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Facelift

Reverses some of the effects of gravity and the ageing process on the face and neck.

Facelift Surgery

Our face is perhaps our most defining feature and is intimately bound to how we view ourselves and how others views us.

There are certain visual cues which we associate with youth and others which we associate with signs of aging. In youth, a sharply defined angle between the neck and jaw is a prominent feature, with a sense of facial fullness over the cheek bones and a smooth transition between the cheek and upper lip. The lower eyelids blend into the upper cheek and the upper lids display a clear strip of skin visible above the lashes with the area below the eyebrows appearing subtly full.

Prices from £6700.

Duration

2 to 4 hours

Anaesthesia

General

Hospital Stay

1 night

Full Recovery

4 to 6 weeks

Final Results

It can take 3 months for visible improvements to appear and you can enjoy a more youthful, rested appearance.

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 than 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 ten years is a good rule of thumb), however, it does not stop them ticking and, following surgery, the effects of ageing 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 ageing 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 facelift 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 with you, 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 facelift, 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 moulded 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 two 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 depends very much on the individual) and can start to 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 one 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 one week to remove sutures, then at the two-week and six-week post-op time points, to ensure you are healing as planned, then at three months, six months, and at a year. You will then be seen yearly for five years.

Have a question?

If you’ve decided to have cosmetic surgery, you now need to choose a surgeon with the appropriate training, skills and experience to carry out your procedure.

It’s important to talk to your surgeon about what you want to change and why.

Anthony specialises in aesthetic surgery; he is registered with BAAPS, a specialist register of Plastic Surgeons maintained by the General Medical Council.

He is nationally acknowledged for providing outstanding medical care and achieving results which meet or exceed patients’ hopes and expectations.

Types of Facelift

Our face is perhaps our most defining feature and is intimately bound to how we view ourselves and how others views us.

There are certain visual cues which we associate with youth and others which we associate with signs of aging. In youth, a sharply defined angle between the neck and jaw is a prominent feature, with a sense of facial fullness over the cheek bones and a smooth transition between the cheek and upper lip. The lower eyelids blend into the upper cheek and the upper lids display a clear strip of skin visible above the lashes with the area below the eyebrows appearing subtly full.

As we age the soft tissues of the face alter through the combined effects of gravity, sun damage and changes in hormone levels. Underneath the soft tissues the skeleton of the face also undergoes modification with bony resorption leading to loss of volume and decreased support for the overlying soft tissues.

This ageing process blunts the demarcation point between the jaw line and the neck, (at worst resulting in a continuous band (or bands) of skin running from the under surface of the chin and jaw directly to the collar bones) and disrupts the clean shape of the jaw line (resulting in characteristic sagging seen with jowls). The cheeks start to develop a hollowed appearance and a line of demarcation appears between the cheek and upper lip known as the nasolabial fold. As volume is lost around the cheek bones the lower lid appears distinct from the cheek itself and can appear to become puffy. In the upper lid excess skin can cause a hooded appearance and the zone between the eyebrow and upper lid tends to loose volume and hollow.

Each of these features is due to specific changes in the anatomy of the face. Proper treatment is dependant on an understanding and knowledge of these changes and an approach that restores support and volume to the muscles, ligaments and skin where these have been lost.

Like most problems in life, a single approach to correct what are often multiple anatomic changes will not work – one size fits all is never going to be the answer in something as individualised as facial aging. Every person will have their own specific concerns relating to how their face has aged and addressing these concerns with a single treatment or procedure will not work, certainly not for all patients.

An example of this is the perception that a neck lift can only be performed as part of a face lift. For many people the idea of having to go through a facelift to change the shape of their neck is too great an ordeal but if as a surgeon you understand the nature of the problem and the underlying anatomy the neck can easily be treated in isolation with fantastic results.

As a surgeon however, it is only through knowledge, understanding (and most importantly listening to your patients concerns and needs) that you can deliver outcomes for your patients that will meet their goals and this means choosing the correct procedure(s) for that particular patient’s needs.

A midface lift is a different sort of procedure from the other forms of facelift on this page as it works by elevating the whole of the upper cheek soft tissues off of underlying cheek bone and lifting it directly upwards. It can be used to reduce the depth of the nasolabial folds and improve the appearance of the lower eyelids, smoothing the junction between the lid and the cheek. If there are folds of skin beneath the eyes (known as festoons) these can also be dealt with by performing a midface lift. The procedure is performed by placing an incision directly below the eyelashes of the lower lid providing access to the lift the cheek tissues off the cheek bone. The tissues are then anchored firmly in a higher position and any redundant skin is removed via the eyelid incision.

A neck lift can be performed as part of a facelift procedure but can also be undertaken in isolation (despite many surgeons believing that it can only be done as part of a face lift). When undertake by itself a neck lift is performed through 3 small incisions – once under the chin and one behind each ear.

The issues that patients frequently seek help for relate to increased volume beneath the chin (usually as a result of subcutaneous fat deposition or enlargement of the digastric muscles), loosening of the edges of the platysma muscles that run from the chin to the collar bones producing parallel vertical lines (known as bands) running from the chin down the front of the neck and excess skin over the front of the neck (or a combination of these problems).

The operation directly removes all excess fat from the neck leaving only a thin layer behind, attached to the skin, to provide a smooth surface once the rest has been resected. Once this has been performed the underlying platysma muscle is examined. Often the free medial or inner edges of the muscle have become loose and need tightening. Beneath the platysma is another layer of fat and 2 additional muscles (called the digastric muscles) which can contribute to fullness under the chin. If needed this fat is removed and the muscles debulked so that any residual fullness under the jaw is addressed. The platysma muscle is then sewn together in the midline (which looks a bit like a corset and is known as a corset platysmaplasty) providing sheet like muscular sling that will hold the soft tissue of the neck in place. Because of the way the surgery directly sculpts of fat of the neck it is also possible to remove the jowls drooping down below the jawline as part of the operation, enhancing the final outcome. Any redundant skin is gathered up behind the ears and excised with the scars lying in the crease behind

As the face ages in addition to the structural changes seen because of the effects of gravity, the individual cells of the soft tissues alter. The densely packed deep fat layers of the midface (the area between the bottom of the lower eyelid to the beginning of the upper lip) shrink. These areas of fat directly support the overlying skin and muscles and when they shrink (or atrophy to use the technical term) the upper layers can slip down – leading to the deflated and hollow appearance that can be characteristic of the aging face. Although hyaluronic acid based fillers can be used to bulk up these areas their effects are not permanent and they can cause problems in the long term with persistent swelling and reduced muscle movement. An alternative approach is to use fat transferred from elsewhere in the body. This is completely natural and compatible with you’re the soft tissues of your face and will not cause and long term ill effects. The procedure can be performed under local anaesthetic and although it can cause bruising usually has a very short period of down time. In addition to the midfacial area fat graft can also be used to treat hollowness in the temple area and to restore volume in the brow region.

Before & Afters

Anthony uses the latest 3D scanning technology to create before and after visuals that give you a realistic view of the results.

Advanced mini facelift and limited platysmaplasty

This 46 year old lady was unhappy with sagging of her jaw line and fine wrinkling at the corners of her mouth. Anthony performed an advanced mini facelift combined with a limited platysmaplasty to correct a small vertical skin and muscle band present beneath her chin.

Following the procedure her jaw line looks much softer with cleaner lines. Her cheeks display improved volume and whilst she does not look as though she has obviously had surgery her appearance is much younger looking.

Advanced mini facelift and submental liposuction

This 55 year old lady felt that she had lost the shape of her face – it had become squarer with a droopy appearance around the jowl area, additionally she felt that her neck had become fuller and lost definition.

After discussing her options with Anthony she decided she wanted an advanced mini facelift rather a more extensive procedure and opted for liposuction in addition, to help define her neck.

As can be seen in her ‘after’ image her jaw line is better defined , her cheeks fuller (notice the scar on the left hand cheek is less visible and tethered than previously) and the neck less full.

Advanced mini facelift

Anthony performed an isolated advanced mini facelift on this 72 year old lady. Her main concerns were that her jowls had sagged and that she had developed fine wrinkling over the outer part of the cheek. She felt that these made her appear older than she felt and wanted a fresher look.

She did not want to have a general anaesthetic and did not want to have a long period of down time.

Following surgery her face looks younger and fuller without looking like she has obviously had a facelift.

Isolated neck lift

Anthony performed an isolated neck lift on this 40 year old lady who was happy with her facial appearance but hated the way her neck had changed to look more like that of her mother and she was adamant that she did not want any changes in her facial appearance.

During the operation fat was removed from beneath the skin and beneath the platysma muscles, these were tightened to produce a strong muscular sling to support the neck tissues providing a more youthful appearance.

Isolated neck lift

This 74 year old lady had felt unhappy with her neck for most of her adult life. She had undergone previous jaw surgery with silicone jaw implants inserted on either side to maintain jaw width which didn’t help her neck definition.

Anthony performed an isolated neck lift where fat was removed from under the skin and the platysma muscle tightened and anchored to the underlying tissues resulting in a well defined jaw line and a tight neck contour. Skin excision from the upper portion of the neck has also provided a tightening effect in the lower part of the cheek resulting in a rejuvenated but natural appearance without looking like work has obviously been done.

Composite deep plane and face and neck lift

This 64 year old lady had concerns relating to her neck, jawline and face. She felt that the sagging of the soft tissues had aged her unduly and wanted to regain the appearance she had when she was younger.

After discussing her concerns Anthony suggested a composite deep plane face and neck lift in which the tissue of the cheeks were lifted and fat removed from the neck and the jaw line. The platysma muscles were stitched together in the midline sharply redefining the angle between the jaw and neck.

As can be seen from the ‘after’ images the surgery produced a significant rejuvenating effect on the whole of the lower face, mid face and neck.

Composite deep plane and face and neck lift

This 63 year old lady attended clinic with a list of procedures she thought she needed including upper and lower eyelid surgery, facelift and neck lift.

She was particularly concerned with the loss of definition between her jaw and neck and the sagging appearance of her cheeks.

Anthony suggested a composite deep plane face and neck lift before considering other procedures. The ‘after’ images show how the neck had been sharply defined following surgery and the jaw line rejuvenated. Additionally the sagging appearance of the mid face has been corrected with a youthful convexity being restored to the area.

Midface lift

Anthony performed a midface lift on this 40 year old lady who came to clinic complaining of continually being told she appeared tired. She had developed dark circles under both lids and felt that her lower lids had a puffy appearance.

During the procedure Anthony lifted the soft tissues of the upper cheek and resuspended them higher up on the outer wall of the orbit. At the same time the fat that was responsible for giving the lower lid its bulging appearance was re-draped over the lip of the orbit smoothing the junction from the lid to the cheek.

As can be seen from the ‘after’ images she achieved a natural, softer, more youthful appearance to the midfacial area.

Insight

Discover facelifts in more detail through the articles below…

Is there anything I should do to look after my facelift results?

The facelift is the cosmetic surgery gold standard for achieving dramatically younger looking results. Patients can hope to look up to ten years younger, with results potentially lasting up to 15 years. However, there are many factors that can influence how long the results last, some of which are out of the patient’s control.

If you’re looking to maximise your facelift results, below you’ll discover some of the steps you can take after your facial rejuvenation surgery.

Ensure you follow aftercare advice

The most important thing you can do to look after your facelift results is to follow your surgeon’s aftercare advice and, after your operation, Anthony  provides comprehensive guidance and support for your recovery period.

It goes without saying you should also ensure the surgeon carrying out the procedure is appropriately qualified and experienced; the more skilled the surgeon is, the longer the results should last.

Protect your skin against sun damage

While a facelift can generate impressive results, it doesn’t stop the natural ageing process. This means you’re going to need to focus on continuing to protect the skin against potentially damaging extrinsic factors such as the sun.

The sun’s UV rays can cause the skin to start ageing prematurely by breaking down the skin’s collagen and elastin, causing hyperpigmentation and wrinkles to form. Therefore, to protect your results, it is recommended that you use a good-quality sunscreen every day.

Ideally, the sunscreen should contain zinc and offer at least SPF 30 protection. You should also limit your exposure to the sun, particularly during peak times.

Consider undergoing additional procedures

Facelifts do generate impressive results by themselves. However, many patients choose to undergo additional anti-ageing procedures to maximise their results.

One of the most effective combined treatments to utilise alongside a facelift is a neck lift. After having a facelift, the neck can appear dramatically older, giving away the patients actual age.

A neck lift ensures the neck appears just as youthful as the face, creating the most effective results.

Non-surgical aesthetic procedures such as anti-wrinkle injections and temporary hyaluronic acid dermal fillers can also be combined with a facelift for optimal results.

Quit smoking

All wound healing depends on the blood supply, but smoking causes the small blood vessels known as capillaries to constrict, decreasing the supply of oxygenated blood to skin flaps and wounds.

As a result, healing speed is comprised and scarring can be worse than in non-smokers and, in rare cases, the skin and tissue can die. Studies have found that smokers can also experience more infections, blood clots, increased pain and discomfort and potential issues with the anaesthetic.

The good news is that a recent study published in the Plastic and Reconstructive Surgery journal found many patients who follow their surgeon’s instructions to stop smoking in advance of their surgery and during the healing period are smoke-free five years after their procedure.

For more advice, call 0117 325 5034 to arrange a consultation.

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