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The original facelift was a dissection purely under the skin to pull it tight in the hope of removing creases. The subcutaneous facelift is still undertaken for older patients, especially when they are having a repeat operation or for mini-lift procedures done as a day case under local anaesthetic.
Newer techniques include repositioning fat and muscles in the face back onto the cheek bones by using a SMAS list and also pulling on the platysma muscle in the neck, which has been further refined to produce the extended SMAS and combined with a brow lift is often called a composite facelift. |
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These types of lifts are known as the first generation of facelifts. Further generations of facelift, involving the subperiosteal dissection of the face with hitching up of the mid-face and muscle around the eyes and cheek fat, have led to second, third and fourth generations of facelifts.
We have extensively studied the various forms of facelift and we can undertake extended SMAS dissections and subperiosteal endoscopic facelifts. We constantly evaluate (audit) our result and we will discuss with you the best way of approaching the operation to the individual patient given what you wish to try and correct.
It is important to remember that the more dissection that is undertaken, the more prolonged will be the post-operative swelling and bruising. Like all things in cosmetic surgery, what one wants to get is the balance of the maximum gain for the minimum pain.
Facelifting is a major undertaking and, therefore, requires careful preparation, planning, surgical performance and post-operative care. We have available a team of plastic surgeons, specialist anaesthetists, nurses and aesthetician, all of which, will help to speed up and smooth your recovery period.
At the first consultation, following examination, photographs will be taken and the broad principles of surgery will be explained to you and the type of operation that is recommended will be described. There are several different procedures that may be used with a facelift, in particular, chemical peel, dermal fat grafts to the lips and fat injections, augmentation of the chin and, of course, eyelid surgery and brow lifting.
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In addition to your surgeon, the anaesthetists are fully qualified, experienced and very up to date in their field. It is not the practice of this Hospital for surgeons to administer their own anaesthetics other than for simple, minor or twilight procedures.
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The full operation is a long and detailed procedure, which will produce an excellent long-term result and improvement for a considerable number of years. At the second consultation a more detailed discussion will be undertaken with the aid of the photographs and this will allow you to ask me any questions that, undoubtedly, will arise following our first consultation and the reading of our information sheets.
The best candidate for a facelift is a man or a woman whose face and neck have begun to sag but, whose skin has still some elasticity and whose bone structure is strong and well defined. Most patients are in their forties and sixties, but facelifts can be successful on people in their seventies or eighties and is increasingly undertaken on younger patients, particularly those whose face has aged with smoking or excess sun.
A facelift can make you look younger and fresher and it may enhance your self confidence in the process, but, it should not give you a totally different look nor can it restore the health and vitality of your youth. Before you decide to have surgery, think carefully about your expectations and discuss them with the consultant.
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MACS lift
The original subcutaneous face lift involved just lifting up the skin on the face, stretching and then re-draping it. This has now been modified by the use of internal suspension sutures.
This type of facelift is undertaken as a day case, usually under local anaesthesia with sedation. This procedure with limited incisions done as a day case, allows the maximum effect for the minimum amount of surgery and is suitable for the younger patient or the older patient who does not want a major procedure.
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SMAS Face Lift
It became apparent that, to produce a better correction of the face, a deeper lift was required and the pull was, therefore, on the underlying muscle in the neck and on the fascia in the face. This was the SMAS facelift. More recently, as the anatomy has became better understood, this SMAS plane is dissected much further across the face towards the nose, allowing a much greater correction of the mid-face and is known as the extended SMAS face lift and is most popular in the US.
The Mask
The mask, or deep place facelift, has developed from craniofacial surgery and involves an incision in the scalp as part of the brow lift with an extension of this to dissect the structures deeply in the face via a lower eyelid incision and with incisions also placed inside the mouth to help with the dissection. The draw-back, however, is that the post-operative swelling does take a lot of time to settle and the full effect of the lift, will not be apparent for three to six months. Some patients find an altered look to the eyes a problem.
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Our technical, patient-care and support personnel are resourced to an extremely high standard. At the Cambridge Private Hospital, effective teamwork is of the essence and each link must be utterly dependable.
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Endoscopic Face Lift
With the introduction of endoscopic (keyhole) surgery, it has been possible to undertake the dissection of the above mask lift through very small incisions, just above the ear and through the lower eyelid. This is at present being developed as a 3rd and 4th generation facelift and whilst good results are obtained, there is no long term follow-up on this type of surgery.
Composite Facelift
The composite facelift is a combination of the brow lift and extended SMAS facelift and is advocated for the older patient to produce a harmonious elevation of all structures in the neck, face and in particular, around the eyes.
Other types of face lift include:
 Short Scar Face Lift (S-Lift)
APTOS Lift
Chemical Peels
Lifting creams
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It is important you realise that the results may not be immediately apparent until after the swelling and bruising are gone and the scars soften.
It is not surprising that some patients are disappointed and depressed at first. This is normal and should not alarm you.
It is not easy to be bruised and swollen when your expectations are toward improving your appearance. Fortunately this period passes quickly.
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All surgery carries some uncertainty and risk. But, fortunately, when a facelift is performed complications are infrequent, but, must be treated promptly. Individuals vary greatly in their anatomy, their physical reactions and their healing abilities and the outcome is never completely predictable. Complications that can occur include:
Haematoma: (a collection of blood under the skin) which must be removed and this usually occurs immediately after surgery during your stay in the hospital.
Nerve Injury: Numbness of the skin in front of the ears and cheeks is routine but, some patients will be aware of this in a wider area over the ears and neck. Recovery takes place over a course of three to six months. Injury to the nerves that control the facial muscles are usually temporary. This is usually a concussion, caused by stretching and will recover within a period of six to eight weeks. Very occasionally this facial weakness can be permanent, producing either an asymmetric smile or an inability to raise the eyebrow. This major complication is in our experience extremely rare.
Infection and poor healing: Infection is again a very rare complication and always responds to antibiotics. Poor healing of the skin is most likely to affect smokers. Occasionally, small persistent lumps may appear in the cheeks, two to three weeks after surgery, as the swelling goes down, this is scarring under the skin and no specific treatment is required as they always resolve and flatten spontaneously over a period of weeks.
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In addition to your surgeon, the anaesthetists are fully qualified, experienced and very up to date in their field. It is not the practice of this Hospital for surgeons to administer their own anaesthetics other than for simple, minor or twilight procedures.
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Scars are usually fine and well hidden. But, in some individuals the scars may tend to thicken, itch and become red for six to twelve weeks. Such hypertrophic scars can be helped by incisions. The most obvious scars are behind the ear where tension is maximal. You would be advised not to wear your hair tied up or back for at least six months, in order that your hair can flow forwards and cover these scars. Men may find they have to shave behind the ears because of the repositioned beard.
Having a facelift does not stop the clock, your face will age with time and you may wish to repeat the procedure five or ten years down the line. However, the effects of even one facelift are lasting and you will continue to look better than if you had never had a facelift at all.
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This web site has been prepared to give a basic understanding of the procedure before a consultation takes place, and to cover many of the questions frequently asked about this type of cosmetic surgery. Final decisions should not be made until an individual assessment has taken place with the surgeon.
There is no obligation on the part of the patient to undergo surgery by attending for consultation. If you have any further questions or would like to arrange a consultation please do not hesitate to .
43 Cambridge Road
Cambridge, SG8 5QD
(P) 01223 208 085
(F) 01223 208 251
(E) contact@cambridgeprivatehospital.co.uk
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Registered with the
Health Care Commission
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Pre and Post Operative Instructions on Face Lift (Rhytidectomy)
Before and After Photographs of Face Lift (Rhytidectomy)
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