Face Lift (Rhytidectomy)

Your consultation is designed to be perfect opportunity to ask all the pressing questions that you have to your consultant, ahead of making a decision on surgery. It is vital that you are fully informed before making your final decision, and the consultation is therefore a key part of the education and decision making process.

Some good examples of questions to ask, include:

• Am I a good candidate for this procedure?
• Do you think my goals are realistic given my existing anatomy?
• Can I see some before & after pictures of facelift procedures you have done previously?
• How long will my recovery take?
• Is it true that Cadogan offers 24/7 on call nursing service?
• What can I expect in terms of bruising, swelling and scarring?
• What are my options if I am unhappy with my results?

As we age our skin loses its elasticity, and the underlying tissues lose their volume, as well as bone losing its structure. A facelift works by repositioning the soft tissues and skin to its former level and plumping out the soft tissues to give the refreshed look of natural youth.

A facelift is regularly done as a Day Case procedure, under local or TIVA, our gentler version of general anaesthesia. The procedure may take several hours, but you, the patient, will be able to go home to rest on the day of the surgery.

For a full standard facelift, the surgeon creates an incision in the front of the ear, up towards the hairline and behind the ear into the scalp. He or she will then lift the skin up off the face, gently pulling it into an upwards direction and removing any excess skin.

Depending on your individual case, the surgeon is likely to also tighten the SMAS, the deeper tissues on the face, or perform a neck lift to tighten the skin around the chin and jowls. Once the procedure is completed, the incision will be closed with staples or sutures, and dressings will be applied.

These days we generally use fat grafting in association with non-surgical procedures to help fill in concaves in the face that occur with age. There are numerous types of facelifts, depending on the results you're looking for, and the condition of your skin, your surgeon will decide what is best for you and make recommendations.

After your surgery, you will be asked to come in for a post-operative appointment to come back and see our nursing staff at the Clinic between 1 and 2 weeks after your surgery. At this point your incision sites will be reviewed, and your preliminary healing will be assessed.

After 6 weeks your surgeon will personally review your progress – again at the Clinic - and make sure you are recovering as expected. In addition, they will remove any stitches and advise you on the need for further dressings.

Throughout the recovery period you will have full access to our 24/7 on call nursing service, and full access to the Clinic and our post-operative facilities.

Our aim is to make you feel as comfortable as possible during the entirety of your recovery period.

As your anaesthetic or sedation wear off you will wake up in our recovery facilities at the Clinic. You may feel a little drowsy but this often wears off within a few hours. After several hours in recovery, you will eat and hydrate. At that point, you will be allowed to leave the Clinic by our nursing staff.

It is common to feel a little pain and discomfort in the immediate aftermath of surgery. This will wear off in due course. Our 24/7 on call service is open to all patients for any question or query they may have at this time.

You will not be able to drive yourself home after the surgery. You should arrange for someone to pick you up and take you home. In addition, you will need to ask someone to stay with you for the first 24 hours after your procedure.

You will need to avoid exercise for a few weeks, but you will be able to back in front of a computer as soon as the next day. There will be some swelling and bruising at the incision areas, which is normal and will fade in time and heal over the next week or so. You should be back at work after 2 weeks.

You may have heard or read online about patients, who are in pain with considerable swelling for weeks or months following a facelift, but this is highly unusual. It may be the result of poor technique or deep plane facelift, where all the soft tissues are lifted off the bone and placed at a higher level.

While this can give good results, we at the Cadogan Clinic, do not feel that the discomfort and long recovery time of this deep plane technique is worth it. We focus on getting you lasting, impactful results, without unnecessary downtime and pain or discomfort.

Final results are typically first seen six or so weeks after your procedure, with ongoing improvements beyond this point likely as the healing process fully completes over the coming 12 months.

Your surgeon will be able to give you specific guidance at your consultation.

Facelift results are essentially permanent but surgery will not stop your face from naturally ageing. For patients who take care of their skin, avoid smoking and excessive sun exposure, it should be possible to enjoy the benefits of a facelift for many years, having essentially 'put the clock back' a decade or so following surgery.

You should expect to retain the benefits from your facelift surgery. If it makes you appear 10 years younger, you should always retain that 10-year advantage.

There are also many non-surgical procedures that can be used to maintain results on an ongoing basis beyond surgery and keep your face looking young and fresh.

These are all offered at the Cadogan Clinic, and include:

• Anti Ageing Injectables, e.g. Botox
• Dermal Fillers
• Lasers
• Chemical skin peels

The latest and possibly the best adjunct is Stem cell treatment.

• Don't smoke! Smoking ages you, accelerating the ageing process dramatically.
• Drink less alcohol! Alcohol dehydrates your skin and we want your skin to remain firm and supple in order for results to be long-lasting.
• Keep a healthy weight! Significant weight fluctuations can change the shape and elasticity of the skin on your face. To remain that vibrant, youthful look following your facelift, avoid or cut back on alcohol.
• Drink lots of water! Water hydrates your skin, it keeps the face looking full and fabulous.
• Always wear sunscreen! Every day- no exceptions. The sun damages your skin, causes wrinkles and advanced ageing.
• Take care of your skin! Following the instructions laid out to you by your surgeon for proper aftercare are of the utmost importance. It's also important to use high-quality skin creams, serums and to continue having professional treatments such as peels, fillers or Botox to continue to support your desired aesthetic.

Certain lifestyle factors can increase the risk of complications during and after your surgery. These include smoking, drinking alcohol, being overweight and taking drugs (for medical or recreational use.)

The most common impact of smoking before your surgery is that it increases your chances of developing an infection and inhibits your body's natural healing processes. We insist that all patients stop smoking and using nicotine products at least six weeks before surgery. Reducing alcohol intake is also strongly advised.

Your doctor will discuss your current BMI and drug use at your consultation and advise you further on this.

Aside from lifestyle factors, there are other external factors that determine how long a facelift will last, such as age of the patient and the condition of the patient's skin.

Darker skin that is in a healthy condition will respond better at the time of the surgery, as opposed to fairer skin that has sun damage or is thinner. However, patients who are under the age of 60 typically have the longest lasting results.

The skill of the surgeon and the technique used are also an important factor in the longevity of a facelift.

Your surgeon will give you specific advice on how to wash and bathe after the surgery.

In general, you may gently shower and wash your hair 48 hours after a facelift surgery, taking particular care on the treated areas. You can also blow dry your hair on a cool setting. Be gentle when brushing or combing your hair so that you do not catch your comb in the suture lines. You must follow your surgeon's specific advice.

It is normal to feel a little self-conscious when you are in public following facelift surgery due to the visible swelling, redness and bruising that will inevitably occur on the face during the preliminary recovery phase.

The vast majority of bruising and swelling should have comfortably settled by around 2 to 3 weeks, so it is at this point that you should first plan to be seen by friends and colleagues.

Full recovery can take several months, so we do advise you plan well ahead to ensure that you give yourself enough time to recover before a major event such as a wedding or birthday. We would recommend allowing between 2 to 3 months.

It is typically possible to start wearing makeup again 2 weeks after your procedure. At this point, you can then use camouflage or concealer cosmetic products to cover any remnant bruising you may still have.

Of all the scars you may have from plastic surgeries, scars on the face are the best of the whole body. They are not only well hidden, but also settle efficiently. For most healthy people, surgical scars from a well-performed facelift do not cause any issues.

Even for patients who produce keloid scars can consider having a facelift, even though they will require extra Scar Management during their aftercare treatment.

Facelifts are becoming less invasive and scars fewer. Nevertheless, the standard scars themselves are short and hidden around the contours of the face, in the front of the ear, under the earlobe and in the crease behind the ear.

It is perfectly possible to carry out a facelift under a local anaesthetic, but most of our patients prefer the type of general anaesthesia we give at the Cadogan Clinic (Total Intravenous Anaesthesia (T.I.V.A.)) for full facelift surgery.

TIVA delivers anaesthetic intravenously via a computerised pump able to monitor anaesthetic levels closely. This close calibration allows your anaesthetist to keep you at a relatively shallow level of anaesthesia, meaning your sickness is minimal following your procedure and you can start your recovery quickly. You will also be allowed home an hour or two after the surgery is completed, even if the surgery has taken several hours.

Local aneasthetic or sedation are better options for less invasive facelift surgery such as mini-lift or micro-lift surgery.

Plastic surgeons tend to be sceptical of non-surgical injection-led treatments when it comes to delivering long lasting facial rejuvenation results.

However, we do recommend non surgical alternatives for younger patients or patients with only minor signs of ageing.

There are limits, however. It is very difficult to fix drooping, sagging older skin. with a non-surgical facelift. You also cannot expect full resolution of deep wrinkle lines and drooping skin with fillers and injections, and of course, over time fillers fade and need to be replenished.

There are also various laser and high energy device rejuvenation treatments that we offer at the Cadogan Clinic, such as Laser Resurfacing, IPL, and Ultherapy. These treatments can be sufficient for some patients, but this depends entirely on the condition of the skin.

We typically recommend non-surgical treatments as a maintenance adjunct to surgical treatment, wherever possible. Surgical facelifts remain the better option to ensure dramatic, long lasting results. When it comes to drooping, sagging skin and deeply set wrinkles on the face, a surgical facelift is the best option.

In sum, whilst non surgical treatments can delay the effects of ageing to a certain superficial level, but the emptiness of the face and folds of loose skin will require surgery.