storing fat in undesirable places along with crepe-looking skin. Cellular elasticity and fat volume changes can be lost with age, especially around the cheeks and eyes, giving a more drawn appearance. The skin then naturally develops folds and begins to sag or droop.

Factors which can speed up the aging process also have an effect on the skin, sometimes well before it naturally should. Natural aging processes are heavily influenced by various environmental and behavioural factors, such as air pollution, sun exposure, poor nutrition habits (including extreme dieting programmes), overuse of alcohol, smoking and stress.

The most common reasons a person may consider a face-lift are:

  • Loose facial skin, especially around the jowls (lower jawline)
  • Sagging or sunken cheeks
  • Deeper creases or lines around the lower eyelids (hollowed looking eyes), chin and lips (thinning lips)
  • A loss of definition in the face
  • Excess fat in the neck
  • The development of visible platysmal bands (bands of skin around the neck)

 

What makes you an ideal candidate for a face-lift?

Various factors will be assessed by a surgeon prior to booking a face-lift procedure. The most important of all is a meeting of expectations. A surgeon can only achieve what is realistically possible and a potential candidate not only needs to be well aware of this, but desire a realistic result too. Knowing potential limitations is also important to realistically understand and be comfortable with before proceeding with this surgery. If expectations are realistic from the get-go, chances are the preparation process can commence.

Various factors will be assessed to pre-determine whether a face-lift procedure can achieve the best results or if an alternative treatment option may be better. These include:

  • Elasticity of the skin: A surgeon will want to assess the skin and level of elasticity to check whether it is likely to be able to conform to the new contours following the procedure. Some natural suppleness and flexibility is needed for this, as well as for the healing process.
  • Bone structure: A well-defined underlying bone structure is also important in order to be able to provide support. This helps to achieve more satisfying results. Individuals with less distinct features may not be able to achieve the best results with a face-lift procedure. Instead facial implants could be considered either as an alternative or in combination with a lift procedure if the surgeon feels it is achievable.
  • Overall health condition: A surgeon will wish to know a complete medical history in order to make a realistic assessment for face-lift surgery. If a person has any pre-existing medical conditions, these must be disclosed, as well as if any medications or supplements are being taken. A surgeon will also note whether a person is ‘physically fit’ enough to handle the ‘trauma’ of such a surgical procedure (i.e. is physically able to handle both the surgery and recovery period).

 

What factors may not make you an ideal candidate?

A surgeon may not recommend face-lift surgery (or take caution) if any of the following comes to light during a consultation:

  • Serious medical conditions (mental and physical), including hypertension (high blood pressure) and diabetes – these can increase the risk of severe complications.
  • Tobacco use and cigarette smoking – this can interfere with the healing process. If a person wishes to have a face-lift they may be requested to stop smoking altogether ahead of time, as well as during recovery.
  • The taking of aspirin or other blood-thinning medications – these will need to be stopped at least one week prior to surgery as they can increase the risk of bleeding and blood clotting.
  • A history of weight gain and loss (repeated) – Skin that is repeatedly stretched can become loose prematurely once again. A surgeon will be cautious about recommending a face-lift if this becomes apparent during a consultation.

What else should you consider beforehand?

Medical health insurance providers do not typically cover the cost of a cosmetic procedure even through it is regarded as a major surgery. If not performed for functional reasons, cosmetic procedures will generally need to be privately paid for in full. This will include the surgeon’s fee for the procedure, the operating facility (hospital or clinic), the anaesthesiologist’s fee, prescribed medications, and other services (such as a follow-up post-surgery).

In some instances, a medically functional reason may be partially covered. It is advisable to check this with a medical health insurance provider beforehand if applicable.

Female doctor assessing the face of a woman electing to have a face-lift procedure.

What happens during your first consultation?

During an initial consultation, a plastic surgeon will do the following:

  • Medical history review: A surgeon will ask a series of questions related to current and past medical concerns, problems or diagnosed conditions. He or she will also assess current and past use of medications (over-the-counter or prescribed) as well as the use of any supplements (including herbal varieties). This is to assess whether there is any potential risk for bleeding (during and after a procedure) or blood clotting, which can be serious complications. It is important to disclose any known allergies at this point as well, and what medication is being used to treat these.
  • Discuss expectations: During the consultation, expectations will be high on the list of discussion points between a potential candidate and a plastic surgeon. Benefits of a face-lift procedure, as well as potential risks (which can include hair loss or scarring) will be discussed.
  • Perform a physical examination of the skin: An examination of the facial skin will then be done. He or she will also carefully look at a potential candidate’s neck and bone structure. Thin, angular facial structures typically achieve the best (or most desirable) results following a face-lift procedure. Round facial structures, low cheekbones or short jawbones often make it more complicated to achieve the most desirable results. During the examination, a surgeon will also make note of any skin abnormalities, markings such as scars or asymmetrical areas of the face. This will then be used to determine the incision technique that may produce the best result. A surgeon is likely to request the taking of photographs for their medical records, which will also be used to show the achieved difference post-op.

 

The following may also be recommended in preparation for surgery:

  • Medication recommendations (if applicable): A surgeon will strongly advise avoiding aspirin, anti-inflammatory medications or herbal supplements prior to surgery. These increase the risk of bleeding, which can be a very serious complication either during or shortly after surgery. Elevated blood pressure levels may also err a surgeon on the side of caution and a prescription for medication may be given for a period of time before the surgery.
  • Personal care: A surgeon may advise hair washing and bathing the night before surgery, as well as on the morning of a face-lift procedure.
  • Food and liquids: A face-lift is classified as a major surgery requiring anaesthetic. As a result, undigested food in the system could result in discomfort or complications. A surgeon will advise a patient to avoid consuming food after midnight, the night before a procedure. Liquids may also need to be restricted after a certain time.
  • Assistance with transport: Anaesthetic can leave a person feeling fairly drowsy for a short period of time as it wears off. For this reason, it can impair a person’s ability to focus or make appropriate decisions. It is best to arrange for transport following a surgical procedure. A surgeon may also advise a person to arrange for someone to help care for them in the days following surgery as they recover.

Risk factors and complications

As with any surgical procedure, there is a degree of risk for potential complications. These should have been discussed prior to having a face-lift surgery. Certain risks will affect individuals differently, particularly if the person has a pre-existing medical condition.

The general risk factors or side-effects that affect most candidates for face-life surgery are:

  • Scarring: Making a cut into the body effectively wounds it and will result in a permanent scar. Incisions are made in places that allow a surgeon the best access to perform the surgery (i.e. the natural contours of the face and hairline), but also allow the patient some degree of discreetness to be able to easily conceal them. One way to easily conceal scars, especially as they heal is to grow hair out a bit prior to surgery. Aside from the appearance of scars, in general, as the wounds heal, they can also become raised and inflamed. A surgeon can assist if this happens by administering corticosteroid medication injections to help improve their appearance.
  • Bruising and swelling: ‘Wounding the body’ will cause it to bruise and swell during the period of healing. Facial features will become distorted somewhat in the process and movements may stiffen a little too. Cold compresses and elevation in the weeks following surgery can help the healing process along, as bruising disappears and the swelling decreases.
  • Skin sensation changes: The superficial sensory nerves in the face are likely to be affected as a result of surgery too. This is as a result of repositioning tissues in the face, causing numbness in the scalp, cheeks and neck. Numbness can linger for quite some time – as little as a few months or up to a few years post-op.
  • Facial nerve injury: It can happen that the loss of sensation in the face may be more severe. If damage to the facial muscles occurs, it can result in facial nerve paralysis. Weakened facial muscles can improve somewhat within a few months to a year. If not, a specialist will need to assess individual cases for possible corrective surgery and treatment.
  • Hair loss (alopecia): Temporary or permanent hair loss near the site of incision is not uncommon in those who have undergone a face-lift procedure. If temporary, hair growth will occur within 3 months post-op. Permanent loss of hair will require corrective procedures involving the transplant of skin with hair follicles. The bare area of skin can also be removed or a portion of a person’s scalp with hair can be transplanted in the bare area (especially if it is a large area).
  • Skin loss or skin necrosis: It can happen that blood supply to the facial tissues can be interrupted during the surgical procedure, resulting in skin sloughing (the casting off or shedding of skin tissues). Smokers are at higher risk of this potential complication and this is one of the main reasons why a surgeon will urge a candidate to halt their habits for a period of time beforehand.
  • Other: Any surgery whereby a cut is made in the body is at risk of bleeding under the skin, blood clots (pulmonary embolism) or hematoma (when blood accumulates outside of the blood vessels), adverse or allergic reactions to anaesthetic or infections.
  • Results: Being a cosmetic procedure, there is always some degree of risk that the results once completely healed will not be as the person expected. It’s very important to understand what the procedure can and can’t do in terms of expectations before having a face-lift.

If in the days following surgery, if excessive pain (especially on one side of the face or neck within 12 hours of surgery), inflammation, swelling or redness, shortness of breath, chest pain, irregular heartbeat or fever are noted, a surgeon will want to assess for signs of further complications including infection or internal bleeding as quickly as possible.

How is the procedure done?

Surgical techniques for face-lifts are continuously being improved. Modifications made aim to make the procedure easier to perform, improve physical healing (such as scarring) and shorten recovery time for patients. Depending on the original aim, lasers and endoscopy techniques have shown some pleasing results.

The nature of the procedure requires that a face-lift be done in a hospital environment or at an outpatient surgical facility or clinic. The type of anaesthetic used will be predetermined by your surgeon and may only numb a portion of a person’s body or render them totally unconscious for the duration of the surgery.

Surgical team performing a face-lift procedure in a hospital theatre.During the surgical procedure

A surgeon will have discussed the techniques to be used in surgery and why well before the actual day. This is to ensure that a person is well-informed about what will happen in a surgical theatre, and ultimately what to expect post-op and through recovery. Incisions will need to be made for the procedure and will thus result in some scarring. Different techniques allow for these wounds / scars to heal ‘out of sight’ and away from the areas of the face and neck a person wishes to improve.

Incision techniques will also depend on the area of focus for re-working, and will have been discussed during earlier consultations. Common techniques a surgeon may use include:

  • Traditional face-lift incisions: An incision is made along the hairline beginning at the temples and ending either around the front of the ears or in the crease behind them. Another incision can also be made under the chin if working to improve the appearance of the neck as well.
  • Limited incisions: Short incisions are made in the hairline beginning at the temples and towards the front of the ears. Additional incisions may also be done in the lower eyelids or just under the upper lip.
  • Neck-lift incisions: These cuts will begin in the front of the earlobes and around the back of the ears and into the lower scalp. A small incision may also be made just under the chin.

Once incisions are made, the surgeon will then perform the surgery according to the face-lift technique agreed upon during consultations. He or she will then work with facial tissues, muscles and the SMAS (superficial musculoaponeurotic system) layer to reposition and re-work the new contours needed to achieve the desired result.

Skin will then be repositioned or draped back into place, over the newly made contours. If there is any excess skin or tissues, these will be removed before sutures (stitches) are made or staples and tape are used to seal the wound.

In general, a procedure can take anywhere between 2 and 5 hours to complete. A surgeon may require more time in theatre if an additional procedure, such as a brow-lift or eye surgery, is to be performed on the same day.

What to expect during recovery

After the surgical procedure

Once incisions have all been sealed they will be covered with surgical bandages and gauze. These may be bulky so as to provide gentle pressure on the wounds. This will help to alleviate bruising and swelling.

Drains (small tubes) may also be placed behind one or both ears (just under the skin) to help remove any excess fluids or blood during the initial days of recovery.

What will the first few days be like?

Close-up portrait of a woman with a bandaged head and face.Initially, facial skin may feel a little stiff and numb. If unprepared, this can be a little shocking to experience. It is, however, quite normal and not usually a cause for alarm. In the weeks and months following surgery, strange facial sensations, like numbness, can persist. It is best to be well prepared to expect this before having the surgery done.

The texture of skin may also become a little dry and rough in the months following surgery. This is also normal. Men sometimes experience a shift in the placement of growing beard hairs which have been rearranged in the face-lift process. This may mean that shaving habits will need to be adjusted a little. If desired, men can make use of laser hair removal techniques or electrolysis instead of shaving hair growth in the new position.

A summarised overview of post-op care involves the following:

  • Home care: Pain medication and antibiotics will need to be taken as recommended by the surgeon for a prescribed period. The head will need to be rested at an elevated angle to assist with swelling and bruising. This will also provide more resting comfort. A person must refrain from excessive facial pressure or motion and try to avoid wearing clothing that needs to be placed over the head.
  • The first post-op consultation: A surgeon is likely to request a consultation a day or two after the procedure. Drainage tubes and bandages may be removed and antibiotic ointments applied to the incisions. New bandage dressings will be placed over the incisions. A surgeon will also provide an elasticised facial sling which can be worn over the bandages within the next 2 or 3 days. Bandages and dressings must be kept dry through the recovery period. A surgeon can also advise when normal daily activities and hygiene habits, such as hair washing or bathing can be resumed.
  • One week later (5 to 10 days): A surgeon will request the next follow-up a week later to remove stitches (if not dissolvable) and assess the healing progress. Incisions will also be checked for potential ingrown hairs. If there are any, a surgeon will remove them so as to prevent any inflammation or infection in the wounds. Bruising and swelling is likely to be at its worst 2 days post-op. The prescribed pain medication and elevation of the head will help to alleviate discomfort considerably.
  • The remainder of the recovery period (up to 6 weeks): As incisions begin to heal, crusts may form. Gentle hair washing with shampoo can help to gradually remove these crusts without causing any damage to the skin or worsening scarring. After about 1 week, ladies may be allowed to apply make-up to the face as a way to conceal and facial redness or bruising, but only to the edges of the healing incisions (scars). A surgeon will request that sun exposure be limited or avoided until scars are (at least) no longer pink in colour (as this is when they are at their most sensitive to sunlight). Smoking will also be prohibited for between 2 and 4 weeks post-op, and alcohol intake restricted too. Normal activities can usually be resumed within 2 to 3 weeks following surgery. Vigorous physical activity can be resumed 4 weeks following surgery. Scarring can take up to a year to start visibly fading.

 

Coping with pain and swelling

  • Medication: Whether prescribed by a surgeon or recommended over-the-counter, it is advisable to take all medications according to the directions provided. This will help to ease both the discomfort or pain, as well as swelling. The initial few days is when the taking of medication is most important. Often, swelling and pain begins to ease by day 4, gradually improving thereafter until a full recovery is made.
  • Understand the recovery process: Following surgery, a person is going to look worse at first before looking better. A face-lift is an invasive procedure. Signs of surgery can be alarming at first. It is wise to prepare for this. Facial skin may appear ‘bunched up’ at the front of the ears, eyes are likely to be very swollen (even if no surgical procedure was done to this area of the face), and the bruising will be apparent on the face, neck or décolletage areas of the upper body. Pain in the ears may also be experienced.
  • Use cold packs: Swelling can be alleviated quite effectively with the use of cloth-wrapped cold packs or compresses. These can be placed on swollen areas for 30 seconds at a time and re-applied in about 15 minutes, and then again in an hour or so. Ice or ice-cold compresses should never be placed directly on the skin. Such cold can slow down blood flow, and thus affect the healing process.

 

Skin care tips

The general rule of thumb when it comes to all cosmetic corrective procedures is to take the very best care of the skin as possible. There are no absolute rules, except that the best possible care being taken will encourage quicker healing during recovery, and ensure lasting results.

Many specialists will have certain preferences, however, and may offer appropriate skincare advice both before a procedure and as an ongoing routine thereafter. There may be bad habits to break or things to be tweaked in a skincare routine that can help to improve the skin’s appearance overall.

Some things to take into consideration include:

  • Topical creams and lotions: Whether prescribed or recommended over-the-counter, cortisone based creams do not effectively promote healing. Creams, serums or moisturising lotions that contain retinoids can exacerbate inflammation post-op too. They also have a strengthening effect on the skin. Many surgeons will recommend discontinuing use of these creams at least a week or two before surgery, as well as shortly afterward. When appropriate, a surgeon may advise resuming use as part of a skincare routine.
  • Exfoliants: A surgeon may advise against the use of exfoliants (especially scrubs) a week before surgery. It’s not always essential, but in some cases, it can be helpful to avoid any skin irritation (microscopic tears which can slow down the healing process). Once the facial skin has healed and has returned to its normal texture and colour, it is safe to make use of exfoliants as part of a skincare regime (they can assist in the healing process, enhancing desired results). A surgeon will be able to guide one on the appropriate use (or disuse) of exfoliants at the best time before and after surgery.
  • Cleansing and moisturising products: Skin post-op will be incredibly sensitive and is prone to healing with a degree of discolouration if not handled with utmost care. A surgeon will be in the best position to provide guidelines that will assist in preventing any pigmentation. In general, the use of mild, hypoallergenic products (non-soap cleansers and fragrance-free creams or moisturisers) are best. Mild astringent pads may be easiest to use for cleansing (without applying too much pressure), especially on sore areas of the face during the first few days. A surgeon will advise that the face must not be submerged in water until the incision wounds are closed up, and healing well. Instead, cleaning can be done by using cleansing pads or a clean, damp cloth to gently remove dirt, dried blood or fluid from the face. It’s important to cleanse properly and with utmost care, even though the skin will be sore and sensitive. Regular cleansing helps the healing process, as well as avoids build-up of dirt or bacteria which can lead to breakouts. Silicone-based serums can also help to heal highly sensitive skin. These usually contain antioxidant and skin-repairing ingredients which will do wonders for helping the skin to heal.
  • Sun exposure: With skin being incredibly sensitive in the days following surgery, sun protection is essential. Direct sunshine should be avoided, especially during the first few days. Thereafter a good sunscreen (at least SPF 30 or 40) that blocks alpha and beta sun rays is best. Sunscreens with a higher SPF can sometimes block the pores of the skin, so one at 30 or 40 usually works best.
  • Hydration: Nothing nourishes the skin quite like a sufficient amount of moisture. Skin is best rejuvenated with a sufficient amount of water (daily intake), not only to nourish, but also to flush out toxins from the body.
  • Allow proper healing: Healing skin is often a little uncomfortable. It can itch and scab. For some, the temptation to pick can get the better of them. It is best to be mindful that the wounds need to heal. Picking at peeling skin or scabs will cause further damage or markings, which won’t help achieve desired results. Picking also runs the risk of developing infection, as well as scarring. Minimise swelling with cloth-wrapped ice packs or cold compresses, and sleeping (or sitting) at an angle that elevates the head above the heart. Sometimes using pillows on either side of the body can make this position more comfortable. To treat bruising and skin discolouration, arnica can be used, topically or taken orally. A surgeon may also caution against things which may raise body heat, such as participating in hot yoga, having a soak in a hot bath or tub or sitting in a sauna.

 

What about using make-up after having a face-lift?

Make-up is best used when the skin has settled a little following surgery. Normally, one week after the procedure is fine, but it is best guided by a surgeon. He or she will assess how well healing is (or isn’t) taking place. If healing is going well through the recovery period and the incision wounds have closed sufficiently, make-up may be used to conceal any discolouration caused by inflammation (redness) and bruising). The epidermis (top layer of skin) will need to be recovering well before a surgeon will be comfortable for make-up to be used.

Tips for using make-up:

  • The best make-up to use will be mineral-based as these are typically gentler on the skin, while still providing adequate coverage.
  • Skin discolouration which is red or purple can be rectified with a green base to help balance out the contrast in colours. This can help to create a more natural-looking skin tone. Foundation can be sealed with a mineral-based powder that is one shade darker usually works best.
  • Clean all make-up off at the end of the day. It is essential to cleanse the skin before going to bed every night.

 

How should you sleep after having a face-lift?

The initial days following surgery will likely be highly uncomfortable. Pain and discomfort will be accompanied by swelling, which can make it difficult to sleep comfortably.

Tips for a good night’s rest

  • It’s a good idea to prepare the home for additional post-op comforts. Following a face-lift, it is best to keep the head elevated above the heart, and especially so during sleep. Elevation eases swelling, which in turn will help to alleviate some discomfort. Additional pillows and cushions can help to comfortably keep the head elevated.
  • Resting will also be much easier if one arranges for a close friend or relative to stay during the first week of recovery to assist with basic things around the home, especially during the first few days after surgery.
  • Caffeine beverages may prove disruptive to sleep, especially when combined with prescribed pain and antibiotic medications. Herbal or caffeine-free beverages are best drunk before bedtime instead, many of which have a soothing effect which can promote better sleep and rest.
  • Try and stay as still as possible during sleep as this will be more comfortable. Odds are that any movement that does occur will cause a person to awaken and shift back into a comfortable position anyway.
  • It is sometimes best to sleep alone, for the first week, when discomfort is at its worst, so as to keep the now very sensitive facial area away from any potential harm.

Portrait of woman happy with the result of a face-lift procedure.

Results – Is a face-lift worth it?

The main aim of a face-lift procedure is to achieve a healthier and more youthful appearance. Smoothing out loose or dropping skin, however, is not a permanent solution and cannot prevent the natural aging process.

Drooping and other signs of aging can still occur in time after having a face-lift (or any other kind of cosmetic procedure) done. Time and environmental factors such as sun exposure, as well as lifestyle habits will all have an influence on how quickly the skin ages.

Having a face-lift procedure, however, does achieve dramatic results and can ‘take years off’ their appearance. For many this dramatically reduces any anxiety they may have about growing older and improves self-confidence levels immensely.

Most signs of aging are thus dramatically reduced with this kind of cosmetic surgery, but it is not a fix for sun damage or facial wrinkles (especially around the eyes, nose or lips). Skin damage is best treated with other treatments and procedures.

Research has suggested that within 5 to 6 years after a procedure, at least 21% experience a relapse. The majority (at least 76%) of face-lift patients still look more youthful (with other signs of natural aging) than they would have had they not had the surgery.

The skill and experience of a surgeon also has some impact on how well a face-lift procedure works. The more experienced and skilled, the better the chances of a successful result with minimal risk of complications. A skilled surgeon will be well aware of how to work with male and female patients.

Both men and women can experience distorted earlobes post-op, or a startled look if too much skin is removed during the procedure.

Why is a face-lift for a man more complex to perform?

A male typically has a much richer blood supply than that of a woman in order to support the naturally thicker skin. In general, all men have thicker skin throughout the body. This makes the procedure a little more time consuming for a surgeon. A man’s beard will also need to be factored in to the time necessary to complete surgery as well as the placement of incisions.

A surgeon will typically add on about 45 – 60 minutes’ worth of time to a face-lift procedure for a man than he or she would a woman.

Incisions made are a little different for a man than they are for a woman, especially when it comes to the area near the ears. For a woman, these incisions are made in the curvature of the ear (at the side of the face as it meets the jawline).

The same incision does not work as well for a man who would normally shave the same spot For a man, the incision will need to be made a little further in on the face, making it more visible. For a surgeon, this can take longer to close up (suture) as extra care needs to be taken to stitch as carefully and neatly as possible for optimum healing.

Close-up of surgeon hands drawing markings on the face of a man preparing for cosmetic surgery.

Why is it not possible for a face-lift to completely correct wrinkles and facial lines?

It is not possible for surgery to ‘iron out’ the appearance of fine lines and wrinkles. This is a common misconception which should not be sought out if this is the primary aim. A face-lift is not an appropriate procedure for aging skin and correcting its quality. A face-lift can only achieve a youthful look for ‘sags and bags’.

Fine lines and wrinkles are better suited to chemical or laser facial treatment or the use of fillers, which specifically target these problems. The quality of skin cannot be corrected with surgery, any more than a wrinkled shirt can be pulled to remove creases as a substitute for having it ironed.

A surgeon will assess the problem areas of the face carefully and ensure to advise what can and can’t be done with this surgical procedure. Other areas of concern, such as wrinkles, may be referred to another specialist who is equipped with more appropriate tools to achieve the best results. If any attempt is made to stretch the skin as a means to remove fine lines, chances are that a person will only achieve a ‘just come out of a wind tunnel’ effect, which will not be appealing at all.

What is a ‘weekend face-lift’?

A weekend face-lift, also known as a mini face-lift or S-lift, is also a surgical procedure (carrying the same amount of risk), but involves less manoeuvring and repositioning of the face, as well as the removal of less tissue, than a more traditional (full) procedure.

A mini procedure concentrates of rearranging tissue either on the mid-portion of the face, or the lower third (not both). This allows a surgeon to focus on set areas (target and treat specific problem spots) of the face instead.

Smaller incisions are usually made and the use of other techniques, such as an endoscope, and other miniaturised instruments to lift and reposition tissue and skin.

Thus, the biggest differences between the two types of procedures are the size of incisions made, how many are made (at least 3), and the amount of skin and tissue removed. If problem areas don’t appear as large portions of the face (i.e. they are more localised) a mini procedure may be considered to achieve the desired result.

A mini procedure is less of an expense and recovery can be considerably shorter than a full procedure working with larger portions of the face. The downside is that results don’t typically last as long - approximately 5 to 10 years as opposed to as many as 15 years.

Some have opted for a mini procedure as a ‘touch-up’ when sagging occurs years after having a full surgery. The procedure is effective in removing minor sagging or bags around the jawline, cheeks or neck. This procedure is not normally done to correct problems around the forehead or eyes.

What is a vampire face-lift?

In recent years, the vampire face-lift has been made popular by a variety of high profile celebrities. Despite the name, the procedure is not a surgical one and should not be classified as a face-lift.

Instead it is a facial rejuvenation treatment that involves injectables and does not make use of general anaesthesia, surgical incisions or stitches (sutures).

This treatment harnesses the body’s natural growth and healing potential, found in the blood (hence the name) to rejuvenate skin.

For this procedure, the patient’s blood is drawn and spun in a centrifuge to separate the cells and extract the platelet-rich plasma (PRP). PRP is the substance that enables clotting, stimulates collagen production and facilitates tissue regeneration and healing. Once the PRP is extracted, it is mixed with calcium chloride to form a thicker substance known as platelet-rich fibrin matrix (PRFM) an injectable hyaluronic acid dermal filler like Juvederm® or Restylane and injected into strategic areas of the face with the aim of adding volume to the cheeks and smoothing fine lines and wrinkles.

The benefits of this procedure are that it is minimally invasive and skin regeneration lasts for months and up to a year after the procedure. It is not, however, beneficial for those with advanced signs of aging, who would benefit more from traditional cosmetic surgery procedures such as a face-lift.

 

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