Facial Rejuvenation Surgery

It is best to think of ‘Facial Rejuvenation Surgery’ as the application of one or more appropriately chosen surgical techniques which address the effects of ageing that are unique for each individual person. Often it is important to consider rejuvenation of several parts of the face rather than just one area in order to maintain a sense of facial balance. Today, facial rejuvenation surgery is performed so that scars are well concealed and should result in a fresher, natural and more youthful appearance.

Not all people age the same way, and this is especially true of the way different people’s faces age. In some, the forehead and brows are more of a problem, in others it may be puffy eyelid bags or excess eyelid skin, and in others the neck or jowls. Careful analysis is important in order to choose the combination of appropriate treatments that are correct for your face, and to prevent the unusual expressions that can occur following the use of inappropriate surgical techniques. Mr Kirkpatrick will guide you through this multiplicity of surgical techniques and help you to choose the surgery that is appropriate for your individual needs. Here is a brief guide to the options that Mr Kirkpatrick may discuss with you.

What is a facelift?

The terminology of facial rejuvenation surgery can be very bewildering. Terms such as cutaneous facelift, deep plane facelift, subperiosteal facelift, endoscopic facelift, SMAS facelift, extended SMAS facelift, lateral SMASectomy facelift, composite facelift, MACS facelift, masklift, midface lift, volumetric facelift, SOOF lift, browlift, endoscopic browlift, necklift and platysmaplasty, (to name but a few!) present patients with a bewildering choice.

Since the original ‘facelift’ procedures, there have been considerable advances in recent years in the surgical techniques available to rejuvenate a person’s face. Many of these techniques have developed in parallel with recent scientific advances in craniofacial surgery, and increased knowledge of the anatomy of the face. These developments can avoid the unnatural ‘over-pulled’ or ‘over-tightened’ appearance that can be produced and is too often seen.

All surgical techniques have their advantages and disadvantages. Often, the more complex the surgery, the better, and longer lasting, the final outcome. However, there may be a longer time for full recovery; including the time for swelling and bruising to settle. Thus, for each individual, there will be a range of options that will need to be discussed and tailored to each person’s ‘ageing’ needs, as well as their personal, social and work circumstances.

Non-surgical treatments which improve the fine lines and wrinkles around the eyes, between the eyebrows, and of the forehead can also be very rejuvenating and should be considered either as an alternative to surgery or frequently as complimentary to it.

What is a cutaneous (Skin only) facelift?

This is often called a ‘traditional’ facelift. The skin is lifted from the underlying tissues of the face and pulled upwards and backwards towards the ears where the scars are hidden. Although a relatively simple technique, with a short recovery time, the ageing deeper structures are not treated and rejuvenation is not usually long-lasting. Furthermore, distortions of the face can produce an unnatural appearance. Nonetheless, in some people this remains a very appropriate type of facelift.

What are SMAS facelifts?

SMAS stands for Sub-cutaneous Musculo-Aponeurotic System, which is a thin but strong layer of facial tissue beneath the skin to which the facial muscles are attached. A variety of techniques that lift this deeper layer of the face have been described, and this accounts for many of the different names of facelifts. By lifting these deeper layers in the face, longer lasting and more youthful contours of the face can be achieved.

What are subperiosteal facelifts (Mask lift) and endoscopic facelifts (Endoface)?

These techniques derive from the practice of craniofacial surgery and are only indicated in specific circumstances for a few patients. Essentially all the soft tissues of the face can be released from the underlying bones and lifted at the deepest layer of the face. Sometimes, where appropriate, Endoscopic or keyhole surgery is used which allows the use of smaller incisions well hidden within the hair. These techniques can be very powerful and may change the shape of the face. They do, however, usually have a longer recovery time.

What is a midface lift?

For many people the lower eyelids are their biggest problem. As the cheek below the lower eyelids ages, the lower eyelids become baggy and a deep groove develops along a line between the lower eyelid and the cheek. Often the cheek sags so that a groove also develops between the nose and the corner of the mouth. A midface lift tries to address this problem by lifting this mid portion of the face and restoring the youthful continuity between the lower eyelid and cheek. Such midface lifts can be performed at different levels in the face depending on the ageing process and are often very rejuvenating. These are also more complex procedures and therefore have a longer recovery time.

What is a volumetric facelift?

Some people seem to age more because they have lost the plump fullness (fat) beneath the skin of the face. Restoring this lost volume of the face (a volumetric facelift), usually by fat grafting techniques, will often be significantly effective either alone, or in combination with other facial rejuvenation procedures.

What is a neck lift or platsmaplasty?

The neck can be unsightly either because of too much laxity, or too much fatty deposition. To help tighten vertical folds in the neck, and restore the angle between the neck and the chin, a procedure known as an anterior platysmaplasty may be appropriate. This involves tightening and lifting the wide bands of muscle (called platysma) which may hang down below the neck and chin. Excess fatty deposits below the chin can be improved by removing them directly or by liposuction techniques.

How long will I need to stay in hospital?

Following most facial rejuvenation procedures, an overnight or occasionally two-day stay is necessary. Mr Kirkpatrick will guide you depending on your own particular circumstances.

How long does it take to recover from facial rejuvenation surgery?

People are unique and just as they age differently, so recovery times also differ. The time taken before returning to work very much depends on what surgery you’ve had and what work you do. In general, after facial rejuvenation surgery it is wise to allow two to four weeks recovery time. It takes longer to recover from deeper plane facelifting and may take up to twelve weeks for all the signs to disappear.

How long does facial rejuvenation surgery last?

The rate at which ageing occurs, and continues, varies from one person to another. In general, the deeper the level at which a facelift is done, the longer lasting the results. However, the more extensive the surgical procedure the longer the recovery time is likely to be. Mr Kirkpatrick will be able to guide you as to what you may expect to be achieved.