Facelift

What is it?

Facelifts are often perceived as tightening of the skin, but this isn't what a modem facelift is about. Today the focus is on volume and plumpness rather than simply ironing out wrinkles.

It's a two-step process that involves tightening and repositioning the fat and muscle known as the SMAS [superficial muscular aponeurotic system] under the skin, then gently draping the skin back over the top. The results are lasting, natural-looking and without the infamous "wind-tunnel" effect.

What can it do for you?

The most significant improvement is usually seen in the jowls, lower face and neck, while plumpness is restored to the cheeks.

For those worried about the top half of their face, a brow lift will raise the brows and reduce forehead wrinkles. Facelifts that combine these two operations are popular with older patients.

A facelift won't have much impact on lines around the mouth and will only soften rather than remove deeply ingrained lines on the cheeks and around the eyes

Surgeons will combine a facelift with fillers and Botox to address wrinkles, but these are done a few weeks after the operation, when recovery is complete.

The procedure

There's no such thing as a standard facelift.

Most surgeons tailor their operations to the individual's needs. Although incisions vary, they generally start at the hairline, just above the ear, and continue in a line in front of the ear or just inside the ear canal and behind the lobe. Sometimes an incision is also made under the chin.

The surgeon then separates the skin from the SMAS, which is tightened along with fat and muscle tissue in the neck, and any excess skin is trimmed away.

Surgeons generally use stitches around the ear and staples in the hairline to avoid hair loss.

It's also worth pointing out that facelift surgery involves a general anaesthetic and one or two nights in hospital.

Cost

From £5,000 to £9,000.

Recovery time

For face and neck lifts (the most popular combination), the operation takes three to four hours and dressings are removed after about 24 hours.

Stitches come out after 10 to 14 days and swelling usually subsides around this time. Most people will be able to return to work after two weeks.

You will usually be encouraged to sleep in an elevated position for a week to reduce swelling and to avoid activities that put pressure on the stitches. You can expect to feel tightness and numbness around the ear for three to four months, but any severe pau is unusual and you should alert your doctor.

What can go wrong?

Most complications after surgery are temporary, but in order to minimise the risks, make sure you use a reputable surgeon.

After facelift surgery, there's a two to three per cent chance you might get some bruising under the skin, called haematoma. This may require the stitches to be removed, the bruising washed out and the skin restitched.

About one per cent of patients go on to develop an infection. This usually occurs around the ear and can be tackled with intravenous antibiotics.

You may also suffer from a small amount of temporary hair loss around the hairline where an incision has been made. This occurs when blood flow to the scalp has been restricted. In heavy smokers, this hair loss can last for up to three months.

The level of scarring depends on your skin. Some people scar more than others and in darker skins it can be more noticeable. Injury to the nerves that control facial muscles is a rare but serious complication. You may also end up with asymmetries or irregular contours if the operation is carried out by an inexperienced surgeon.

How long does it last?

Provided you look after your skin, the effects of a facelift can last for up to 12 years and will turn the clock back by about seven to 10 years.

Around the age of 50 is a good time to have one. The quality of the skin then is more elastic, so you get better results that last longer.

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