10 Questions to Ask Your Plastic Surgeon Before a Facelift

Director Liz Washington

So you’ve scheduled your consultation with a specialist plastic surgeon to discuss facelift surgery and you have some time to wait before your appointment comes around.

Now is the perfect opportunity to prepare for your consultation with some research and question planning.

Dr David Sharp Plastic Surgery director Liz Washington lists 10 topics to consider, before committing to facelift surgery:

What is facelift surgery?

A facelift is a surgical procedure that tightens and reduces sagging skin on the mid and lower face – and upper neck. Facial muscles may be surgically tightened to further lift and improve tone. Excess fat may be removed via liposuction, or repositioned to replace lost volume. Modern facelifts improve key aspects of the ageing mid and lower face:

 

    • Bone structure depletion
    • Fat pad loss
    • Loose skin that has migrated south
    • Sagging and jowls along the jawline
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Will I still look like ‘me’ after a facelift?

Yes. A facelift will take your natural anatomy and age into account; after the surgery you will still look like ‘you’ – just refreshed and firmer in the mid and lower face. Like all aesthetic surgery, facelifts will work with your natural appearance to enhance and improve, but they will not perfect. 

What is the best age to have a facelift?

How we aesthetically age depends on a number of factors, including genetics, lifestyle, stressors, common facial expressions, environment and weight loss or gain. So just as our faces age differently, there is no one single perfect age for everyone to get a facelift. Our facelift patients range from people in their early 40s seeking mini facelift, which firms and redefines the jawline – through to men and women in their 70’s who are looking for the natural-looking, ‘total’ facelift results that Dr Sharp is known for.
The majority of Dr Sharp’s facelifts are performed for patients aged 50 to 65, but older and younger people have facelifts too. The decision to undergo a facelift is a deeply personal one and should not be impacted by other people’s perceptions or wishes. The best time for you consider facelift surgery is when you feel bothered by mid and lower face ageing, or excess upper neck skin.

How can I tell if facelift surgery is right for me?

This is something we discuss extensively with patients preoperatively, during two or three consults, before proceeding with surgery. Facelift surgery isn’t for everyone; before booking surgery, both patient and surgeon need to be on the same page and feel 100% confident with moving ahead.

The objective of facelift surgery is to reduce the severity of the above aspects of ageing, by improving the contours of the face and upper neck. While a facelift can help to make the face and skin look younger and smoother, it will not remove all lines and wrinkles, especially deep creases around your mouth or in the eye area. Other treatments can be performed alongside facelift surgery to address these highly active areas of the face, which are prone to deep wrinkles and lines.

The ideal candidate for a facelift is a patient whose face and neck have begun to look saggy and depleted, but who has well defined bone structure and healthy, elastic skin. That’s a very narrow window in the process of ageing and many people aren’t in a position, or wishing to, undergo facelift surgery while they are still in this phase of ageing. Therefore patients often seek facelift surgery both before and long after the aforementioned stage of ageing, and that’s ok. Rather than focusing on a patient’s age, results are actually more dependent on other factors, including pre-existing anatomy, body fat and overall health.

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What should I keep in mind before having facelift surgery?

Facelift surgery is best undertaken when your physical, emotional and mental health is in a good place.

We encourage patients to prioritise great nutrition before and immediately after the surgery, to ensure their body is in the best possible condition for healing. Dr Sharp performs this procedure on non-smokers and patients with a BMI under 30.

Interestingly, patients rarely complain of significant pain after facelift surgery, but they sometimes report feeling ‘tight’ and irritated by the compression garment (see video above) and drains, which serve an important recovery purpose, but do require some temporary adjusting-to, in the immediate postoperative period!

Patients usually take 2 weeks off work and cannot lift anything heavy or engaging in exercise/exertion for 6 weeks. Daily scar massage and our recommended light based scar therapy regime – along with a Fraxel resurfacing laser treatment at 12 weeks post surgery – is also something to prepare for in advance of the surgery. Attending these appointments can be time-consuming, but important.

While a facelift should make you look younger, it will not raise sagging eyebrows, remove deep frown or forehead lines, change your upper or lower eyelids, or erase wrinkles around the mouth. Other forms of treatment, such as Fraxel laser, skin boosters, PRP or other cosmetic injectables can be used alongside facelift surgery to improve these areas.

How long do facelift results last?

The normal ageing process will continue after the surgery. When patients maintain their weight, good health and skin care, the results of facelift surgery can last between five and ten years. Stress, smoking, weight fluctuations or poor skin tone will accelerate the ageing process, as will some health conditions – whether you have a facelift or not. Some patients have two or even three facelifts in a lifetime, depending on the extent of each procedure and the amount of scarring that occurs with each facelift.

Are facelifts painful?

Facelifts are performed under general anaesthetic, so you are blissfully unaware that the surgery is happening! Pain relief is provided for the days after surgery; most patients report that paracetamol is enough to keep them comfortable, but pain thresholds vary between patients so taking regular, prescribed pain relief is important if you are sensitive to pain.

We recommend that patients sleep in an elevated position for the first week or two after surgery, and only undertake light activities during the first 6 weeks.

Will have scarring after a facelift?

Yes, you will. Dr Sharp always endeavours to minimise facial scarring and to position scars as inconspicuously as possible, taking hair coverage and natural skin folds into consideration. Our postoperative facelift care includes products and treatments that are designed to optimise scarring as well. Patients are also asked to undertake at-home scar care using daily massage and scar gel.

But scars are an inevitable part of any surgery and will always be visible, to vary extents – especially if:

  • you had poor skin quality preoperative (eg. thin, sensitive or sun damaged)
  • you have sparse hair coverage in your hairline
  • you contract a wound an infection after your surgery that delays or complicates your incision healing
  • you are genetically predisposed to poor scarring

 

Over time, scars fade and are less distinguishable. The scar maturation process takes up to 24 months and this can require an incredible amount of patience. It’s important to consider how you might feel during this period if your scars are visible. Will this have an impact on your wellbeing, self esteem, hairstyle or social choices? These and other considerations will be raised by your surgeon preoperatively for personal reflection.

Are there potential risks and complications from facelift surgery?

Yes, all surgeries carry risks. Patients with a history of cardiovascular disease, lung disease, smoking, diabetes or obesity have a higher risk of developing complications. Dr Sharp provides a detailed list of the more common complications for consideration prior to surgery; while even the most ‘common’ complications do not occur often, it is still important to consider how a complication could impact you emotionally, physically or financially. Dr Sharp also provides detailed postoperative instructions and our postoperative nursing care team are in regular contact with patients during the postoperative period to support the best possible recovery.

What are your surgeon’s qualifications?

Seek the opinion of at least two qualified specialist plastic surgeons before proceeding with facelift surgery. Facelift surgery is a major operation and it is important to ask your plastic surgeon whether, in the case of a complication, they have the experience required to assist you. Also ascertain whether they have admitting rights to a private inpatient hospital if you required readmission for a complication. If you are travelling from interstate or a regional area for surgery, discuss what would happen if a complication were to occur after you travelled back home. Despite facelift complications being rare in our experience, discussing these possibilities prior to surgery is an important part of your preparations.

Remember that not all surgeons are actually RACS-qualified surgeons. At the time of this article being published, any doctor in Australia can call themselves a “surgeon”, whether they are a Fellow of the Royal Australasian College of Surgeons, or not. Visit the Australian Society of Plastic Surgeon’s website to check if the surgeons you are considering for your procedure are actually plastic surgeons.

 

To book a consultation with Dr Sharp and find out if facelift surgery is right for you, please call our friendly patient support team on 3202 4744.