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Face Lift and Neck Lift: Face lift and neck lift are related procedures. A face lift is basically a neck lift with extra attention paid to the cheek and cheek fold areas. These operations are often combined with other surgeries such as eyelid (blepharoplasty) and brow lift (foreheadplasty) to rejuvenate the entire facial area. These operations are designed to remove excess skin and re support the sagging soft tissue beneath the skin. How is it done?  The operation is usually done in a private operating facility as a daycare stay under either local anaesthetic with sedation or a general anaesthetic. The classic facelift incision starts in the temporal hairline or sideburn area and runs down just in front of the ear or just inside the ear canal. From here it runs behind the earlobe, onto the back of the ear and then into the hairline behind the ear. This results in a hidden scar except for a small segment just in front of the earlobe. Fortunately in the vast majority of patients this segment heals as a fine white line and is not noticeable. Once the incision is made the neck and cheek skin are lifted and freed up. They are then pulled upwards and backwards. The excess skin is then removed. While the incision is open techniques are used to tighten the muscles under the skin on the neck and to lift sagging soft tissue structures of the cheek. Often liposuction is used to remove fatty deposits along the jaw line, in the neck, or in the folds around the mouth. Following this the skin is sutured using dissolving stitches that run under the skin surface to avoid stitch marks. A neck lift is basically the lower 2/3 of a facelift. Patients with less skin laxity may be a suitable candidate for a "mini" face lift ("S" lift) which gives a less dramatic improvement but is a smaller operation with a shorter scar and shorter recovery.Recovery: The physical recovery (as in discomfort and anaesthetic recovery) after a face lift is usually fairly mild and lasts for several days. It is well controlled with regular pain mediation. As well there is an "appearance "recovery. Typically for the first two weeks there is very noticeable swelling and bruising. Some of this can be concealed with makeup. Between two and four weeks swelling improves and bruises disappear and most patients feel comfortable going out in public (as in shopping etc.). After one month appearances are almost back to normal and any minor scars can be easily covered with makeup. A chin support is used for the first month to help mold the re contoured structures during the healing period. Potential Complications: Early There are risks involved in any form of surgery, and although these are uncommon, they cannot be ignored. Infection usually causes redness and inflammation near the incision. This can usually be treated with antibiotics, but occasionally may have to be drained. It can lead to delayed healing and increased scarring. Bleeding after a facelift can cause a blood collection called a hematoma. If this is large enough it may have to be removed otherwise it can cause healing problems. Delayed wound healing or skin loss can be caused by infection or bleeding. It can also be caused by poor skin circulation. This is most common behind the ear. Secondary "touchup" surgery may be needed for this. It is more common in smokers, and for this reason it is recommended that smokers be smoke free for one month prior to surgery, or have a "mini" procedure. Nerve related problems can result in numbness or weakness in the face. This is usually due to swelling or stretching of the nerves and resolves. Rarely this can be permanent. It is normal to have some cheek or ear numbness after facelift surgery which usually resolves over three months. Late Complications: Hair loss may develop around the scars. Wide or thick scars are unusual and tend to occur behind the ears. They are more likely in dark skinned patients. These can usually be improved with "touchup" procedures. Ear lobe deformities can occur as the tightened neck and cheek skin heals. These may benefit from a "touchup". Skin color variation (darkening or reddening) can occur in some patients due to abnormal personal healing characteristics. Asymmetry or facial or neck contour defects may be noted after surgery. No one has a perfectly symmetrical face, and because of this you cannot expect perfect symmetry following the operation. Sometimes imperfections are improved and occasionally they are made more noticeable.  Before  After  Before  After  Left: Before, Right: After |
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