FACELIFT

The operation of facelift is designed to reverse the changes of ageing that occur naturally in the face. It will improve sagging in the jowls and neck line giving a more youthful appearance to the face. It will not correct fine wrinkling or improve the deep furrows which run from the nose to the side of the mouth. The operation can be combined with surgery to the eyelids and occasionally the brow. In addition it is possible to have liposuction to the neck.

The hospital holds a pre-assessment clinic (PAC) which is run by the nursing staff. You will be invited to attend one of these clinics a week or two before the operation. They are intended as a medical screen to identify problems and carry out any necessary tests before the day of your surgery. Sometimes it will be arranged for you to see the anaesthetist at this clinic.

Surgery takes place under general anaesthesia and is a lengthy procedure lasting more than two hours. Some of the incisions are hidden within the hair bearing scalp but part of the wound is visible, running in the crease line in front of the ear, around the lobe and into the crease behind the ear before hiding itself within the hair bearing scalp behind the ear. Although these scars are initially pink they do fade (but not disappear) and can be hidden by make up.

You will need to be in hospital for one night. You will wake up with drains, thin plastic tubes connected to bottles, under the skin of the face and these will need to be removed the day after surgery. The face will be considerably swollen for a few days and this removes all the fine wrinkles in the skin. Swelling can be reduced, but not stopped, by sleeping propped up on pillows. Unfortunately the fine wrinkles return when the swelling settles. Bruising will develop and this can sometimes be considerable, spreading down to the upper chest. Normally the bruising fades within a few weeks. Bruising and redness of the immature scars can be hidden by application of makeup.

Hygiene can be a problem after surgery because you will wake up with matted, messy hair clogged with blood and antiseptic. This can, and should, be washed normally as soon as possible. However the staples may make hair brushing and washing difficult. You are encouraged to wash the hair and face as normal. This is usually possible the first day after surgery.

It is sometimes necessary to make an incision underneath the chin to tighten skin around the neck. This will leave a scar.

Photographs will be taken before the operation as part of your clinical record. These photographs remain confidential and are kept securely.

Before leaving hospital you will be given an outpatient appointment but if you have any problems, worries or concerns after discharge from hospital please feel free to telephone for advice. I can generally be contacted on 07850 484 672 but if I cannot be reached immediately a message can be left on my office answerphone (0208 463 0019) and I will get back to you as soon as possible.

Your GP will be given full details of your surgery and progress.

COMPLICATIONS

Numbness of the facial skin is inevitable after this surgery but generally settles down over a few months and sensation returns. During this period of numbness you must be very careful about sun exposure and avoid sun burn.

Numbness can be experienced in the earlobes and occasionally this is permanent. The scar around the earlobes can tighten up and cause distortion of the lobe. This is not generally very noticeable but the appearance can be different from before the operation.

In rare cases, the facial nerve, responsible for moving the muscles of facial expression, can be damaged during the operation. On the rare occasions that this happens the corner of the mouth is distorted and the eyebrow doesn’t move. Fortunately such nerve damage is usually temporary and function recovers over a few months. It must however be remembered that very occasionally the damage is permanent and movement does not come back.

Bleeding can sometimes continue after the operation and despite drainage tubes acting as an escape valve, emergency surgery to remove a blood clot is occasionally necessary. Very small areas of bleeding can give a lumpiness underneath the skin which can last for several months.

Nicotine reduces the blood supply to the skin and so smokers are strongly advised to stop their habit before surgery takes place. There is a very real risk of wound infection, breakdown and skin loss (particularly behind the ears) in smokers. This risk is reduced, but not altogether removed, by stopping smoking before surgery.

Scarring within the hair bearing scalp can sometimes stretch to give bald patches although these are generally easily hidden by hair styling. The hairline, particularly in front of the ear, is moved upwards and so this area will appear different after the surgery.

Metal staples are used to close the incisions within the hairline and these are generally removed a week to ten days after surgery. The visible part of the wound is closed with a running, dissolving stitch, which does not normally need to be removed.

Modern facelifting techniques, which tighten the deeper structures within the face, can have a very pleasing, rejuvenating effect. However it must be remembered that this merely turns the clock back but does not stop it ticking. The effects of time will continue so the benefits of a facelift are not, therefore, life long.

08/03/05