What is a facelift?
A facelift, or rhytidectomy, is a surgical procedure that tightens the underlying structures - and removes loose or sagging skin - on the mid to lower face and neck. Facial muscles may be surgically tightened to improve their tone.
Excess fat may also be removed or repositioned as part of the surgery.
Sometimes, facelift surgery is combined with fat transfer or dermal filler therapy to replace volume in the mid face that time has taken away.
As we age a number of tell tale facial signs develop. These include a ‘sagging’ appearance to the middle of the face, deep creases below the lower eyelids, and along the nose extending to the corner of the mouth.
As fat either disappears - or moves south on the face - loss of skin tone in the mid and lower face creates jowls and excess loose skin, creating an undefined and irregular jawline.
In some cases, excess fatty deposits or excessive loose skin under the chin and jaw can give a person of normal bodyweight the appearance of having a double chin. These issues are addressed with facelift surgery by subtly tightening and lifting the skin and underlying structures in the mid and lower face.
Why have a facelift?
Common goals of facelift surgery include:
- reduce fine lines and deep facial folds
- eliminate jowl lines and droop created by loose muscles or excess skin
- restore a sharper, firmer-looking jaw line and smooth the contour of the neck
- restore a more youthful, yet natural, appearance
As people age, the effects of gravity, exposure to the sun, and the stresses of daily life can be seen in their faces. Deep creases form between the nose and mouth; the jawline grows slack and jowly; folds and fat deposits appear around the neck.
A facelift can’t stop this aging process. What it can do is set back the clock, improving the most visible signs of aging by removing excess fat, tightening underlying muscles, and re-draping the skin of your face and neck.
A facelift can be done alone, or in conjunction with other procedures such as a forehead lift, eyelid surgery, or nose reshaping.
Non-surgical treatments, such as chemical skin peel, dermabrasion or skin resurfacing of the face, may be undertaken at the same time as the facelift.
The aim of these treatments is to treat sun-damaged skin and crow’s feet around the eyes, and fine lines around the mouth, which are not removed by facelift surgery.
A facelift can make you look younger and fresher, and it may enhance your self- confidence in the process. But it can’t give you a totally different look, nor can it restore your appearance to that of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr David.
before and after photos (left)
patient #1 had facelift surgery with wrinkle injections and Fraxel
patient #2 had facelift surgery with wrinkle injections
WHY WE TEAM FRAXEL WITH OUR FACELIFTS
The aim of a facelift is to reduce the signs of ageing by improving the contours of the face and neck and removing excess skin.
But it does not improve poor skin condition, discolouration or pigmentation commonly experienced as we age. For this reason, we offer our patients a full face Fraxel treatment - if the treatment is appropriate for their skin - when they have facelift surgery.
This medical grade laser comfortably stimulates collagen production, plumping the skin while its dual laser function also resurfaces and removes pigmentation, sun damage and pre cancerous solar keratosis.
The result is complete facial rejuvenation, both skin deep - and beyond.
What a facelift won't do
As a restorative surgery, a facelift does not change your fundamental appearance and cannot stop the aging process.
A facelift can only be performed surgically; non-surgical rejuvenation treatments cannot achieve the same results, but may help delay the time at which a facelift becomes appropriate and complement the results of surgery.
Is a facelift right for me?
The best candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity and whose bone structure is strong and well-defined. Most patients are in their forties to sixties, but facelifts can be done successfully on people in their seventies or eighties as well.
Before you decide on facelift surgery, there are some important issues to keep in mind:
- While a facelift should make you look younger, it will not raise sagging eyebrows, remove deep frown lines in the forehead, change your upper or lower eyelids, or get rid of wrinkles around the mouth. Other forms of treatment may be more appropriate for you
- Suture facelift, or thread lifting, is best suited for younger and middle-aged patients whose tissues have sagged with time or sun damage. It is not recommended for people with very thin or dry skin. Your surgeon will need to assess your individual suitability for this type of treatment
- The results of a facelift usually last between five and twelve years. Most people can have two to three facelifts in a lifetime, depending on the extent of each procedure and the amount of scarring that occurs with each facelift
- Facelift surgery does not “stop the clock” of ageing. The normal ageing process will continue after the surgery
- Smokers are at increased risk of complications. If you are serious about undergoing surgery, you should quit smoking
Facelift surgery may be a good option for you if:
- You have sagging in the mid-face
- You have deep creases below the lower eyelids
- You have deep creases along the nose extending to the corner of the mouth
- You have fat that has fallen or is displaced
- You have loss of muscle tone in the lower face which may create jowls
- You have loose skin and excess fatty deposits under the chin and jaw, creating the appearance of a double chin
- You are physically healthy and you do not have medical conditions that can impair healing or increase risk of surgery
- You have realistic expectations of what face lift surgery can accomplish
You are a non-smoker or have stopped smoking
Facelift surgery explained
A facelift procedure includes the following steps:
Step 1 – Anaesthesia
Facelift surgery is performed under a general anaesthetic with a specialist anaesthetist; you will be asleep and feel nothing during surgery.
A variety of other procedures can further enhance the outcome of a facelift. They include:
- Fat grafting or transfer to recontour the facial structure
- Resurfacing techniques to improve the tone and texture of facial skin
- Wrinkle injections or dermal revolumising fillers
Step 2 – The incision and procedure
Incisions usually begin above the hairline at the temple, extending in a natural line in front of the ear - or inside the cartilage at the front of the ear - and continuing behind the earlobe to the lower scalp.
If a neck lift is also required, a small incision may also be made under the chin. Dr Sharp separates the skin from the fat and muscle below. Fat may be trimmed or suctioned from around the neck and chin to improve the contour. Dr Sharp then tightens the underlying muscle and removes excess skin.
Step 3 – Closing the incisions
Once healed, the incision lines from a facelift are usually well concealed by the hairline; Dr Sharp aims to integrate these into the natural contours of the face and ear.
Step 4 – See the results
The visible improvements of a facelift appear as swelling and bruising subside over several months following surgery. Your final result will restore healthy facial contours and provide a more lifted, full appearance.
Facelift recovery: what to expect
During your facelift recovery, a support garment will be in place around your face. It will minimise swelling and bruising. Thin tubes will also be present to drain any excess blood or fluid that may collect under the skin.
There isn’t usually significant discomfort after facelift surgery; if there is, it will be reduced by the use of pain medication, prescribed by your anaesthetist at the time of surgery. Severe or persistent pain or a sudden swelling of your face should be reported to Dr Sharp immediately. Some numbness of the skin is quite normal; it will disappear in a few weeks or months.
Dr Sharp will tell you to keep your head elevated and as still as possible for a couple of days after surgery, to keep the swelling down.
If you’ve had a drainage tube inserted, it will be removed approximately two days after surgery. Support garments, when used, are usually removed after seven days. Don’t be surprised by your bruised and puffy appearance; it is only temporary - in a few weeks this will have subsided significantly.
Most of your stitches will be removed after about five days. Your scalp may take longer to heal, and the stitches in your hairline could be left in for longer.
You will begin to return to activities within two to three days, with just gentle activity around the home, slowly increasing over the first post operative week. Take special care when touching your face and hair; your skin will be tender and numb, and may feel strange. Resist the urge to itch or touch the incision areas - remember these are wounds that can become infected if strict hygiene standards are not followed.
Dr Sharp will give more specific guidelines for gradually resuming your normal activities. These include avoiding strenuous activity, including exercise and heavy housework, for at least two weeks (walking and mild stretching are fine); avoiding alcohol and vigorous exercise for several months. Most importantly, eat healthy nutritious food to fuel optimal healing and get plenty of rest.
In the weeks following surgery your face may look and feel strange. Your features will be distorted by swelling and bruising, your facial movements may feel unusual, you will most likely experience some numbness and you will feel self-conscious about your scarring. Some bruising may persist for two or three weeks, and you may tire easily.
By the third week, you’ll look and feel much better. Most patients are back at work about ten days to two weeks after surgery. If you need it, special camouflage makeup can mask most bruising that remains.
Healthy nutrition and regular physical activity, including gentle core strength exercises and practicing good posture, are integral to obtaining and maintaining optimal long term results.
Dr Sharp and his team can also medically support your results after facelift through the non surgical treatments available at his Greenslopes Private Hospital and Ipswich clinics, including:
- Cosmetic fillers to recreate lost facial volume and enhance natural facial curves
- Wrinkle injections to reduce crows feet and forehead lines
- Fraxel laser to improve and maintain healthy skin condition, remove sun damage and promote collagen production
- Dermapen fractionated skin needling to reduce the colour and visibility of scars
- Specially formulated prescriptive skin care to improve healing and scar optimisation
Contact our experienced clinicians on 3202 4744 to find out more.
Facelift results and expectations
It is important that your surgical incisions are not subjected to excessive force, abrasion or movement during the healing period.
It may take a few months for swelling to fully dissipate and for incision lines to mature. As swelling and bruising subside, the visible improvements of a facelift appear. Your final result should not only provide a more rejuvenated and rested look, but it may also help you feel more confident about your appearance.
Remember that facelift results may not be immediately apparent; even after swelling and bruises have dissipated, your face may not feel ‘settled’ for months. Men whose beards or skin have been repositioned may find they have to shave in new places, behind the earns and on the neck.
You will have scars from your facelift, however Dr Sharp endeavours to conceal these in the hair or natural creases of the face and ears. With good care and patience, these scars will fade within time until they are scarcely visible. Talk to our skin team if you have any concerns regarding scaring, as our scar optimisation protocol can assist with accelerating your scar healing and improve its appearance.
Having a facelift may turn back the clock, but it does not halt the ageing process. Your face will continue to age with time, and you may wish to repeat the procedure one or more times five or ten years down the line.
Ongoing sun protection and a healthy lifestyle will help extend the results of your rejuvenated, more youthful appearance.
How do I choose my surgeon?
Facelift surgery is very safe, and performed frequently by plastic surgeons in Brisbane. However it is a major procedure – and therefore, choosing the right surgeon is of upmost importance. Facelift surgery should be performed by a qualified plastic surgeon who is registered as a Fellow of the Royal Australasian College of Surgeons. You can confirm your surgeon’s credentials here.
Dr David Sharp is a qualified plastic surgeon with a special interest in reconstructive and cosmetic plastic surgery. His personalised approach means that you receive plenty of pre operative time with him to discuss your specific facial rejuvenation goals and ask any questions.
It’s normal to feel both nervous, and an excited sense of anticipation, when planning your facelift. Dr Sharp takes the time to ensure you have as many consultations as you require, to ensure your treatment is customised to suit your face, age and expectations – and address any concerns you may have.
Facelift risks and complications
Like any surgery, you must weigh up whether the benefits out way the risks for you. While facelift surgery is common, it also carries risks. Your pre-operative consultations with Dr Sharp will enable him to discuss potential complications with you, and help you determine whether the surgery is right for you
Facelift risks include:
- Anesthesia risks
- Poor wound healing and skin loss
- Facial nerve injury with weakness
- Temporary or permanent hair loss at the incisions
- Fluid accumulation
- Numbness or other changes in skin sensation
- Persistent pain
- Unfavorable scarring
- Prolonged swelling
- Skin irregularities and discoloration
- Sutures may spontaneously surface through the skin, become visible or produce irritation that require removal
- Unsatisfactory results may include: asymmetry, unsatisfactory surgical scar location and unacceptable visible deformities at the ends of the incisions. It may be necessary to perform an additional surgery to improve your results.
- Deep vein thrombosis, cardiac and pulmonary complications
Complications are rare, and Dr Sharp and his team manage each of these risks with the upmost care to further reduce the likelihood of them occurring. In the event they do occur, most can be treated quickly and easily with prompt intervention.
Everyone’s body responds differently to surgery. In some cases, post-operative revision surgery might be required.
Some factors, such as weight, lifestyle or health problems can increase the chance of a complication occurring. Dr Sharp will take time to learn about your potential risk factors during your pre operative consultations, and will determine if they are relevant to your surgery.
What kind of anaesthetic will I have?
Facelifts are performed under a full general anaesthetic. A specifically selected range of medications are administered during the surgery to ensure your post-operative comfort. Dr Sharp works with an experienced team of trusted anesthetists.
The procedure is performed in accredited day hospital and inpatient facilities. Some patients go home a few hours after surgery, while others prefer to stay in hospital for a day or two following their procedure.
How much time should I take off work?
You should avoid strenuous activity for up to six weeks. Depending on your work, you could need to take up to three weeks away from work, although many people return to work - particularly if it involves sedentary activity - after 9 to 14 days.
How much do facelifts cost?
Potential costs include:
- Dr Sharp’s fee
- Anaesthetist fee
- Assistant’s fee
- Theatre costs
- Support garments
Facelift is not covered by private health insurers.
After your consultation with Dr Sharp, you will be provided with a written estimate of fees.
It is important to understand that, in the case of complications or revision surgery, the cost of your facelift might extend to future surgical procedures and hospitalisations. We encourage patients to think about how they would fund further treatment beyond the immediate costs expected.
How long do the results last?
Your result will not last forever; facelift turns back the clock but it does not stop the aging process. You may wish to undergo further facelift surgery in 5 or 10 year’s time to retain your lifted, firm appearance.
Dr Sharp’s experienced team of medical professionals can assist you in maintaining and complimenting your results with a range of non surgical solutions, including:
- volume and filler injections to naturally restore lost facial volume, or enhance your lips
- wrinkle injections for fine forehead lines and crows feet
- Fraxel for collagen stimulation and removal of sun damage or pigmentation
- Dermapen fractionated skin needling to promote collagen production
- Medically formulated skincare that addresses the key signs of aging with key active ingredients
- Our SPF50 dry touch sunscreen (perfect for grease-free everyday wear under makeup)
How do I know if I need a necklift or facelift?
Often, patients think they need a neck lift to address their jowls and sagging skin in this area, however the cause of their lower face concerns actually began with the loss, and migration of their fat pads, skin and underlying facial support in their mid face - causing skin and tissue to hang around the lower face. In this case, a facelift may address these issues and a neck lift might not be required.
If there is excess skin below the jawline, on the neck - or small deposits of fat accumulated under the chin area - a neck lift procedure may also be required. This procedure is tailored to the patient’s desired outcome. In some cases, liposuction may be used to remove excess fat, while in others only the platysma muscle is tightened and excess skin removed. The neck lift incision is made across the front of the neck, and the scar is often integrated into the lines of the skin to reduce its appearance.
Facelift: words to know
- General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
- Hematoma: Blood pooling beneath the skin.
- Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
- Tear trough: Deep creases below the lower eyelids.
- Nasolabial fold: Deep creases between the nose and cheek
- Jowls: A jaw line that sags into the neck, usually caused by loss of muscle tone in the lower face.
- Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
- Rhytidectomy: A surgical procedure also known as facelift, to reduce sagging of the mid-face, jowls and neck.