Purpose: To rejuvenate the face and give the face a more youthful appearance
Length of operation: 3-4 hours (depending on technique)
Anaesthesia: General anaesthetic
Inpatient stay: 1-2 days
Follow up: 1 week, 3 months, 6 months, 1 year
Time off work: 2-3 weeks
Recovery: 3-4 weeks
Risks: Scar, Ear Lobule Distortion, Hair Loss, Facial Nerve Injury, Asymmetry
This is a common plastic surgery operation for an aging face. The operation involves a range of procedures which include:
- Resurfacing methods-chemical peels
- Fillers-like Restylane
- Botox injection for frown lines
- Blepharoplasty (eyelid surgery)
- Brow lift (for the forehead area)
- Minimal incision facelift operations (limited incisions, thread lifts)
- Full facelift operation
These procedures can be used alone or in conjunction. The aim is to give you a more youthful appearance. Dr Sanjay Azad will carry out a detailed assessment of the face and then discuss the most appropriate procedure/s with you.
The results are generally excellent with high satisfaction rates. In this description I shall take you through the operation, hospital stay, recovery and the complications. Once you have met me for the initial consultation, I would be quite happy to see you again for a second consultation, so that you can clarify any of your doubts.
Procedure / Hospital Stay
It is advisable to stop smoking for 4 weeks and stop contraceptive pill and hormone replacement therapy for 4weeks prior to the procedure. Aspirin needs to be stopped for at least 10 days before the procedure, as it thins the blood out and can make for more bruising. If you are hypertensive then it is particularly important that this is well controlled prior to the procedure. On the day of the operation Mr Sanjay Azad with do skin markings over the face. Photographs for documentation and teaching purposes are standard and will be discussed. The procedure is done under general anaesthetic and takes several hours to perform. The duration of operation will vary depending on the mix of procedures you undergo. The procedure is done using an incision which typically runs from the hairline, down just in front of the ear and skirts below and behind the ear to the scalp hairline. If you have a high hairline in the area of the sideburns, then it is necessary to modify the incision to zig-zag through the sideburns. We shall go through with you on this in some detail. The operation involves the skin and the deeper tissues in the face. The areas addressed include the neck and the face. Facial aging commonly affects the eyelids and for this reason it may be necessary to have a blepharoplasty (eyelid reduction) procedure to give the most harmonious result.
While you are in hospital you will have blood tests, fluids through a drip and pain killers. The stitches are partly dissolving type and partly non-dissolving in nature. At the end there is a bulky dressing and a drain in each side. You will feel quite bruised and swollen after the operation and this settles in due course. We advice on using cold packs for the first few hours as this helps to reduce swelling. We take precautions to prevent clots in your calves by putting on stockings and giving you a blood thinning injection. The hospital stay is conventionally 2 days and depends on your recovery and drain removal.
Recovery After Surgery
At discharge, the bulky dressing is removed and you need to attend the dressing clinic in a weeks time. You will be given some pain killers to take home. Keep an additional pillow under your head for a few days, as this helps to reduce swelling. Further dressings may or may not be required depending on the wound. The bruising typically takes 2-3 weeks to disappear. Initially the bruise becomes tan coloured and this fades in due course. You will be seen again in 3 months time. Photographs will be taken at this stage.
You should avoid smoking for 4 weeks after the procedure. Recovery is individual, but most patients get back to work and driving in 3-4 weeks time. It is important in the healing phase to apply a sunscreen cream otherwise the scars can become pigmented. This should be used for at least 1 year after the procedure. Gentle massage of the face with a moisturizing cream, in an upward direction is also helpful in the healing process.
Overall results are excellent but there are some well known limitations, risks and complications which you should be aware about. Scars, infection and blood clots are risks of any procedure. Facelift surgery does not treat the fine wrinkles on the face. This will require a resurfacing procedure like a chemical peel. The face is rarely symmetrical on both sides and there may be persisting asymmetry. An important nerve runs in the cheek called the facial nerve. This can rarely be damaged giving rise to facial weakness. In most instances this is due to bruising of the nerve and recovers in a few months time.
- Mr Sanjay Azad advices his patients to take Tablet Arnica (30 strength) once a day prior to surgery. This is a homeopathic remedy which has been found to reduce bleeding and bruising after surgery.
- No make up should be applied on face prior to the operation.
- Do not cut your hair prior to surgery so that the incision can be well hidden.
- Do get a scarf and sunglasses which will be useful after surgery.
- Continue taking Arnica tablet once a day for 2 weeks after surgery.
- Pain killers after surgery are typically a combination of codeine and paracetamol. Avoid any tablets like ibuprofen or diclofenac which can potentially thin the blood and cause more bleeding or bruising. If you have any allergies please highlight this to Mr Sanjay Azad.
- If there is any bleeding through the bandage, please contact the team.
- Do not consume alcohol for 2 days after surgery.
- It is useful to apply ice compresses to the exposed area of the face during the first 2 days to reduce swelling.
- You can wash your hair 3 days after surgery.
- Try not to do too much after surgery and take a soft diet for the first three days. Limit activities such as bending, straining and lifting. Avoid excess neck movements and heavy exertion for the first month. Aerobics should only be done 3 months after surgery.
- While sleeping keep your head elevated (to 45 degrees) by using an additional pillow. This should be used for the first week after surgery.
- Do not go into direct sunlight for first 6-8 weeks after surgery. Also use sunblock daily.
- It is common to have swelling of the face and sometimes bruising of the neck and chest. Bruising typically settles down in 2-3 weeks time. It is safe to apply makeup after the first week to mask the bruising.
- It is useful to massage the face with moisturizing cream after surgery which helps in the settling down process.