sagging, antiwrinkle, face, lift, tightening, skin, sydney

Traditional Face & Neck Lift Surgery

…. a longer-lasting, fresher and younger look!

As we age our skin progressively loses its elasticity and starts to sag causing laxity and folds. The deeper tissues of the face, namely the fat and muscle layers, also develop laxity and contribute to this downward migration of tissues.

This sagging of the skin and deeper tissues produces the following common signs of facial ageing:

  • in the brow area it creates a ‘heavy’ or ‘hooded’ appearance over the eyes.
  • the cheek fat pads descend creating ‘hollows’ across the mid-face causing a ‘drawn’ and ‘tired’ look.
  • on the lower face, increasing skin laxity and sagging skin create looseness around the jawline and jowls;
  • on the neck the skin becomes progressively looser and ultimately develops vertical folds.

How is it done?

Full Face & Neck Lift Surgery can take around 4- 5 hours and S-Lifts or Mini-Lifts around 3 hours.  For your comfort and safety, all are performed in a hospital and you need to stay for 1 or 2 nights after your surgery.

Depending on the type of Facelift you need, either General Anaesthesia, or a combination of Local Anaesthesia and Intravenous (Twilight) Sedation, is administered by our Specialist Anaesthetist.

Our Surgeon will review you the following day. If you have had no bleeding or other problems, your dressings and bandages will be replaced with lighter, more comfortable ones and you can then return to your home or hotel and recuperate there.

How will I look and feel after my surgery?

Pain for most patients is surprisingly minor and easily relieved with simple pain relievers.

As would be expected, there will be some bruising and swelling of the face but this largely settles within 3 weeks. In addition, the face can feel a little tight or numb but these also settle over time.

Patients should allow around 3-4 weeks before resuming work and social activities.

Scars are initially pink and unless you have olive, brown or Asian skin they should fade to white in about 12-18 months. In the meantime, makeup can be applied to hide them.

What are the various types of traditional facelifts?

1. Standard Face & Neck Lift

A Standard Face & Neck Lift is indicated when there is significant skin laxity over both the face AND lower neck. The incision begins in or next to the hair at the temple, extends down in front of the ear, curves around the ear lobe, runs up behind the ear and finally crosses into the hair at the back of the head.

standard-face-and-neck-liftIncision/Scar Location for Standard Face & Neck Lift

The skin is then lifted off the underlying sheet of muscle known as the SMAS and the SMAS  is then tightened. This tightening of the SMAS is what lifts the sagging skin and facial tissues to produce a more rejuvenated and youthful appearance. The excess skin produced by the lifting of the SMAS is then trimmed off. Finally, the incisions are sutured (stapled in the hair) and a pressure dressing is applied. The sutures and staples are removed around 7 days later.

In years gone by, only the skin was pulled back and the SMAS was ignored. This not only produced short-lived corrections, it also put excessive tension on the skin which delivered a ‘wind-tunnel’ appearance. Nowadays, most face-lift surgeons agree that the underlying SMAS is the principal tissue to be tightened and the key to avoiding the ‘wind-tunnel’ look is to then lay the skin back gently without any tension before removing the excess. This combination of tightening the SMAS but not the overlying skin is the secret to producing a very natural rejuvenation without an obvious over-stretched ‘surgical’ or ‘wind tunnel’ look.

2. Mini-Lift

lower-facelift

Mini-Lifts are only suitable for those whose neck skin looseness does not extend below the level of the thyroid cartilage (the Larynx or ‘Voice-Box’). Once there is significant skin laxity below this level, a Standard Lift will be necessary in order to correct the loose skin on the lower neck.

A Mini-Lift is simply a less extensive version of a Standard Lift. In a Mini-Lift the incision extends downwards from the temple as it does in a Standard Lift but it finishes at the ear lobe. The remainder of the procedure with tightening of the SMAS is similar to a Standard Lift.

3. S-Lift

s-liftIncision/Scar Location for an S-Lift

This ‘catchy’ marketing term has come to be popularly used to describe any Facelift less extensive than the Standard Lift. However, in reality, it is only a minor variation of the Mini-Lift because the incision still finishes at the ear-lobe like a Mini-Lift.

In our opinion, the S-Lift has a number of disadvantages which include:

  • The location of the incision: Part of the S-Lift incision, and therefore the final scar, is located just outside the hairline at the temple. A scar in this location, no matter how fine, is not hidden by hair and is therefore more visible than the scar of a Mini-Lift which is located within the hair.
  • The amount of skin to be removed is estimated from the outset. In a classical S-Lift,  a strip of skin in front of the ear is removed before any tightening of the SMAS is performed. This is totally a reversed order of all other Facelift techniques. Estimating the amount of skin to be removed before any tightening the SMAS is risky and prone to error either way.  Only after the SMAS is tightened can we accurately see how much skin needs to be removed.
  • It has limited application: Like its Mini-Lift counterpart, an S-Lift is a limited Facelift and will not correct loose skin on the lower neck. Loose lower neck skin requires either a Neck Lift alone or a Standard Face & Neck Lift if the face also needs to be lifted.

4. Neck Lift

This is another variety of limited ‘lift surgery’ where only the neck skin needs to be lifted. The incision starts at the ear lobe and runs upwards on the back of the ear and up into the hair behind the ear. It is the same as the ‘back half’ of a Standard Face & Neck Lift. On its own, it is indicated for those less common instances where only the neck skin needs to be tightened.

5. Brow Lift

Brow Lifts are indicated when the brow has significantly descended. It can be done alone or as part of a Standard Face Lift procedure. Sometimes, brow descent can be a contributory factor, or even the sole cause, of ‘heaviness’ or ‘hooding’ of the upper eyelids. Brow lifts can be performed in several ways:

  • Coronal Lift: The original, and unfortunately the most invasive technique, in which a long incision is made right across the scalp behind the hairline. The skin is lifted off the forehead, pulled upwards, the excess skin removed, and the skin edges then stapled together.
  • Endoscopic Brow Lift: A less invasive technique where five incisions 1cm long are strategically positioned across the forehead behind the hairline. Through these ‘keyhole’ incisions instruments are passed to perform the brow lift.
  • Suture Brow Lift: The least invasive of all where sutures are inserted through tiny inconspicuous slits behind the hairline and passed down to the eyebrows to lift them.

6. ‘Deep Plane’ Facelifts

These are more involved Facelift techniques where the deeper tissues under the SMAS are also lifted. However, because many important nerves and major blood vessels lie under the SMAS, they are more exposed to inadvertent injury during a ‘Deep Plane’ Facelift. Although the duration and degree of correction is greater with this type of Facelift, many surgeons believe that the increased risks of nerve and vessel injury outweigh its potential benefits.

Associated Procedures:

Irrespective of the type of Facelift needed, if you also have fatty deposits in the jowl areas or under the chin you will also need liposuction of those areas at the same time. Facial liposuction is done via one or more tiny, inconspicuous incisions under the jawline.

In patients with a very loose Platysma Muscle on the front of the neck, the Platysma also needs to be tightened. This is done through an additional, inconspicuous 4cm incision under the point of the chin.

What improvement should I realistically expect?

Not infrequently, patients presenting for Face/Neck Lift Surgery often have pre-conceived misconceptions on how they will look after surgery. Accordingly, it is important that you have a thorough understanding and a realistic expectation on what the surgery can and cannot achieve. In other words, if you expect more than a Face & Neck Lift can possibly achieve, you could be disappointed in spite of an excellent surgical result.

Realistically, you must bear in mind that:

  • ‘Lift Surgery’, as the name applies, will only lift and tighten loose, sagging skin.
  • ‘Lift Surgery’ will not remove facial lines and wrinkles, only loose skin. If you wish to improve wrinkles you will need additional treatments after your facelift such as Dermal Fillers, Anti-Wrinkle Injections, Laser Skin Resurfacing or a combination of these..
  • Facelift surgery will only improve, not remove, the ‘smile lines’ that run from the nose to the corners of the mouth.
  • ‘Lift Surgery’ cannot totally correct large folds of loose skin on the front of the neck – the so-called ‘Turkey Neck’.
  • Face & Neck Lift Surgery will not make you look 15 or 20 years younger! You will look better for your age than before, perhaps even a few years younger, but you would be unrealistic to expect a Facelift to make you look 10 or 20 years younger!

 

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Frequently Asked Questions

What type of Facelift will I need?

Basically, there are two types of Traditional Facelift Surgery: Mini-Lift (sometimes called an S-Lift) and a Full Face & Neck Lift.

A Mini-Lift is all that is needed when the skin laxity is confined to the lower face and upper neck.  However, if the neck skin’s laxity extends below your larynx (the voice box), only can a Full Face & Neck Lift correct this.

How will I look immediately after Facelift Surgery?

Initially, your face will be swollen and there will likely be some scattered light bruising as well. These appearances should subside sufficiently within 3 weeks to allow you to return to work and social activities.

Skin sutures and any staples within your hair are generally removed around 7 days later.

In time, the skin incisions around your ears should end up fairly inconspicuous and easily hidden with make-up.

 

How long will the correction from a Facelift last?

On average, the correction from a Surgical Facelift should last in the order of 7-8 years.

What other procedures are sometimes included in a Facelift?

If indicated, additional procedures such as Blepharoplasty (Eyelid Rejuvenation Surgery), Facial Liposuction or a Brow Lift can be included at the same time as the Facelift.

Is a hospital stay required?

In most cases, overnight stay is all that is required. Once our Surgeon checks you the next day, you can go home to rest and recuperate there.

What are the costs?

As there are so many varieties of Facelift Surgery, not to mention potentially additional procedures, the Surgical Fee component of your total cost cannot be predicted until our Surgeon has assessed you.

In addition to the Surgical Fee, there will be additional costs for the Anaesthetist (based on the duration of your surgery) and the Hospital.

Can I claim any of my costs on Medicare?

Unfortunately, no. Being a cosmetic procedure, Facelift Surgery is not eligible for a Medicare rebate, nor can you claim on Private Health Insurance.

Before and After photos

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