A facelift restores a more youthful appearance to the lower face and neck by removing major wrinkles and sagging skin. It will also re-establish contours along the neck and jawline. To be successful it is important to maintain a natural appearance without creating the "pulled" look of an over-stretched facelift. Therefore, there will still be movement and expression with some fine lines remaining after the surgery.
The procedure is performed under general anaesthetic and lasts for 2-4 hours. Most patients will stay in hospital for the following night and will then be discharged home with some antibiotics and painkillers. Incisions are hidden in the hairline of the temple, around the ear and into the hairline behind the ear to a variable extent. For a long-lasting result it is important to address the underlying muscle and fascia (the SMAS) as well as the overlying skin. The SMAS layer is usually tightened with sutures and the skin tightened and closed over the top.
Common side effects
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Swelling- this is normal following a facelift and reaches a maximum about 3 days following surgery. It may last up to 3-weeks and very occasionally up to 6 or 8-weeks in some patients.
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Bruising usually comes to the surface within a few days and then gradually resolves over 2-3 weeks. Occasionally extensive bruising can require many weeks or months to totally resolve.
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Loss of sensation, feeling of tightness, headaches- it is usual to have a reduction in skin sensation after a facelift. This can include the skin around the cheeks, chin and neck and it is also possible to have numbness of the lower portion of the ear and the hairline, both above and below the ears. Feeling will usually return over a period of 8-12 weeks but in some patients this does take a little longer. The tight feeling in the face and neck can sometimes cause headaches but usually subsides after a few days to weeks.
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Alteration of the hairline- especially in the side burn areas.
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Hair loss- this can occur around the temple or behind the ear. This is usually temporary with normal regrowth within several months.
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Scarring- scarring will occur whenever the skin is cut and of course, every effort is made to place scar lines where they will not be detected by the unknowing observer. Although scarring on average is minimal, scar maturation varies from person to person and occurs over 6-12 months, with scars passing through a red, itchy and lumpy phase, prior to settling down to thinner, softer less distinct lines.
Complications
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Infection- this is rare as the face has an excellent blood supply. Antibiotics are administered to further minimise this possibility.
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Blood clots or haematoma- although care is taken to minimise bleeding, occasionally there may be bleeding after the operation (sometimes triggered by coughing or straining). This is usually within the first 24-48 hours after surgery and requires further surgical exploration to drain the collection of blood.
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Delayed healing and skin necrosis- Fortunately a very rare complication of facelift surgery but is more likely in smokers. The area most frequently affected is the non hair-bearing skin behind the ear. If necrosis occurs, it is usually allowed to heal on its own, or occasionally small skin grafts are used to speed up the healing process.
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Nerve damage - Damage to the nerves which supply the facial muscles can occur infrequently (about 0.7% of facelifts). This may cause facial distortion - weakness of the eyebrows or around the mouth. This is usually transient and returns to normal over 6-weeks to 6-months. Occasionally it can persist as a permanent complication.
Further information about this procedure can be found here
http://www.plasticsurgeryfoundation.org.au/patient-information/procedures/cosmetic-surgery/facelift-surgery/
