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Facelift surgery

A facelift aims to reverse some of the effects of gravity and the ageing process on the face and neck. Most commonly patients request improvement in the definition of the jaw line and the shape of the neck.

In youth a sharply defined angle between the neck and lower jaw marks out the boundaries of the neck and jaw, however the ageing process blunts this demarcation point and at worst results in a continuous band (or bands) of skin running from the neck directly to the chin. This can have a very ageing effect on the face and makes the face and neck appear ‘heavy’.

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Frequently asked questions

What does a facelift do?

The soft tissue ligaments of the face (structures that connect the skin to the underlying bone of the facial skeleton) stretch as a result of the effects of gravity on the facial fat pockets that they are holding in place. This contributes to the overall ‘sag’ of the face, causing jowls to appear, deepening of the nasolabial folds (the lines present between the cheek and the upper lip), and the appearance of marionette lines (the lines present between the lower lip and the cheek).

A facelift improves the appearance of the neck and returns the soft tissues of the cheek closer to their original location by tightening the soft tissue structures underneath the skin. It will not return you to how you appeared when you were 20! It will however make you appear much fresher and less tired (the optimum result for many patients is that friends and colleagues will comment on well or less fatigued you look rather that asking if you have had surgery!). A good analogy is that a facelift turns back the hands of the clock (a rejuvenation effect of roughly 10 years is a good rule of thumb), however it does not stop them ticking, and following surgery the effects of aging will again start to take effect.

Does having a facelift make me age more quickly afterwards?

No, you will continue to display the effects of aging in the face and neck at the same rate as always, only now you will be aging from the ‘reset’ age of your face (ie; you will keep the gains you have made in your appearance). Depending on the particular areas you wish to address, and on your joint consultation discussions with Mr. MacQuillan, the type of face lift that is best suited to your needs will be determined. Like a bespoke item of clothing, a facelift needs to be tailored to the individual.

What will Mr. Macquillan ask me about in the consultation?

During the consult for your facelift Mr. MacQuillan will ask you about what you feel are the areas that could be improved on with regards to your neck and face. He will ask in detail about this so it is worth spending some time beforehand writing down the specific things that you would like to address. He will also ask you about your general health, previous medical history and then go into detail about the surgery, how it is performed and what you can expect from the operation. He will examine your face and eyes and together you, with will formulate the plan best suited to your needs. You will be given plenty of time to ask questions and it is often worth drawing up a list beforehand as quite often people forget on the day! After the consult you will receive a detailed letter based on the discussion of the consultation and invited back for a further appointment prior to surgery.

What does facelift surgery involve?

Although there are several variations of face lift, they all share several common characteristics; They all involve elevating the cheek from the underlying soft tissue to create a pocket allowing access to the stronger fibrous layer beneath. This can be molded with stitches to improve the shape of the neck and face. Depending on how much work is needed in the neck the size of the pocket differs, as does the stitch placement. Often the surgery will include liposuction underneath the chin.

What happens when I come into hospital?

You will come into hospital on the day of your facelift and be admitted to your room. You will be seen by Mr. MacQuillan in your room, and he will run over the surgical plan with you one final time. You will be reviewed by the consultant anaesthetist who will be putting you to sleep, and given the opportunity to ask any questions you may have regarding the anaesthetic. When you are ready you will be taken down to theatres for your operation.

Following the operation you will wake up with a protective bandage around your head (though your face including eyes, mouth and nose will not be covered by it) and you will have a drain (a small tube placed beneath the skin to remove any blood collecting there) in either cheek. The bandage and drains will be removed the following morning after which you will be able to mobilise. Most patients go home the day following surgery.

How quickly will I recover from a facelift?

For the first week following a facelift you will need to restrict your activities and take things quietly. It is essential that you sleep upright (ie; several pillows stacked behind you so that you are at least 45°) to help reduce swelling. Your face and neck will continue to swell for a day or so after your discharge from hospital, however if you are worried that your swelling is rapidly increasing (a sign that you might be developing a haematoma ) or are having difficulties coping please contact the team and you will be reviewed urgently. It is normal to have some bruising to the lower face and neck and this lasts for 2 weeks usually.

After one week you will be reviewed by Mr. MacQuillan in outpatients and your stitches will be removed. You will generally start to feel much better by the beginning of the second week and you will be able to resume normal activities but should continue to avoid bending down, lifting heavy or even medium weight objects and not undertake exercise beyond walking. By the end of the second week you should be able to return to work (some patients go back to work after the first week but this is depends very much on the individual), and can build up activity levels. The main reason for having avoided lifting, bending down and exercise is that the pocket created between the cheek and the underlying soft tissue can fill up with blood if the venous blood pressure rises sufficiently (which is the effect of the aforementioned activities). By the end of the second week the pocket should be well healed and you can start to resume normal daily life. You can start to gently massage your cheeks to help reduce swelling and quicken the healing process and you can apply moisturiser to the scars on your face and neck. A frequent (and important!) question that is often asked following a facelift is when is it safe to have a hair wash? The answer to this is that provided you use a mild shampoo it is safe to wash hair from day 1 and all patients are given the option of a hair wash before going home in their hospital room.

How often will I be seen by Mr. Macquillan following my facelift?

You will be seen regularly and on a long term basis. Mr. MacQuillan will see you at 1 week to remove sutures, then at the 2 week and 6 week post op time points to ensure you are healing as planned, then at 3 months, 6 months, and at a year. You will then be seen yearly for 5 years.

Before & after

Facelift Surgery Bristol
Facelift Surgery Bristol