Facelift procedures may differ, but their goal is the same: to improve visible signs of facial ageing. A facelift is a surgical procedure that rejuvenates the appearance of the ageing face through the removal of excess fat, tightening of the facial muscles and re-draping of the skin on the face and neck.
In this article, Costhetics invites you to learn more about traditional and leading- edge techniques so that you can make an informed decision about whether a facelift is the right procedure for you.
Doctors call it rhytidectomy, but you know it better as facelift surgery. It lifts and tightens the skin and underlying muscles to rejuvenate facial structure and create aesthetically pleasing contours. Both surgical skills and an artistic eye are required to achieve beautiful, natural-looking results with negligible scarring.
Facelifts are in-demand locally and globally. In Australia, facelifts were ranked among the top five most popular cosmetic surgical procedures in 2009. More recent data from The American Society of Plastic Surgeons (ASPS) demonstrates that the demand for facial rejuvenation procedures remains strong.
“Facial rejuvenation procedures were especially robust last year, with more Americans opting for facelifts, forehead lifts, eyelid surgery, fillers and peels. With new devices and products hitting the market each year, there are more options and choices available to consumers wanting to refresh their look or a little nip and tuck.” ASPS President Robert X. Murphy, MD.
Did you know that more than 90% of facelifts in Australia are performed on women over the age of 50? That statistic is rapidly changing, however, as men discover the restorative value of a facelift.
The trend is reflected in U.S. cosmetic surgery statistics where facelifts are the most popular procedure for both male and female baby boomers aged 51 to 65+. People in this age group accounted for more than 80% of all facelifts in the US in 2010.
The most important factor in determining whether or not to have a facelift, however, is not really your age. The key issue is whether or not you have facial ageing changes that can be corrected with facelift surgery.
What are those changes? Most patients list eight changes as their impetus for choosing facelift surgery. If you’ve been thinking about this rejuvenating procedure, consider whether any or all of these apply to you.
Facelifts cannot correct all signs of facial ageing. The procedure will not improve
Because facelift surgery is not a cure-all, it is often performed in combination with other procedures such as nose reshaping, neck lift, forehead lift, eyelid surgery and skin treatments. An experienced surgeon can recommend which procedures are best suited to achieving your goals.
Desire is not the only factor that determines whether or not you are a good candidate for facelift surgery. There are physical and emotional considerations as well. A skilled, experienced surgeon will talk with you at length to determine your suitability for facelift surgery, and recommend a specific procedure based on your unique circumstances.
A good candidate for a facelift is a man or woman who
You and your surgeon are partners in your facelift success, so selecting the right provider is an essential part of the equation. Personal recommendations and online research can provide a rich pool of candidates, but who is the right surgeon for you?
The Australian Society of Plastic Surgeons recommends that you shortlist 2 to 3 surgeons for an initial consultation. Here is a list of key questions you should ask when putting together that list:
Once you and your surgeon decide that you are an appropriate candidate for facelift surgery, you will then discuss which of the following techniques is best suited to your needs.
The SMAS Lift – When people speak of a “traditional” facelift, this is the procedure they mean. The SMAS lift addresses the superficial musculoaponeurotic system (SMAS), which is one of the deeper layers of facial tissue. The SMAS is a layer of fibrous tissue covering the muscles that control your facial expressions and help you create dynamic facial expressions.
SMAS surgery lifts the superficial layers of skin as well as deeper tissues of the face and neck (known as the SMAS), which tend to grow lax and sag as we age. SMAS facelift surgery is very effective at addressing laxity and loss of volume and troublesome ageing issues including:
Incisions are usually made above the hairline at the temple and extend down along the natural creases of the skin, continuing in front of the ear or at the edge of the ear, dipping below the ear lobe to extend behind the ear. Your surgeon will tighten the SMAS layer with sutures, remove excess skin and then stitch up the incision.
Endoscopic Facelift – An endoscopic facelift is a procedure performed with the aid of an endoscope, a small pencil-shaped probe with an attached camera. This high-tech device transmits video images of the facial structures onto a screen. The surgeon uses these images as a guide in performing the surgery.
The endoscope is inserted through a number of small incisions hidden in the hairline. This procedure is effective for younger people without a significant amount of excess skin and no neck sagging.
Endoscopic facelifts can generally be performed on an outpatient basis, under local anaesthesia. This makes them less expensive than traditional facelifts and less risky because they don’t require general anaesthesia or an overnight hospital stay. It should be noted, however, that small incisions limit the scope of this procedure to the lifting of sagging cheeks.
Mid-Face Facelift – This procedure uses small cuts in the hairline and the inside of the mouth to deliver modest, subtle improvements to the face. It is an excellent choice for people between the ages of 40 and 50 whose cheeks are sagging with skin folds and who are experiencing lax skin in the nasolabial area.
In a mid-face lift, the natural fatty layer over the cheekbones is lifted and repositioned. The procedure can be performed endoscopically or through the lower lid, along with eyelid surgery (blepharoplasty).
Short Scar Lift – The short scar lift is an umbrella term that covers a number of facelift techniques involving minimal lengths of incision and hence shorter scars. Usually these incisions do not extend behind the ears.
Short scar lifts are best suited for those in their 40’s and 50’s who have low to moderate levels of excess skin and whose necks show minimal signs of ageing. This technique means a much smaller scar than other techniques.
One short-scar technique requires an S-shaped incision in front of the ear or at the temple. Your surgeon will use this short incision to resuspend facial tissues, improving smile lines and reducing jowls by tightening the skin. Another technique, called a minimal access cranial suspension lift, or MACS, requires an incision that ends at the earlobe.
Thread Lift – Also known as a Feather Lift, this procedure lifts sagging skin, but is considered a non-surgical facelift. It is best suited to people in their 30’s and 40’s whose skin is only minimally loose or sagging.
The doctor uses sutures (threads) with barbs to grab skin layers and pull them upward. No skin is cut away. It can be performed under local anaesthesia and is significantly less expensive than other types of facelift procedures. It should be noted, however, that this is not as effective as other types of facelifts. A thread lift often acts merely as a bridge until a surgical facelift is appropriate.
Deep Plane Lift – During a deep-plane facelift, the surgeon repositions soft facial tissues by lifting the whole face. This technique is suitable for older people with a lot of sagging and loose skin, but surgeons report many clients in their early 40s requesting this procedure.
The deep-plane facelift is currently the gold standard in facelifts. Unlike more superficial procedures, it repositions deep facial soft tissue that lies beneath the SMAS layer, allowing the whole face to be lifted. The deep plane lift
Because the deep tissues of the face are more fibrous and less elastic than the more superficial layers and the skin, there is minimal pulling and stretching in the deep plane lift. It also requires less healing time than the SMAS facelift because there is minimal disruption to the skin or tissues of the face.
Anyone who is a candidate for a standard facelift is a candidate for a deep-plane facelift. It is the preferred technique of surgeons for secondary or revision facelift surgeries because most first-time facelifts have been standard facelifts. There is also a limit to how far the face can be ‘pulled.’
To read more about the deep plane facelift technique click here.
If you have short hair, you might want to let it grow out a bit before the surgery to cover your surgical incisions during the recovery period. If you dye, bleach or chemically treat your hair, have this done ahead of the surgery. It will be at least a month before you can safely treat your hair again.
Make arrangements for someone to drive you home after your procedure or hospital stay. It’s also a good idea to have someone stay overnight with you on your first night home.
The technique you and your surgeon choose will also determine the length of time the procedure takes. Usually, a facelift takes several hours—longer if you are having a number of procedures in conjunction with the facelift surgery. In some instances, if a few procedures are to be completed, your surgeon may schedule more than one surgical session.
Facelift surgery is performed in a hospital under general anaesthetic. Even if you are able to go home after the effects of the anaesthesia have worn off, your surgeon may want you to stay overnight to be monitored.
After your surgeon has completed your facelift, and the incisions have been closed with sutures or mini staples, your face will be wrapped in a bandage. This will put pressure on the wound areas and minimise bruising and swelling. A small, thin tube may be placed under the skin to drain the excess fluids that build up after surgery.
Tubes, bandages and sutures are removed a week following surgery.
You should expect some swelling and bruising on the face to last between three and six weeks. During this time your facial muscles may feel stiff and as if they are not working properly, and you may feel that your face looks distorted. Don’t worry. These impressions are only superficial and will go away as the swelling subsides. You can use camouflage makeup to hide bruises after a week.
Scarring is natural following cosmetic surgical procedures. Your scars may take many months or longer to heal. The healing process can go on for as long as two years. During this period, raised, lumpy, itchy or red scars will fade in colour and flatten, making them less obvious.
There are a number of things you can do following any surgery to improve healing and optimise results. Click here to read the full list.
Specific healing-friendly things to do after a facelift:
Most people can return to work after two weeks. It is important to remember, however, that everyone heals differently. So discuss this with your surgeon, and you will be given the go ahead if your wounds are healing normally.
As with any surgical procedures there are risks involved in a facelift. Inform yourself of potential risks and complications involved in any surgical procedure before you elect to have it done. Specific complications that may occur during or after a facelift include:
Just as you would discuss potential benefits before surgery, it is always advisable to ask your surgeon to address the potential risks as they apply to you. Your surgeon can also advise you on how to avoid or minimise some types of risk.
Some Australian private health insurers may help pay for the hospital bed and theatre fees. Getting a doctor’s referral will enable you to make a claim on these costs.
Your surgeon will help you estimate potential costs after a consultation. The cost of a facelift will depend on the type of facelift you have. Once that is decided, costs will also vary depending on the surgeon and the hospital used. Your surgeon will help you estimate potential costs after a consultation, but here are some guidelines:
You should expect the costs to be higher if you are having combined procedures at the same time. For a more detailed look at the costs associated with facelift surgery in Australia, read our article What Does a Facelift Cost in Australia?
This information is correct as of 2017.
If you have more questions, Costhetics recommends that you contact us or a surgeon listed below.