1. Who is the best candidate for a facelift?
The passage of time, your genetic make-up, your lifestyle including smoking and being a sun lover; all these factors can play a role in the ageing process of the head and neck. What happens? The skin and soft tissues on your face and neck may become thinner, they sag and this can lead to drooping, wrinkles, jowls, a double chin, ‘turkey gobble’ neck and an always tired appearance.
If you have any of these features or problems then, as long as you are healthy in yourself and have realistic expectations then you may be a good candidate for a facelift. There are many types of facelift and an in-depth, individualised consultation is best to work out what might be best for you so that you completely understand your options, but also understand the risks. Often facelifting techniques can be combined with other procedures, or other techniques such as chemical peels.
2. What should a facelift patient do to prepare for surgery?
I do not suggest any sudden changes just before facelift surgery. However, in the run up to surgery one can take certain steps: of course it is good to have a healthy lifestyle with good nutrition and exercise and a lot of motivated patients may be doing this anyway.
Some things should be stopped before surgery: multi-vitamins, fish oils and the like should be stopped two weeks before surgery. Smoking dramatically increases the risks of surgery so this should be stopped before your operation or certainly in the perioperative period.
Other steps to prepare for surgery may be more mundane – whilst in hospital you will be well cared for but once home you may find things harder so make sure the home is ready; if you can it may be advantageous to have arranged help and support for cooking, cleaning and generally having friends or family around or nearby. Plan to allow yourself the time and space to recover; it is not ideal to squeeze surgery into a small gap when you have deadlines and hard work and stress – if you allow yourself the time to recover you will actually recover more quickly.
3. What are the potential risks of the facelift procedure?
The risks of surgery will be explained in some depth at your consultation; the risks are somewhat dependent on the type and extent of surgery. They include the risks of any operation such as bleeding, infection, scarring and asymmetry.
Bleeding will not be life threatening but if it occurs it will need to be addressed. Antibiotics will be given at the same time as the anaesthetic but in fact as the blood supply to the face is so good infection is rare. No one is symmetrical, and you will not be symmetrical after surgery but you will be as symmetrical as I can make you. There will obviously be bruising and swelling; the majority of the swelling will resolve in a few days but bruising can last three or more weeks.
There can be risks to the nerves that provide feeling and movement in the face so it is important that your surgeon is entirely happy with facial anatomy and has undertaken plenty of procedures and variations of procedures; serious risks are rare but make sure that you feel comfortable with your surgeon; he should be trained, experienced and able to adequately address any problems that may occur.
4. When should a patient expect to see the final results of their facelift?
You will see an immediate improvement as the tissues have been operated and tightened – the skin will be tight plump with swelling and smooth. As the swelling goes down and the healing process progresses the appearance will settle. There are various phases to this; the first phase of significant swelling and bruising may last two or three weeks; at six weeks a tighter phase in the healing kicks in which will then slowly progress to softening and relaxation of the tissues. You will have in essence your final result often at between four and six months.
5. How long does a facelift last?
Many, many years ago, when I was training, my teacher used to say that facelifts can take off to 10 years and last five to ten years. I think now that this is the wrong way to look at facial rejuvenation surgery. Surgery will of course make you look younger but you haven’t stopped the ageing process just put it back a bit so you will carry on ageing from the new point which you have achieved. Let me put it this way: if you are say, fifty and surgery puts you back to 40, then at sixty you are more likely to look nearer 50 and so on.
How much change happens with surgery depends on what you want to achieve and there are different facelifts which achieve differing outcomes. I think that the most effective way to achieve long-lasting results is to do something to a facial layer called the SMAS; in the face this is a sheet of tissue that is elastic and I have various ways to manipulate and adjust this so that your outcome is both natural and long lasting.