Facelift

Facelift (Rhytidectomy) ABROAD

Procedure: Improves sagging facial skin, jowls and loose neck skin by removing excess fat, tightening muscles and re-draping the skin. Is most widely done on women over 40. Facelift surgery can be combined with eyelid surgery, liposuction of the chin and endoscopic forehead lift.
Duration of Procedure: 3-4 hours.
Anaesthetic: Local anaesthesia with sedation or General anaesthetic.(administered by board certified anaesthetist)
In/Out Patient: Usually outpatient. More extensive surgery may require an overnight stay.(over night stay in Dr. Jedeikin’s Recovery Retreat)
Postoperative: Temporary bruising, swelling, numbness and tenderness of the skin;
Recovery: Return to work after 10 – 14 days. More strenuous activity after 2 weeks or more.
Bruising: Visible for 2 – 3 weeks. For several months, avoid exposure to direct sunlight.
Results: The improved jawline and profile, and removal of jowls, greatly improves facial definition, and lasts for 7 – 10 years.
Before/after illustrations: Owing to recent legislation, these photo’s have had to be removed until the situation has been clarified. For example images, please contact:ingrid@plasticsurgerysa.co.za
General

AFacelift and neck lift surgery is a very commonly requested procedure from patients abroad.

A facelift is an operation whereby loose muscles of the face and neck are tightened, and the skin re-draped and the excess trimmed to improve facial contours. It is done to rejuvenate one’s appearance, and is effective wherever the skin of the face and neck sags excessively. However, it is never possible to remove all skin folds or eliminate all wrinkles. Only as much skin is removed as is safely possible.

It is very important to understand that it is not actually the skin which is used to suspend the jowls and the neck. It is in fact the underlying facial fascia known as the SMAS. Dr Jedeikin will explain this to you either via email or Skype.

Occasionally, additional procedures can be done at the same time as a facelift, such as eyelid surgery, a brow lift, neck surgery, and laser skin resurfacing of certain areas. These options will be fully discussed at the consultation.

Some of the most frequently asked questions about facelifts follow below:

Is major surgery required?

A facelift is a major surgical procedure, taking about three hours. It may be performed under local anaesthetic with sedation, or general anaesthetic. To minimise swelling, drain tubes are inserted after the operation and are removed about 24 – 48 hours later. Postoperatively, there’ll be swelling of the face/neck and possible bruising on the eyelids. Bruising will be most apparent on the second and third days, and subsides from between one and six weeks after surgery, depending on your age, type of skin and healing ability.

When can I resume normal activities?

You may go home on the same day of the operation, if fully awake, or you may overnight in hospital. You must not drive, so please arrange that someone fetches you. It will also be necessary to have a responsible adult spend the first 24 – 72 hours with you at home after the surgery. Alternatively, stay for this period at a medical recuperation facility. Dr Jedeikin has a Recovery Retreat where most of his patients recover for 2-4 nights after facial surgery. The option of this facility will be made available for patients from abroad as well as local patients.

Social activity should be limited for about 10 – 20 days. Avoid strenuous activity for 2 – 6 weeks or when all bruises have faded and there is no discomfort; but it is best to avoid any physical activity. You can shower by the second day (after drains have been removed) but be careful not to apply any strain to the wounds and not to ‘fiddle’ with them. Most patients can return to work and normal activities wearing light make-up, after about seven to ten days.

How long does a facelift last?

This is impossible to state for a given individual, as there are many factors involved that determine the eventual outcome of a facelift: your age, aging rate, skin type, and degree of pre-existing sun damage. Each individual’s healing ability, changes in weight, smoking history and general state of health are also determining factors. A facelift can defenitly slow down the rate of the aging process, while ‘turning back the clock’. However, most patients’ facelifts show sufficient improvement to keep them looking younger than their contemporaries indefinitely; and one can have another facelift in later years to maintain one’s more youthful appearance.

Can complications occur?

Complications and bad results are uncommon with this type of operation, but they sometimes occur. It’s not possible to list all potential complications; but the most common acute complication is haematoma formation, which is caused by bleeding within the first 48 hours postop. This is more common in hypertensive (high blood pressure) patients, smokers and patients taking certain blood thinners/anti-inflammatories preoperatively. Haematoma requires immediate drainage and prolongs healing by a week or two. Dr Jedeikin will give you a list of medications that must be stopped preoperatively.

Other potential complications are infection; bleeding; blistering of the skin that may result in scarring; unequal facial discolouration and swelling; abnormal facial contours; nerve damage causing temporary or permanent loss of feeling in the face; and weakness of the facial muscles. Very occasionally, a complication may necessitate further surgery.

Certain complications, particularly blistering and skin loss around the ears, occur more frequently in smokers. Patients who smoke should not do so for at least four weeks before and after the operation, to reduce the chances of complications.

Dr.Jedeikin is most pedantic about this mandatory rule.

Will there be visible scars?

The surgical scars are permanent but the incisions are placed so that they are barely discernable. The exact position of scars will be discussed at your consultation.

What costs are involved?

There are three cost areas, which will be discussed in advance: the surgical fee, facility fee and anaesthetic fee. Once you decide to proceed with the surgery, a deposit of 10% (of the overall fee) is required; this secures the operation date, and includes a preoperative consultation at no further charge. The Recovery Retreat costs will be emailed to you.

How should I prepare for the operation?

You’ll be given strict preoperative instructions during the preoperative visit. Wash your hair the night before and the morning before surgery. Do not eat or drink after midnight before the day of surgery.

You’ll be given two sedative pills – one to take the night before surgery and the other to take on the morning before leaving home, to relieve the unavoidable anxiety. Because of the sedative, it is essential to arrange that someone drives you to the hospital. Don’t apply any make-up or facial moisturiser that same morning. Wear loose-fitting clothing that’s easy to remove.

What postoperative care is necessary?

A facelift is a delicate and extensive procedure. The fine suturing of the deep muscle layer must be protected from tearing in the first two weeks. Sudden jerks or movements may cause the innermost stitches to pull free and so compromise the long-term result. The following restrictions must be observed after the operation:

  • Report tight bandages and excessive swelling immediately.
  • Do not remove any bandages yourself.
  • Do not turn your head from side to side.
  • Do not sleep flat.
  • The head of your bed should be elevated to ensure that you sleep comfortably (use 3 pillows).
  • Avoid strenuous activity, getting overheated, and sun-bathing for at least two to three weeks.
  • Keep away from pets during the early stages of healing as their hairs can contaminate your scars and cause infection.
  • Be careful when drying your hair; use the lowest heat setting for the first two months to avoid the possibility of damage to the skin or hair.

If you have any further questions, I’ll be glad to answer them.