Face Lift (Rhytidectomy)

A face lift can help you look the best you can for your age by giving you a more youthful, rejuvenated facial appearance.

  1. What is a Face Lift?
  2. Why you might consider a face lift?
  3. The Consultation
  4. The Operation: What Happens during Surgery?
  5. Recovery / Convalescence

What is a Face Lift (Rhytidectomy)?

A face lift, or rhytidectomy, is a surgical procedure aimed at reducing the visible signs of ageing of your face.  It can help reduce wrinkles, firm up sagging skin, eliminate deep furrows, reduce heavy jowls, and remove or redistribute fatty deposits under the skin.  Overall, a face lift can help you look the best you can for your age by giving you a more youthful, rejuvenated facial appearance.

Face lift surgery is the third most popular cosmetic surgery intervention.  For the majority of people who undergo the surgery, it can seem literally to ‘turn back the clock’ on the ageing process by reducing the effects of environment, stress and time.

Face lifts can be performed on your whole face (a full face lift) or just on your brow area, lower face, or neck only.  Surgery typically lasts between two to four hours, but varies according to the intervention(s) carried out.  The surgery can also be carried out with other procedures such as eye lid surgery (blepharoplasty).

The effects of a facelift can last for around seven to 10 years.  But how a face lift works for you will depend to a large extent on your expectations and emotional well being, as well as a variety of other factors.  Your age, general health, smoking, gender, ethnic and genetic make up, and skin and bone structure as well as the environment in which you live (pollutants, harsh sunlight etc) can affect the outcome of your face lift surgery.  Your surgeon will examine all these factors in detail to determine the type of procedure that suits your needs and advise you of the best possible outcome of your face lift.

Why you might consider a face lift?

Face lifts are mostly carried out on people in their 40s, 50s, or 60s but the procedure has also been successful in older people.  Younger people are advised to opt for non-surgical facial procedures such as a chemical peel or microdermabrasion.

As with any cosmetic surgery, you should think carefully about your expectations and have realistic goals.  The intervention is designed to give you a more youthful look, and can also have the side benefit of making you feel more confident about yourself.  You need to be prepared for your ‘new look’ and understand how it may affect your health and emotional well being.

You may be considering a face lift if you have:

  • Mid-facial area that is sagging
  • Visible furrows or creases below the lower eyelids
  • Furrows in the skin along the nose extending to the corner of the mouth
  • Fat that has fallen or is displaced
  • Lack of muscle tone in the lower face which is contributing to heavier jowls
  • Sagging skin and excess fatty deposits under the chin and jaw

Before considering a face lift, you need to be in good health – preferably a non-smoker (or be prepared to stop smoking for a given period before and after your surgery) – and to have a positive, realistic approach to your surgery.

What face lift surgery won’t do

Face lift surgery can only work on specific areas of your face.  You can have other, complementary surgery in conjunction with your face lift to rejuvenate brows (brow lift) and eye lids (blepharoplasty).  A face lift won’t change your overall appearance.  Generally, the results of a face lift last between seven and 10 years, but this differs according the individual.  Some people opt for minor corrective surgery in years following, in order to retain the benefits of their face lift surgery and investment.
A facelift can only be performed surgically, but non-surgical rejuvenation treatments can be used to work on superficial facial lines and to improve skin texture.

The Consultation

The pre-operative consultation with your cosmetic surgeon and the immediate weeks before surgery are very important if you are to make the most of your face lift surgery.  You will need this time to prepare yourself emotionally and physically.

The more candid you are at this stage, the better your surgeon will be able to assess the type of face lift surgery required (full, mini, brow, mid-face or neck only) and its likely outcome.

Be clear about what you expect the surgery to achieve.  If you wish, provide photos of how you expect your facial appearance to be after surgery.  Your surgeon will assess your expectations and advise you if they are attainable.

The surgeon will examine all aspects of your face such as your skin quality (fatty deposits, laxity, elasticity and so on) and bone structure and ask you detailed questions about your overall health, well-being, goals and your medical history.  The surgeon forms a surgical plan based on this information to select the optimum face lift for your needs.

What to expect from the surgeon

Be prepared to supply information on and/or discuss:

  • Your expectations of the surgery
  • Any medical conditions, drug allergies and medical treatments
  • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
  • Any previous surgery
  • Any family history that may be relevant to your facial characteristics

During the consultation, your surgeon is likely to:

  • Assess your general health
  • Evaluate any health conditions
  • Examine your entire face, assessing brows, skin laxity and so on
  • Discuss the likely results of your surgery
  • Discuss the value of and any complications of combining your face lift with other facial area surgery such as eye lid or brow lift surgery
  • Take photographs for medical records
  • Talk about the type of anesthetic used and its effects

You may be asked in preparation for surgery to:

  • Take certain medications or adjust your current medications
  • Have certain lab tests or further medical evaluation
  • Refrain from smoking in advance of surgery
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Questions you should ask

It is important that you are fully informed of the after care, any possible complications and the likely results of your surgery.  You will also need to know how the procedure is carried out, in particular where incisions are made and where any scarring is likely.  Below is a checklist of some key questions to ask:

  • What type of face lift surgery is best for me and why?
  • How do I best prepare for the operation
  • Do I need assistance in post-operative care?
  • What results can I expect?
  • What side effects or complications may occur?
  • What discomfort will I have?
  • How will my face look immediately post op (bruising, swelling etc)?
  • Are there any activities or environments I should avoid while I recover?
  • How lasting can I expect the results to be?
  • What other cosmetic procedures can I consider in conjunction with my face lift?
  • What instructions should I follow after the operation?

The Operation: What Happens during Surgery?

Surgery takes around two to four hours. The position and type of incisions depend on the type of face lift.  The procedure can be performed under general anesthetics or with a combination of mild sedatives and local anesthetics; again, depending on the extent of the surgery and your surgeon’s recommendation.

Traditional face lift

The surgeon starts the incision at the hairline by the temples, just above and in front of the ear and then circles the lobe.  The incision is placed where it will be least visible and most easily hidden along the hairline and for men it is positioned to retain their natural beard line.  If you wish to reduce a sagging jaw line, cuts may also be made under your chin.

The skin is carefully separated from the underlying tissue and muscle.  The surgeon then tightens the skin and muscle, repositions any connective tissue and may remove excess fatty deposits or excess skin.  Then, the skin is raised upwards and outwards to the incision point, and any excess is trimmed off before the skin is closed using fine sutures, metal clips or stitches.

After surgery, you will have dressings applied to the entire incision area.  You may have bandages running around your eyes and over your head.  These are usually required only for the first couple of days following surgery.  You may have very fine plastic drainage tubes inserted into the incision area to ensure that blood and other fluids don’t built up under the skin.  Again, these are usually needed only for 48 hours.

Mini- or limited face lift (minimal access cranial suspension)

This alternative to the full face lift requires fewer and shorter incisions at the temples and around the ear lobes.

Neck lift

This corrects sagging jowls, loose neck skin and any fat accumulation under the chin.  The incision here can still start at the front of the ear lobe, but will then go around behind the ear ending in the lower scalp area.

Recovery / Convalescence

What to expect immediately
At first, you will experience some bruising, inflammation and some discomfort.  But once the immediate swelling subsides, you will begin to see your rejuvenated self.  It does take varying amounts of time for face lift surgery to heal and for individuals to realise the benefits of their surgery.

Immediately post-op, you will be advised to rest with your head in an elevated position to alleviate the swelling.  You may need to use ice packs from time to time.  Most painful swelling subsides in the first 48 hours.  Bruising and/or discoloration may last up to two weeks, but you may be allowed to wear concealing make up even a week after the operation.

You may find that one side of your face is swollen more than the other side, that you have some facial numbness or that you have some temporary asymmetry in your facial features for a while.  These are common in the immediate post-operative period and usually correct themselves quickly once the healing process sets in.  As a rule, stitches are removed a week after surgery.

Long-term care

Your surgeon will give you a comprehensive list of do’s and don’ts to adhere to after your operation.  These will include instructions on caring for the incisions and wounds, applying dressing and on your medication, and on any abnormal signs you should look out for.  You are likely to be advised to avoid Aspirin (which can thin blood) and non-steroidal anti-inflammatory medications for the first few days.  Smoking and exposure to sunlight are not recommended.
Some patients find that mild swelling persists for many weeks and if it does, you should consult your surgeon.

You are asked to refrain during the early weeks from strenuous exercise and any activity which requires straining, bending over and lifting as they actions may precipitate bleeding.
The full results of your face lift may not be apparent for up to several months as swelling and bruising can take time to abate. It may also take up to six months for scar tissue to be less visible to all but close scrutiny.  Be patient, as you will need time not only to see the results but also to adjust to your new appearance.  But be alert to any abnormalities in the healing process and keep in contact with your surgeon should you have concerns.