Face lift & neck lift

Overview

Facelift and necklift are what they say. The end result should reduce jowling, neck looseness and facial skin lines, improve jaw definition and put the cheek fullness back up over the cheek bones.

Facelift and neck lift involves making a cut around and inside the ear in women. If the neck is being corrected the cut goes round the ear into the hair behind the ear. As you can see from the pictures below the scars are hard to see.

The skin is pulled up and back and any excess skin is removed. During the operation the muscle layer is also tightened up and additional procedures like facial liposculpture and lip lifts may be used.

I aim for my patients to look significantly but naturally improved not like products of TV cosmetic surgery.

Click here for Facelift FAQs

In this case the following was done

Short scar facelift

Upper and lower lid blepharoplasty

face-lift-16

 


In this case the following was done

Short scar facelift

Gentle neck liposculptureface-lift


In this case the following was done

Short scar facelift

lower lid blepharoplastyface-lift-7


In this case the following was done

Short scar facelift

Lip lift (shortening of the upper lip skin)

Lower lid blepharoplasty

Chin implantface-lift-11


In this case the following was done

Short scar facelift

Dermabraision (surgical sanding) to skin around mouth and cheeks

Upper and Lower lid blepharoplastyface-lift-12


In this case the following was done

Short scar facelift

Upper and lower lid blepharoplastyface-lift-13


In this case the following was done

Short scar facelift

Upper and lower lid blepharoplasty

Dermabrasion

face-lift-14___________________________________________________________________________________________


In this case the following was done

Short scar face and neck lift and neck liposculpture

Facial and neck liposcupture


In this case the following was done

Neck lift through scar behind the ear and neck liposculpture

face-lift

In this case the following was done

Full facelift

Lip lift (shortening of the upper lip skin)

4 lid blepharoplasty

face-lift

In this case the following was done

Short scar facelift

 


 

 

Facelift FAQs

 

Different Types of Facelift Surgery

Short scar face lift / MACS lift / minilift

This operation is good for early changes and lifts the facial tissues using sutures to hold the position of the deep tissues. The amount of skin removed is less than a normal facelift and the operation does not change the neck shape. The scar runs in front of the ear and just round the back of the ear. The movement is upwards. This operation takes about 1 ½  hours and is performed under general anaesthetic.

Extended Short Scar Face lift

This operation is useful if the facial skin is more relaxed. It is a bigger operation and the scar runs from in front of the ear to the hair behind the ear. The deep tissue or SMAS layer is mobilised and can be tightened in both an upward and a backward direction and the contour of the neck can be altered restoring the youthful angle of the neck. This operation takes about 3 hours and is performed under general anaesthetic.

Full facelift or composite lift

This operation is useful if there is a need to deal with changes in the forehead as well. It is a bigger operation and the scar runs from in the hair at the temple to the hair behind the ear. The deep tissue or SMAS layer is mobilised and can be tightened in both an upward and a backward direction and the contour of the neck can be altered restoring the youthful angle of the neck and lifting the brow. This operation takes about 3 hours and is performed under general anaesthetic.

SMAS Lift

Standard facelifts have an extremely high complication rate in smokers. So I am not happy to operate using a standard facelift procedure on smokers. The SMAS lift is a technique which is safer in smokers, but the results are not as dramatic, although the improvement should be stable for 3 – 5 years.

Neck Lift

If the skin laxity is confined to the neck a neck lift can be done through a Short scar incision.

Diagram of Final Scar Position full lift (left) and MACS lift (right):

facelift

Other procedures used to assist the face/ neck lift

Liposuction: can help reduce the fat pocket under the chin and around the jowls. You will be given a facial support to wear if you have liposuction

Platysmaplasty (muscle tightening): using a second small incision under the chin is used to tighten the muscles in the neck

Lip lift: the distance between the nose and the upper lip increases with age and shortening this by removing some of the skin under the nose can improve the youthful appearance.

The details can be discussed during the consultation.

The Face-lift Operation and hospital stay

The operation is performed under general anaesthetic. When you wake up there will be a bandage on your head and drains (tubes under the skin) coming out behind your ears. You will stay in hospital overnight and normally go home the next day, having had the bandage and the drain removed.

If you have needed facial liposuction as well I will give you a garment to support the skin of the face.

You will often be given antibiotic ointment to put on the wounds.

What can go wrong with Face-lift

I feel it is important that anyone having surgery with me is aware of the possible negative sides of surgery and understands the small but real risks. The following paragraphs cover what happens when things occasionally don’t go as expected.

Like all surgery there are risks of complications whoever does your surgery. It is important you are aware that many of the problems you may get after your surgery, if they are treated promptly, have no obvious effect on the final outcome.

All facelift operations have a risk of (in order that they may occur):

  • Bleeding: this may lead to more extensive bruising and swelling, but is unlikely to affect the final result. It is uncommon. There is a possibility that the bleeding may require a return to the operating theatre. The chance of this being necessary is about 5%. In a further few cases small blood clots (haematomas) may be present, but can be removed at around 1 week using a syringe.
  • Infection: there is a very small risk of wound infection which would be expected to respond readily to antibiotics.
  • Opening of the wound line: This is uncommon. If it is a small area it will probably heal without treatment without causing any ill effect on the result. If a more significant part of the wound has opened this may require repairing under some local anaesthetic. Again the final result should be unaffected.
  • Skin flap necrosis. This is a problem that is seen almost exclusively in people who smoke, however even in non-smokers around 2 % have problems with the wound line and very occasionally a further procedure is required to correct it.
  • Facial numbness. The facial skin feels numb after the operation. This should gradually recover over 6-8 weeks but some persistent numbness is possible.
  • Facial weakness. In about 5% of cases there may be a small amount of facial weakness particularly of the forehead or lower lip areas. This normally resolves in 3-4 weeks. More extensive or permanent weakness is rare.
  • Scar: the scar is normally very hard to see, but in some people (2%) bad scars can form which can require further treatment, although it is not uncommon for the scars to become slightly more visible for a while around the 6 -10 week mark. Sometimes the scars are uneven, wrinkled or lumpy. Treatment is available if this is troublesome.
  • Asymmetry: While at the end of the operation your face is symmetrical during the period of settling some slight asymmetry may appear. This is normally invisible to others, if marked it can be corrected.
  • The scars in the hairline can stretch and a there can be some hair loss. This is almost always due to over tightening the skin and is normally avoidable.
  • With all operations the operated area is sensitive to sunshine and should be protected from the sun with SPf50 sun bock for 12 months to avoid abnormal tanning. Once the swelling has settled this should not be a problem.
  • There is a small risk of seroma (fluid collection under the skin) this is normally treated by removing the fluid with a syringe and needle in clinic, occasionally further surgery can be required.
  • As this is a surgical procedure to deal with appearance no guarantee can be given to the final appearance, but if we agree it is an unsatisfactory result correction will be offered at no additional cost.
  • All operations can result in longterm discomfort.
  • All operations have a small risk of Deep Vein Thrombosis (DVT), chest infection and Pulmonary embolism. Death following elective surgery is exceptionally rare (1:250,000 in fit and well people)

After the Face-lift Operation

Expect to feel washed out for a few days after the surgery and to tire quickly although you will return to your normal energy levels in a few weeks.

After the operation you will wake up with a compressive dressing on and 2 surgical drains in the wounds. These are normally removed the next day. The garment should be worn for 7 days until the sutures are removed and then at night for 3 weeks.

For all types of facelift non-absorbable sutures and staples are used which are removed at 5 to 7 days. I will personally see you at 1, 4 and 12 weeks and 6 and 12 months following surgery and more if required.

Expect some bruising and swelling in the first post-operative period. This may last 3-4 weeks but after the first week make-up can be worn and the swelling should be acceptable.

What to expect from Face-lift

Facelift surgery makes an immediate and dramatic difference, although it may take around 2 weeks for the bruising to settle and 4 weeks for the swelling to be nearly gone. There may be some discomfort for a few days. Normally 4-6 weeks after the surgery, there is very little swelling or evidence of recent surgery. By 12 weeks the skin has relaxed and the final result is clear. It may even be quicker than this. The results should be evident for around 5 years and longer in some people. The skin of your cheeks and upper neck will be numb for some time and although the feeling should return it may never be exactly as before the operation.

Cost of Face-lift Surgery

– from £6695 for short scar facelift
This includes all required follow-ups and in the unlikely event you require further treatment due to post-operative problems any further treatment is also included

(prices updated Feb 2018)

What to bring to hospital

If you would like, bring a family member or friend. Bring some easy to put on bed wear, preferably with front buttons and your own clothes and toiletries and something to pass the time like books, puzzles or some music . The rooms have televisions and there is free Wi-fi.

What to look out for after you have gone home

Before you come into hospital, you will get a package that contains a set of post-operative instructions and a thermometer.

Watch out for redness, swelling, pain, discharge, opening of the wound, fevers, sweating and shaking. Whatch to see if your temperature is above 37.2C and you feel unwell or it is above 37.6C.

If any of the above are seen or any of the information of the instruction sheet call the numbers on the instruction sheet or the hospital you had your operation.

Things to Avoid

The following are medications or herbal medicines to avoid before surgery.

Please disclose all medications (including self prescribed and herbal and vitamin supplements) during the consultation. The following increase the risk of post operative problems.

Roacutane or other vitamin A skin preparations / aspirin / steroids / warfarin / clopidogrel / Brufen / alka-seltzer / Fish oil / Flagyl / anti-rheumatics-arthritics / blood thinners eg persantin / St John’s Wort / Aloe vera / Cimetidine / Vitamin E (>600mg/day) / Vitamin C (>1000mg/day) / alfalfa / arnica / bromelain / calendula / celery / chamomile / cloves / Evening primrose / garlic / ginger / ginko / goji berries / licorice / meadowsweet / diabetes medication / blood pressure medication / diuretics

Most fruit and pickles have aspirin like chemicals in them so avoid large quantities in the two weeks before surgery.

Please remember that if you have any questions or concerns to ask during one of your consultations. Writing questions down is sometimes helpful.

Driving

Normally you can re-start driving at around 2 weeks. You are fit to drive if you feel you are fit. I recommend you have someone take you to an industrial zone or supermarket car park late at night so you can attempt driving without risk to others. If you find you can drive without problems you are safe to go out on the road

Work

Depending on how physical the work you do is, you can start working from between 1 and 3 weeks.

If in doubt remember you can always ask for advice.

Exercise

At home rest is necessary for one week and any strenuous activity, bending, and lifting etc. is to be avoided. You can shower once your dressings are reduced after your first appointment.

Physical exercise more than a gentle walk should be avoided for the first least 3 weeks and then only undertaken if comfortable. After 3 weeks I allow swimming and cycling and more vigorous walking. After 6 weeks you can, if it is comfortable, return to full activities.