Facelift

The facelift is a complex operation, which is able to appreciably improve the appearance of the lower two thirds of the face and neck. The procedure is focused on resection of excess skin and correction of droopy mimic muscles. Intervention is often also made into fat tissue.

Who is a suitable candidate for the operation?

Not everybody who believes that they absolutely need a facelift is a suitable candidate for this operation. Sometimes instead of a conventional procedure with resection, it is on the contrary advisable to perform a procedure, in terms of which volume is added to the face. This may concern not only soft tissue, but also the bones. A facelift is not a procedure indicated merely for cosmetic reasons, but is also used to renew facial symmetry in terms of certain diseases such as facial paralysis.

How does consultation take place?

The overall state of health and any possible contraindications to the procedure are ascertained in terms of consultation. The patient’s ideas about the result of the operation are discussed carefully and the condition of all facial and neck tissue is assessed. Not only the condition of the skin, the subcutis, the mimic muscles and the fat pouches is assessed, but also the bones and especially the cheek bones and the chin. After examination of the local finding on the face, it is determined whether the condition is suitable for surgical resolution and which technique will be used in terms of the operation. The patient is familiarised with the scope of post-operative scars and possible complications. A wide range of surgical procedures is currently used, which could differ significantly in terms of scope and location of post-operative scars, number of possible complications, need to use foreign materials, technical demands. Facelifts are most frequently performed from an incision which leads from the hair in front of the auricle, under the lobe behind the ear and into the hair. During the operation, the skin is lifted together with the subcutaneous face and neck, followed by treatment of the layer of ligament and mimic muscles. Once the excess skin has been removed, the wounds are sewn up and drains are inserted. The procedure may be combined with other procedures on the face and neck, such as operation of the upper and lower eyelids, platysmaplasty, liposuction, application of fillers or botulotoxin and others. It is always necessary to inform the doctor of all medicines which the patient uses. This especially relates to medicines which affect coagulation.

Essential pre-operative examination

The procedure is mostly performed using a combination of analgo-sedation and local anaesthesia. A standard pre-operative examination must be undergone before the operation, which is performed by a general practitioner approximately seven to ten days before the procedure.

Hospitalisation

Photo documentation is created before the operation and the operative plan is marked out on the patient’s body. Prevention of thromboembolic diseases by injection of preparations and equipping the patient with elastic tights goes without saying in the case of procedures performed under general anaesthesia and analgo-sedation. The length of the operation depends on the technique used and usually lasts two to three hours. After the procedure, the patient spends several hours in a recovery room and after stabilisation, is moved to a standard ward. Hospitalisation does not usually exceed two days after the operation. When released, the patient is equipped with an elastic sleeve for the face and neck.

Post-operative care

Post-operative pain is not usually great in the case of facelifts and reacts well to regular analgesics. Too much physical activity is not recommended in the period immediately after the operation. Washing of the face and hair is possible after two to three days. An elastic sleeve is worn for roughly two weeks, which stabilises the soft tissue and limits the scope of post-operative swelling. Care for scars is also an important part of the post-operative regime. Once the stitches have been removed, they are lubricated and massaged, and silicone patches may be applied to ensure quicker maturation. Post-operative swellings and hematomas mostly subside completely within two to three weeks. We come across decreased sensitivity of the skin in the area around the scars on an almost regular basis after the operation. A return to normal sensitivity can be expected over the course of a few weeks or months.

Complications

Complications are infrequent. Early post-operative complications include hematomas or accumulation of blood in the wound. Infection may occur in the wound. From among the other complications, we must name the possibility of damage to the sensitive nerves or damage to the facial nerve with subsequent limitation of activity of the relevant mimic muscles. Part of the skin may die. This complication occurs noticeably more frequently in the case of smokers. Later complications include the creation of hypertrophic scars (wide rigid scars that protrude above the level of the skin).