Facelift and Necklift

About 

To date I have done over 640 facelift operations. I do a deep plane SMAS facelift. This surgery is demanding and precise. The technique I use encompasses a facelift and a necklift in one procedure. It addresses problems from lower in the neck, under the chin, on the jowl and jawline, across the cheek to high on the cheekbone. After many years I have refined an approach which delivers maximum effect leaving only a short scar. The line is hidden in the curves at the front of the ear, in the fold of the earlobe and in the crease behind the ear. The skin and soft tissue of the neck, jawline and cheek is undermined, released and lifted upwards and precisely repositioned with many dissolving stitches. The operation reverses the aging process but without the appearance of having had surgery. No one needs to know. The surgery is under general anaesthetic and even though it is very complex, it is now routinely done as a day case. There’s a 2 week down time.

Consultation

I need to know the facial features you dislike to ensure that surgery will be worth-while and you’ll be happy with the outcome. The assessment focusses on locations of excess fat and excess loose skin. I look for loose skin on the cheek, jawline, jowl area, under the chin and on the neck. I pull the loose skin firstly upwards and then backwards to see how much it moves, how this opens the skin fold at the corner of the mouth and smooths out the jaw line and neck. I feel for fat in the jowl and under the chin which would be removed to produce more definition. I assess any excess bulk in the cheek area (buccal fat pad) and whether this should also be removed. To show you what results to expect I take photographs and compare them with previous results in my large database. It is equally important to highlight features which will not be improved. Fine creases on the lips, for instance, will be unchanged.

In addition to looking at the face and neck I also assess the eyes as this is the first feature that others see. If the eyelids show worse signs of ageing, then it may be more prudent to address this area first or to include eyelid correction with the facelift procedure.

How long will it last?

This is the question everybody asks. The longevity of the result depends on the quality of your skin and how it continues to age after surgery. During the operation I will use the best technique possible to produce the best possible outcome.

Operation

There are two layers to address in a facelift. The skin layer and a deeper layer called the ‘SMAS’*. I perform a ‘deep plane’ facelift keeping the SMAS tissue and skin together as one. First though, any excess fat under the chin and at the jowl is removed by fine liposuction. Removal of the buccal fat pad in the mid cheek will also improve definition as will thinning any bulk under the skin below the angle of the jaw. Then I relocate the combined SMAS/skin layer upwards and then backwards. The SMAS layer is robust and withstands the tension of stitches needed redefine the jawline and smooth out the cheek and neck. The direction of movement and tension varies in different parts of the face. On the jawline and neck the movement is upwards, on the cheek it is oblique, at the cheek bone the tension is backwards, whilst behind the ear the skin is moved slightly forwards. Tension on the skin at the incision is avoided to produce a fine scar line. A firm dressing is applied to prevent swelling. This stays in place for 3 days to ensure no swelling or bruising.

 *  SMAS: Subcutaneous-Musculo-Aponeurotic-System

Recovery

Facelift surgery can be done as a day case. I do not use drains. The compression dressing remains in place for 3 days. When it is removed there should be very little swelling or bruising. You can then shower as normal. You must sleep propped up but not on your side. The basic recovery period is 2 weeks. Stay at home and restrict activity. You must rest. The incision lines and the layers of the face must heal together. There will be contact for support at 14 days. This can be remote by phone, or video link. But if there are any concerns you must attend the clinic. A further settling period lasts several weeks before the follow up at 2 months. The skin of the face will feel smooth and initially firm. At 12 weeks all swelling has gone as the firmness subsides. The scar lines are initially pink but will fade to become almost invisible.

Gallery

See photographs of typical results for this procedure