Articles
FACELIFTS – WHAT YOU SHOULD EXPECT
This is article is written in conjunction with Sue Carroll's skin care feature opposite.
Optimising the preoperative state of the skin and continuing after surgery definitely helps the long-term outcome and aids scar maturation. Lymph massage is also very helpful.
There are many techniques of facelift surgery. Essentially surgery involves the lifting and repositioning of different areas of the face. Tightening and lifting the fibrous muscular layer of the face ensures long-lasting results. The excess skin is then repositioned, trimmed and stitched in place without tension.
Incisions run in front of the ears, around the lobes and into the groove behind the ears. Incisions may pass into or along the hairline. A small incision under the chin allows correction of neck skin laxity, muscle tightening and fat resection.
The procedure is completed with dressings, a head bandage and possible plastic drainage tubes.
Facial bruising and swelling is variable and peaks at about 3 days. This gradually resolves in 2-3 weeks but there may be some persistent swelling for longer. Sleeping in a 'head-up' position helps
Early scars may be thick, lumpy, puckered and pink. Wound healing and scar management will be explained to optimize the outcome. The final scars cannot be predicted.
Depending on the technique and additional procedures performed, surgery may take 3 to 6 hours. At the time of discharge a light binder is used to support the facial tissue. A scarf and sunglasses are useful.
After the operation the face and neck feel tight. The skin in front of and around the ears may be numb. This usually recovers, but may be permanent. Men need to take care with blade shaving or use an electric razor. Care is also needed with hot hairdryers.
Most discomfort is felt behind or adjacent to the ears. Infection in facelift surgery is rare. Bleeding can occur and may need a second surgical procedure to drain it. The facial nerve moves the muscles of expression and damage or stretching of this nerve can result in paralysis, a rare but recognized complication.
Usually this is due to stretching or bruising of the nerve branches or as a result of a local anaesthetic. In these cases the nerve and thus movement will recover.
Temporary unevenness or asymmetry may be noted. Facelifts do not address the small lines around the mouth or the deeper lines above and below the mouth (nasolabial fold or Marionette lines).
Sutures or stitches are removed between 3 and 5 days after surgery. At this time wounds are checked and scar management techniques are explained. Cotton buds are useful to clean hard to reach areas. Antibiotic eye ointment may be used on the scar lines. A detailed care plan will be explained.
Recovery is variable, social appointments can be made from about 2 weeks. Avoiding strenuous activity, lifting, stooping and bending in the early stages enhances recovery.