What is a Face And Neck Lift?
As we become older, the skin and supportive tissues become thinner and lose their elasticity. This results in sagging of the face in a characteristic way.
Face and neck lift surgery is done to temporarily reverse this sagging by tightening the skin and supportive structures of the face and neck and discarding the excess skin. Face and neck lift surgery is often performed in conjunction with other procedures for e.g. eyelid surgery, laser resurfacing of the skin, chemical peeling, liposuction of the neck etc.
Face and neck lift surgery
effectively reverses the maturation changes of the skin and underlying tissues
brought about by age, sun exposure and smoking.
The
characteristic changes reversed by face lifting surgery include drooping of the
eyebrows, excessive transverse wrinkles of the forehead, excessive wrinkled
skin with bagginess of the eyelids, deepening of the folds between the nose and
corner of mouth, formation of jowels over the jawline where the cheek appears
to sag downwards into the neck.
helpful advice
General Questions
A face lift
operation is usually performed under local anesthetic with intravenous
sedation. Prior to the procedure, the incision lines are marked with pen in a
position which has been carefully explained to the patient beforehand. The
incision starts in the hairline above the ear and then descends by closely
following the contour of the ear. It then turns backwards behind the ear to
finish in the hairline just above the upper third of the ear at the back. This
procedure is well tolerated under local anesthesia with intravenous sedation
but can of course be done under general anesthetic if the patient so desires.
The
unpleasant injections of local anesthetic cause some stinging for about 2 — 3
minutes on each side. During the procedure the skin of the side of the
forehead, cheeks, neck and behind the ear is raised of the underlying
structures allowing tightening procedures of these layers (SMAS layer).
Depending on the specific problem in each patient, there are variations in the
way in which the SMAS layer is lifted and tightened. The excess skin is then
trimmed off and the incisions around the ears are closed. Any ancillary procedures
such as liposuction etc. are done before the face lift procedure.
On average, a face and neck lift operation takes 3’ – 4 hours. Under intravenous sedation, the patient is not aware of the passage of time and is able to remain co-operative, relaxed and calm during the whole time period.
At the end of the procedure, the patient rests in the ward for a while and is usually allowed to be driven home on the same day. Kindly note that there will be thin soft plastic tubes emerging from the wounds behind the ears and these allow drainage of any blood which may accumulate under the skin in the first 24 hours post operatively. Some patients prefer to stay overnight in hospital especially if there is not round- the-clock help available at home.
Bleeding
and infection are always a risk in any operation. Although we take every
precaution to prevent this from happening, the occasional small bleed occurs
usually on the lower cheek or neck area and requires drainage post operatively.
This can usually be done in the office by aspirating the blood with a syringe.
Very
rarely, it is necessary to return to theatre to drain a larger collection of
blood. This does not usually have any permanent effects and is extremely rare.
Equally
rarely, during the lifting of the skin off the underlying structures, it is
possible to cause some damage to the nerves of the face. In these Cases, there
is usually a temporary (6-8 weeks) weakness of one part of the face post
operatively. It is theoretically possible to cause permanent damage to one or
more nerves resulting in permanent weakness of that portion of the face. This
is extremely rare.
Also
uncommonly, especially in smokers who persist in smoking, the skin behind the
ears may lose some blood supply and form a dead scab. This usually requires
dressings for a few weeks and eventually heals spontaneously.
Please
avoid products that contain Aspirin and high doses of Vit.E for a period of 3
weeks before surgery. Please moderate your alcohol intake pre-operatively.
It is
absolutely critical to avoid smoking for at least 2 weeks pre-operatively.
Smoking interferes with the circulation of the blood supply in the skin and can
cause death of the lifted skin flaps. Furthermore, smoking causes coughing
which may contribute to further bleeding under the skin post operatively. The
risk of complications in smokers who have face lift surgery is exceptionally
high in the manner described above.
lf you
develop any signs of infection, pustules or boils on the face or body before
surgery, please notify your surgeon.
Please do
not wear any make-up to surgery, this includes mascara and nail polish. Please
wear comfortable loose clothes that do not have to be pulled over your head.
You may
have a light breakfast +3 hours before surgery. Post operatively it is very
important to remember that this is a delicate extensive operation. Please do
not laugh, talk excessively or run about as you have had a very large operation
and must rest properly. The fine suturing of the deep muscle layer must be
protected from ruptures in the first 2 weeks. Failure to take care may
compromise the long term end result.
The bandages around the head are usually removed 24 hours after surgery. The bandages frequently appear blood stained. Please do not turn your head from side to side but turn your body as a unit. Keep your chin in an elevated position and your head above shoulder level at all times. Bring a scarf and sun glasses to maintain privacy after the operation.
Please sleep on 3 pillows or
raise the head of the bed for at least 72 hours post operatively. If eyelid
surgery has been done at the same time as your face lift please follow the
instructions as per this procedure.
Swelling
and discoloration, even uneven swelling (more on one side than the other) is
expected. Bruising and discoloration may persist for 3 – 4 weeks after surgery.
There might also be some lumpiness of the neck and cheeks and this may persist
for 6 – 8 weeks but it will disappear. In severe cases it may be necessary to
use physiotherapy.
Avoid
strenuous activity, getting overheated and sun bathing for 2-3 weeks. Please do
not drive until instructed to do so especially if you have had neck surgery
(2-3 weeks).
Any excessive
swelling should be reported. Please do not apply heat to the neck or face
following surgery for 3 weeks because there may be areas of decreased sensation
and the heat may be damaging.
lf you have
pets, please be particularly careful not to allow them close to you during the
early stages of healing. The hair etc. can contaminate your scars and cause
infection.
Lastly, if
is very important to understand that it takes at least 6 months and up to a
year in some cases before the final result of a face/neck lift has settled. It
is necessary to be very patient during this time.
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