Face lift (Rhytidectomy)

The Operation: What Happens during Surgery?

Surgery takes around two to four hours. The position and type of incisions depend on the type of face lift.  The procedure can be performed under general anesthetics or with a combination of mild sedatives and local anesthetics; again, depending on the extent of the surgery and your surgeon’s recommendation.

Traditional face lift

The surgeon starts the incision at the hairline by the temples, just above and in front of the ear and then circles the lobe.  The incision is placed where it will be least visible and most easily hidden along the hairline and for men it is positioned to retain their natural beard line.  If you wish to reduce a sagging jaw line, cuts may also be made under your chin.

The skin is carefully separated from the underlying tissue and muscle.  The surgeon then tightens the skin and muscle, repositions any connective tissue and may remove excess fatty deposits or excess skin.  Then, the skin is raised upwards and outwards to the incision point, and any excess is trimmed off before the skin is closed using fine sutures, metal clips or stitches.  

After surgery, you will have dressings applied to the entire incision area.  You may have bandages running around your eyes and over your head.  These are usually required only for the first couple of days following surgery.  You may have very fine plastic drainage tubes inserted into the incision area to ensure that blood and other fluids don’t built up under the skin.  Again, these are usually needed only for 48 hours. 

Mini- or limited face lift (minimal access cranial suspension)

This alternative to the full face lift requires fewer and shorter incisions at the temples and around the ear lobes. 

Neck lift

This corrects sagging jowls, loose neck skin and any fat accumulation under the chin.  The incision here can still start at the front of the ear lobe, but will then go around behind the ear ending in the lower scalp area.

Recovery / Convalescence

What to expect immediately
At first, you will experience some bruising, inflammation and some discomfort.  But once the immediate swelling subsides, you will begin to see your rejuvenated self.  It does take varying amounts of time for face lift surgery to heal and for individuals to realise the benefits of their surgery. 

Immediately post-op, you will be advised to rest with your head in an elevated position to alleviate the swelling.  You may need to use ice packs from time to time.  Most painful swelling subsides in the first 48 hours.  Bruising and/or discoloration may last up to two weeks, but you may be allowed to wear concealing make up even a week after the operation.

You may find that one side of your face is swollen more than the other side, that you have some facial numbness or that you have some temporary asymmetry in your facial features for a while.  These are common in the immediate post-operative period and usually correct themselves quickly once the healing process sets in.  As a rule, stitches are removed a week after surgery. 

Long-term care

Your surgeon will give you a comprehensive list of do’s and don’ts to adhere to after your operation.  These will include instructions on caring for the incisions and wounds, applying dressing and on your medication, and on any abnormal signs you should look out for.  You are likely to be advised to avoid Aspirin (which can thin blood) and non-steroidal anti-inflammatory medications for the first few days.  Smoking and exposure to sunlight are not recommended. 
Some patients find that mild swelling persists for many weeks and if it does, you should consult your surgeon. 

You are asked to refrain during the early weeks from strenuous exercise and any activity which requires straining, bending over and lifting as they actions may precipitate bleeding.
The full results of your face lift may not be apparent for up to several months as swelling and bruising can take time to abate. It may also take up to six months for scar tissue to be less visible to all but close scrutiny.  Be patient, as you will need time not only to see the results but also to adjust to your new appearance.  But be alert to any abnormalities in the healing process and keep in contact with your surgeon should you have concerns.