Why do people have facelifts?
Gravity, age, the lost of skin elasticity and environmental effects have a powerful impact on the face. Jaw lines begin to sag, creases become more obvious and the neck layers loosen.

A facelift removes excess fat, tightens muscles and smoothes out wrinkles by redefining sagging skin. A facelift cannot stop the ageing process, but it can improve your appearance dramatically. The effects usually last for between seven and 10 years. Facelifts can be performed on specific parts of the face such as brow or neck. In some cases clients request a full facelift.

Ultimately most clients of facelifts are looking to greatly improve their self-confidence and enjoy the feeling of smoother, younger-looking skin.

Realistic expectations
You must be realistic about what the procedure can achieve for you. A facelift will not change your personality or make people treat you differently. Everyone is individual and surgery cannot transform you into someone else.

It is critical that you spend time thinking about what you want to achieve from surgery and talk about your hopes with your surgeon.

Everyone’s skin is different and the surgeon will discuss what you can expect to achieve. For example, the elasticity of the face changes as you grow older and the results of a facelift will be different in younger people who have tighter skin.

What happens during consultation?
The surgeon will examine your medical history and discuss the areas of your face that you want to be treated. You will be asked how you want your appearance to be changed and the surgeon will advise you if your expectations are realistic after examining your skin and bone structure

Depending on what is required, the surgeon will advise you of the best techniques for your face. This is a highly individual process and may involve several procedures. The surgeon will want to know why you want a specific look to gain a complete understanding of what you want from the surgery. It is important that you are completely honest.

Getting the most out of your consultancy
Often in cases where clients are unhappy with the results of surgery it is because they did not discuss their expectations thoroughly or were afraid to talk about the outcome or risks.

You have to make an informed decision before signing the consent form so make sure you ask plenty of questions. You want to feel relaxed and confident and completely understand what will happen during surgery.

You may want to know:

• About the surgeon’s qualifications.
• How many operations of your procedure are carried out each year.
• How you prepare for the surgery.
• What realistic results can be expected and when.
• How long the results will last.
• About the side-effects and possible complications.
• How long it will take to recover.
• About the extent of scarring and how it will change in time.
• What happens if anything goes wrong.

Preparing for surgery

• Avoid alcohol, aspirin, garlic and food oils a least a week before surgery as they can cause excessive bleeding.
• Do not eat or drink anything six hours before your general anaesthetic.
• The surgeon and anaesthetist need to know your medical history and if you are on any medication.
• You will be advised of any health checks or X-rays required before your procedure.
• Prior to surgery you will be met by your surgeon who will assess you and discuss your queries.
• Try and give up smoking a couple of weeks before your procedure as it interferes with healing processes.
• You may want to let your hair grow out before surgery so that it’s long enough to hide scars while they heal.
• Bring an overnight bag for your stay and leave valuables at home.

What happens during facelift surgery?
This depends entirely on the type of procedure you require. However, in all cases you will be placed under general anaesthetic and be treated as an inpatient. The facelift technique that is best for you will be discussed with your surgeon. How long it takes depends on what is required. For extensive cosmetic work two sessions may be scheduled.

Traditional facelift surgery
The surgeon makes incisions above the temples in the hairline down to the ear and lower scalp. The skin is then separated from the muscle and fat beneath. Unnecessary fat is removed and the muscles and skin tightened. Excess skin is then trimmed and the incision stitched. After surgery a tube may be placed under the skin to drain away any blood and your face is dressed.

Forehead lift
For a brow or forehead lift, an incision, behind the hairline, follows the arc of the top of the head from ear to ear. If you are bald or have a thinning forehead, the surgeon will discuss with you the ideal incision placement.

Once the incision has been made, underlying tissue is removed and the forehead muscles altered. The eyebrows can also be raised. Excess skin is then trimmed away and the incision stitched.

An alternative procedure for this type of lift is carried out using an endoscope. This camera device, connected to a monitor, is inserted through tiny incisions in the forehead. An instrument to remove excess tissue is then inserted through another incision.

Chin surgery
This is a surgical procedure that can be used to enhance this particular area with an implant or by reducing chin size by removing unwanted tissue.

After surgery

• Your first day is likely to be spent in a recovery room bed being cared for by nursing staff. Your surgeon will visit you and advise you when you can leave.
• Enjoy plenty of rest, keep your head up and as still as possible and avoid any energetic activities that raise your blood pressure.
• You should not drive for two days after the anaesthetic.
• If you have had a drainage tube inserted it will be removed within two days. Bandages are normally taken off after one to five days.
• Avoid alcohol, aspirin, garlic, food oils and smoking. All of these can interfere with the body’s healing processes.
• Any discomfort, bruising or swelling should be treated with a mild analgesic like Paracetamol. Do not use aspirin.
• Don’t be surprised at the bruised appearance of your face. You will not look or feel great and some numbness is normal.
• As the soreness wears off your new face shape will be revealed and in a few weeks you will feel better.

Road to recovery

• Continue taking painkillers if you need them.
• Depending on the surgeon’s advice, elastic dressings or bandages may have to be worn for some time.
• If the surgeon recommends that you take medication such as antibiotics, make sure that you complete the course.
• Your treated area is likely to feel sore during the first couple of weeks, so take it easy and get plenty of rest.
• The surgeon will advise you of when you can return to physical activity.
• Your surgeon will advise you when you can sunbathe.
• Your features are likely to appear distorted at first and facial movements will feel strange until the swelling settles.
• Remember your hair may thin around the temple region and your skin could feel dry. You’ll have some scars but these will be hidden.
• It is important that you contact your doctor if you suffer from an abnormally high temperature, severe pain that is not treated with Paracetemol or if you experience heavy bleeding.
• If you are in doubt about any of the post operative effects speak to your surgeon.
  
  All surgery carries an element of risk
  Most people believe that the benefits of a facelift far outweigh the risk. However before you sign the surgery consent form you should be aware of any possible complications and side effects.

Complications associated with any type of surgery include problems healing, the danger of infection and the potential formation of clots that may be life-threatening. Excessive bleeding or bleeding under the skin, known as a haematoma, may require a return visit to the surgery. Some patients may also have an allergic reaction to anaesthesia. In a minority of cases there may be a problem with fluid loss or an excessive build up of fluid that needs to be drained.

Deciding on a facelift
It is important that you take your time to make an informed decision about having having a facelift. Complications are extremely rare as this is a very common operation, however you must consider any potential outcome.

• You must also remember that a facelift does not stop the effects of aging. Your face will continue to age and you may want to repeat the procedure a few years later.
• After a successful operation you may feel sick due to the anaesthetic and bruises formed by the procedure may take several weeks to heal.
• There will be scars left by the incisions, but these should be located in ‘hidden’ areas. Scars usually fade away but do not necessarily disappear completely. This depends on your skin type.
• There is some potential risk of damage to the nerves that control facial muscles.
• Ear lobes that hang at irregular angles as a result of surgery are easily corrected.
• In men the hair may grow closer to the ears than before the surgery. There may also be temporary hair loss around the incision that could be permanent if hair follicles have been damaged.

Complications are rare and depend greatly on individual circumstances such a person’s health and skin type or the extent of the procedure. Your surgeon will be able to explain how the risks apply in your circumstances.