Facelift

A facelift involves tightening laxity in the supportive soft tissues of the face and redraping the skin, thereby improving the ‘smoothness’ of the face and giving it a more youthful shape. A facelift may also be combined with other surgical procedures such as a brow lift, eyelid surgery or fat grafting as part of facial rejuvenation surgery. The bone structure of the face will not be changed during facelift surgery.

Non-surgical treatments such as anti-wrinkle injections or skin resurfacing may be undertaken also. The aim of these treatments is to treat sun-damaged skin, dynamic wrinkles, crow’s feet around the eyes and fine lines around the mouth which are not removed by facelift surgery.

At your initial consult Mr. Bunker discuss your motivations and concerns, clinically assess for stigmata of aging and generate a treatment plan if appropriate. Facial rejuvenation surgery is a highly individualised and may not be suitable for everyone. Facelift surgery may be a good option for you if:

• You have sagging in the midface

• You have deep creases below the lower eyelids

• You have deep creases along the nose extending to the corner of the mouth

• You have fat that has fallen or is displaced

• You have loss of muscle tone in the lower face which may create jowls

• You have loose skin and excess fatty deposits under the chin and jaw, creating the appearance of a double chin

• You are physically healthy and you do not have medical conditions that can impair healing or increase risk of surgery

• You have realistic expectations of what face lift surgery can accomplish

• You are a non-smoker or have stopped smoking at least 3 months prior

Important considerations are:

• The results of a facelift usually last between five and twelve years. Facelifts can be repeated.

• While a facelift will make you look younger, it will not raise sagging eyebrows, remove deep frown lines in the forehead, change your upper or lower eyelids, or get eliminate wrinkles around the mouth. Other forms of treatment may be more appropriate to address these concerns.

• The natural aging process continues after a facelift.

• Smokers and patients with high blood pressure are at increased risk of complications. You need to stop smoking and have your blood pressure under control to be considering for facelift surgery.

• Facelift surgery is may not be a good option if you are prone to bleeding, have poor healing ability, a tendency to form thick scars or are at increased risk for surgical or anaesthetic complications.

Mr. Bunker performs facelift under general anaesthesia to maximise patient comfort. Modern anaesthetics are safe and effective but carry some risks, which you will discuss with your anaesthetist

Usually one night in hospital is required after a facelift. This allows your blood pressure to be monitored, ensure there are no early complications such as bleeding, make sure your pain is well-controlled prior to discharge and allows any drains inserted at surgery to be removed prior to going home as well as any necessary dressing changes performed.

All surgery has risks. There are general risks which apply to all operations as well as specific risks for individual procedures. General risks and complications of surgery may include:

• Bleeding

• Infection that may require treatment with antibiotics or further surgery in some cases

• Allergic reaction (to sutures, dressings or antiseptic solutions)

• The formation of a large blood clot (haematoma) beneath the skin that may require drainage

• Pain, bruising and swelling around the operated sites

• Keloids and hypertrophic scars that are raised, red and thickened scars over the healed incisions. These may be itchy, annoying and unsightly but are not a threat to health.

• Poor or slow healing

• Wound breakdown

• Short-term nausea following general anaesthesia and other risks related to anaesthesia

Specific risks and complications associated with facelift surgery include:

• Hair loss around the scars, this is usually temporary but may be permanent.

• Loss of skin due to impaired blood supply. This may require a skin graft.

• Bruising and swelling

• Numbness around operated sites. In most cases this is temporary and will improve over many months

• Deformity of the earlobe

• Slight difference in appearance between the right and left side of the face

• Damage to the facial nerve, which occurs in about one in every one hundred patients. It can result in partial loss of movement and a “lopsided” appearance of the face. In rare cases, the damage may be permanent

• Revisional surgery may be necessary to correct complications

Your surgery will take place in an accredited hospital facility.

• Avoid any strenuous activity or exercise in the week before your surgery

• Ensure you have arranged appropriate help at home including someone to stay with you for the first 24 hours. Consider pillows, cool compresses and a telephone within reach. Make sure you arrange for a relative or friend to drive you to and from the hospital or clinic.

• Consider work arrangements. Most patients will remain off work for 4 – 6 weeks after surgery. A medical certificate can be supplied to your preoperatively if required

• Take Vitamin C supplements 1 gram daily starting at least 2 weeks before your surgery, unless you are allergic or unable to tolerate

• Wash your hair the night before your surgery

• Do not wear any make-up on the day of surgery

• Be as fit as possible to help the recovery process

• You will be asked to complete a full medical history. You must list all medications you take including dietary supplements such as fish oil which increase your risk of bleeding.

• Check with your surgeon about your medications as some may need to be stopped. Any additional tests required preoperatively will be arranged by Mr. Bunker or your anaesthetists.

• If you decide to have facelift surgery, your surgeon will ask you to sign a consent form. Make sure you read the consent form carefully before signing. If you have any questions, ask your surgeon.

• You will receive detailed preoperative and postoperative instructions. Follow them carefully.

• Arrange for a relative or friend to drive you home after the surgery. Someone should also stay with you for at least the first day after the operation and preferably for a few days.

• You can usually drink fluids and eat a light meal two or three hours after surgery. You may have some pain and discomfort, particularly around the incisions. You will be prescribed pain medication for home.

• In some cases a small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

• Some bruising and swelling is normal, and may take up to a few weeks to disappear. Sleeping with your head elevated will help to reduce the swelling.

• Depending on the extent of your procedure, you may need to take a few weeks off work to rest. Avoid heavy lifting, strenuous exercise, swimming and strenuous sports until advised by your surgeon.

• Your surgeon will give you specific postoperative care instructions which may include:

• How to care for your surgical sites

• Medications to apply or take orally to aid healing and reduce the risk of infection

• Specific concerns to look for at the surgical sites or in your general health

• When to follow-up with your surgeon

If you experience any of the following symptoms, notify your surgeon immediately:

• Temperature higher than 38°C or chills

• Heavy bleeding from the incisions

• Worsening redness around the incision sites

• Increasing pain or tenderness, or other problems that appear to be worsening

Scars are an inevitable part of any surgery and are created when any incision through the skin heals. Mr. Bunker will endeavour to minimise scarring and to keep your scars as inconspicuous as possible by locating the incisions in hidden sites where practicable. Scars usually fade with time and become barely noticeable. If you are prone to scarring, advise your surgeon.

Revisional surgery may be necessary to correct minor irregularities. Often these can be performed under local anaesthetic in the rooms and do not required general anaesthetic or hospital admission.

Cost is always a consideration in elective surgery and may include:

• Surgical fee

• Hospital or surgical facility costs

• Anaesthesia fees

• Prescriptions for medication

• Postsurgery garments

• Medical tests

A quote for the surgical fee is provided to you prior to surgery. This also contains instructions on how to obtain quotes for associated fees as listed above. If you have any questions, please contact the Practice Manager.

• General anaesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness. When you are under general anaesthesia you are ‘asleep’.

• Intravenous sedation: Sedatives administered by injection into a vein to achieve relaxation. Also referred to as ‘twilight’ anaesthesia.

• Local anaesthesia: A drug injected directly to the site of an incision during an operation to relieve pain. Also referred to as ‘numbed with needles’.

• Jowls: A jaw line that sags into the neck, usually caused by loss tone tone in the lower face

• Meloplasty: Facelift

• Nasolabial fold: Crease between the corner of the nose and mouth

• Rhytidectomy: Facelift

• Tear trough: Deep creases below the lower eyelids