| Whereas previously the emphasis
of the surgery was placed on skin tightening (which gave an
operated, rather than a more youthful appearance), a better
understanding of the effects of facial ageing coupled with a
more detailed knowledge of the facial anatomy, and how this
changes with ageing, has led to the development of modern facelifts
designed to re-elevate and reposition the deeper tissues to
a more youthful position, without the marked skin tightening
stigmata seen in the past.
Effects of ageing:
- General "wear and tear" coupled with sun damage leads
to changes in the skin quality (wrinkles, lines, pigmentary
changes)
- Loss of facial volume, which effects both the soft tissue
padding (fat) and the bone
- Descent (ptosis) of the remaining facial fat - droopiness
leading to heavy naso-labial lines, flattened cheek prominences,
jowls, and sagging neck skin
- Weakened support structures leading to prominent bulges
in the eyelids
A good candidate for the surgery is a patient
in his / her late 40's or 50's who wishes to look somewhat younger
(Patients often tell me that they feel much younger than they
appear, and want to look as good as they feel!) You need to
be in good
general health, and a non smoker to qualify for this surgery.
The surgery is performed under IV sedation
or a light general anaesthetic, most often as a day case - only
occasionally is an overnight stay needed. The duration may be
3 - 4 hours, or longer, particularly if combined with other
surgeries, like
eyes. The usual incision commences in the sideburn area,
and then (in a well camouflaged pattern) in front of the ear,
and often behind the ear in the groove. The scars are usually
well hidden, and generally fade significantly over time. Through
this incision, the skin of the cheek is elevated to expose the
deeper (sagging) tissues (often referred to as the SMAS), which
are re-elevated to a more youthful position. In addition, liposuction
of the neck serves to remove excess fat from under the chin
area, and helps to tighten the sagging neck skin.
Once the SMAS has been re-elevated, some (usually
minor) skin excess is evident, and this is trimmed and inset
to the original incision. Fat may be injected into certain areas
of the face (cheeks, naso-labial lines, and lips) to plump these
out, or gels
may used instead. Finally a bulky, supportive dressing
and face-band are applied to support the re-elevated facial
tissues, and drains to remove excess fluid may also be placed.
Complications can occur with any surgery, and
facelift is no exception. Although uncommon, bleeding, infection,
poor scarring and nerve injury are some of the potential complications
of this surgery. Please read
www.plasticsurgeon.co.za/advice.htm to see what medication
should be avoided in the weeks prior to the surgery to minimise
your risk of complications (this will include herbal and homeopathic
medicines and vitamins, which often promote bleeding at the
time of surgery). Smoking is a major cause of complications,
and I do not offer this surgery to active smokers.
Recovery is generally fairly rapid, and the
dressings are "debulked" 1 day after the surgery.
Drains, if placed, are also removed. An elastic "face
band" is then worn for about a week or 2 post op, to help
stabilize the neck contour, and to minimise swelling. Skin stitches
are usually removed between 5 days and 1 week post op, and by
2 weeks post op, the swelling should have subsided considerably,
although it will be several months before the final result can
be appreciated. The objective of the surgery is to give one
a more youthful, rested appearance without the tell tale signs
of surgery.
Should you have questions regarding the above,
please email me
For a more detailed description of the surgery - click
here
For information on other procedures, click
here |