Facelift / Necklift
The effect of ageing on the face leads to loss of skin elasticity and support for the deeper facial structures. In the upper face, this can cause the brow to droop, the upper eyelid skin to become hooded and the lower eyelids to form bags. In the mid and lower face, the facial skin, cheek fat, and superficial muscles of the face and neck tend to slacken and droop. This causes wrinkling in the neck, deepening of facial folds and smile lines, jowls (sagging skin hanging below the jawline), and deep nasolabial folds (furrow between the upper lips and cheeks). All these effects are worse in people who have suffered chronic sun exposure and in those who smoke and the appearances can make people look older than they really are.
A facelift is an operation to try and reverse the effects of ageing on the mid and lower face and so rejuvenate the face to make it look younger. It is often combined with a brow lift and blepharoplasty surgery (eyelid reduction surgery) to address the upper part of the ageing face. There are many different types of facelift operations, which vary in complexity depending on which physical feature of the face needs to be addressed. Some procedures primarily address the jowls and the neck area, whilst others such as a subperiosteal facelift can address the sagging mid portion of the face. A platysmaplasty is a procedure to tighten the platysma muscles in the front of the neck and at the same time remove any excess fat in this region. Sometimes a combination of all these techniques is required. It is common to combine a facelift with a blepharoplasty surgery.
In order to address the lower face and the neck region, an incision (cut) is made on each side in the hairline above the ear extending just in front of the ear and then passing behind the ear back into the hairline. The skin is lifted off the face and the neck, and the underlying platysma muscle together with its fibrous attachment is pulled and tightened with stitches. The excess skin is pulled and excised and the wounds are closed with a combination of dissolving stitches and staples in the hair that need to be removed after 10 days. In the subperiosteal midface lift, there are incisions in the hairline above each ear, as well as a small incision on the inside of the mouth in the upper gum line, and an additional cut just underneath the eyelashes of the lower eyelid. Using these incisions, the full thickness of the facial structures are elevated off the facial bones and lifted to a more youthful position, and held in place with deep stitches that dissolve. The wounds are then closed with a combination of dissolving stitches and staples in the hair that need to be removed after 10 days. The wounds are then covered with a bandage. All of the facelift operations are performed under general anaesthesia and last between 3-4 hours. Usually a 1 day stay in hospital is all that is required.
This is one of the most commonly performed cosmetic procedures and has high patient satisfaction and low complication rate.