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What is a Facelift? Facelift or rhytidectomy is a procedure of tightening the saggy skin of the face. Facelift procedure is commonly used to enhance the appearance of the face and the neck. The first visible signs of aging appear on the face. The patient usually seeks a consultation with a plastic/cosmetic surgeon to improve the facial skin quality and to given the facial tissues a firm and youthful look.. Why Facelift Surgery? Sagging of the forehead skin, sagging of the cheek fat, prominent nasolabial folds (crease between the cheek and the lip), and jowling (skin folds hanging by the sides of the jaws) are the signs that one sees. Also you can see neck folds or turkey neck as it is called as a person ages. As one can see in this morphed picture of a guy and how he would look when older, the changes are pretty evident. 1. The skin quality is poor 2. The skin has lost tone and elasticity 3. The eyebrow has drooped 4. The malar pad of fat has dropped 5. The cheeks are hollow 6. The jowls have appeared making the face look broader at the bottom rather than at the top giving the shape of an “”truncated Triangle” 7. Deeper folds 8. Drooping of the outer angle of the mouth so, these changes of aging are partly because of loss of skin quality, loss of volume because of loss of sub cutaneous tissue, effects of gravity and of course effects of sun damage and pollutants. Face lift is the last in a series of procedures designed to counteract these effects and correct these signs of aging. Facelift Procedure Facelift procedure is done to tighten the facial and neck skin producing a youthful appearance by effacing the deep folds. The incision or cut is hidden in front and behind the ear and within the hairline. A formal facelift involves raising the skin right from the ears to the lips and pulling the skin up and back and simultaneously tightening the SMAS which is the thin muscular layer under the skin to help tighten it and keep it that way. The excess skin is excised and removed. Post Face Lift Surgery Post face lift surgery the care is very important as the patients have a tremendous amount of swelling and may even have their eyes shut because of the swelling. Most of the swelling goes down by the first week but numbness and tingling sensation may persist till about 4 – 6 months after the procedure. You are also required to wear pressure garments and supports to keep the skin in its new position. As the swelling goes down and things start settling the results will be better appreciated. Facelift require a lot of cooperation from patients in the sense that they have to go through the waiting time till the swelling subsides and numbness settles down. Also they have to refrain from smoking at least 10 days in advance and 15 days post operatively to prevent complications like skin necrosis. And need proper skin care later on. The results of the procedure are long lasting, but over a period of time the effects of gravity and aging do take a toll and the jowling / sagging skin may recur. Complications of Facelift Immediate complications after the facelift procedure can be bleeding, infection and wound gape. Another important complication is the risk of nerve injuries. Bleeding may need to be evacuated in the operation theatre and infection is treated conservatively. Wound gape may require resuturing in rare instances. Nerve injuries can occur because of the extensive dissection involved and the proximity of the superficial nerves of the face even though every care is taken to prevent such an incident. If they occur most of them usually recover spontaneously within 3-6 months as it is a painful and slow process of recovery. Though these are rare they are known to occur. Very rarely the nerve may be cut in which case a re-exploration and nerve repair may have to be done Skin necrosis is another dreaded complication though rare. The skin at the edges may die because of lack of circulation more commonly seen in diabetics and smokers. If it occurs may need a skin grafting with a resultant scar. Late complications can be Scar hypertrophy which has to be treated on its merits to try and reduce it, hair loss in the suture line which can be treated with single hair transplants. MACS Lift (Minimal Access Cranial Suspension Lift) This is a relatively newer approach to facelift. This approach minimizes the extent of dissection thereby potentially reducing the complications but providing decent results to the face lift and the neck lift. This is gaining popularity because of the early return to work patients can have. The extent of dissection is less so the swelling post operatively is also less. Also it gives good neck contours as the direction of pull is vertical. The basic facelift approach is a smaller cut most of it in front of the ear and extending into the hairline. After the liposuction of the neck is carried out, the skin is dissected. Then three suspension sutures are placed from the tissues in the upper neck and cheek and the malar fat pad and these are hitched to the tissues in the head giving the lift that is required. The excess skin is removed. MACS Face Lift What Is A Macs Face Lift? Dr.Surindher has modified the MACS face lift by using barbed “Quill Sutures” for the loops instead of the regular PDS or Prolene sutures which prevents bunching up of the tissues and gives smoother contours and filling to the mid face. Studies have shown no long term difference in the conventional facelift vs the MACS Face lift. But since the complications are less along with good results and early return to work, the MACS Face lift is becoming more and more popular. Prepare for your Face Lift Before Do… Make an initial consultation with your Surgeon. Discuss why you want the procedure done, Openly! We want to know why! Discuss any medications your taking with the surgeon. Discuss a procedure date and plan for work and holidays. Remember you need reshaping time of two –three months. Book your procedure date Pay your deposit to book your date (IMPORTANT) because then we know your serious and we get booked out very fast! Have your blood tests done and sent to your clinic for the surgeon to check over The night before you will most probably be fasting so relax and follow your surgeons instructions Drink plenty of water and keep hydrated before your fasting period Get a good night’s sleep don’t be worried. You chose us to look after you! Shower and make sure you get to the center with ample time so the surgeon can prepare you for your marking and procedure. Download print and fill the consent form (link) and bring it with you. Don’t Drink alcohol or caffeine at least 48 hours before Take any blood thinning medications, such as Aspirin or Advil. Be nervous you are in safe and experienced hands! During Arrive at the clinic on time Listen to staff instructions Stay relaxed Settle into your day care room and take before pictures for reference Practice breathing – to relax this will prepare you for your pain management The surgeon will discuss the target areas with you before taking you into the day care center. He/She will explain any restrictions if there may be. Areas for fat removal will be marked with a surgical marker pen. The admin staff will go over your consent form and you make the payments What happens during the procedure You will be taken into a clean and sterile OT environment with sterilized instruments. The surgeon and his team will check your detail whilst in the OT before the procedure. The pain management team will provide you with pain relief according to the treatment plan and the procedure will start. Your procedure will take place and finish within the allotted time. You will be able to see your extracted fat and measure the amount collected You will be moved back to recovery and you will stay till you have recovered fully, eaten something and you are settled. The team will look after you till you are ready to leave in the evening The surgeon will check up on you. You will be given prescription medicines and instructions for your fast recovery. After Do… walk around and be active as soon as you can on the same day of the procedure drink lots of water and be hydrated take a shower after 3 days of the procedure WEAR your Pressure garment for up to 12 weeks this is imperative for swelling to go down and help with the reshaping of your body Come in for follow ups with your surgeon Don’t… be idle Shout or get angry or strain yourself in any way feel like you’ve had a big procedure and think you need ‘rest’ not wear you’re the pressure garment. drive or operate heavy machinery, lift heavy objects or strain within 2 days of your procedure smoke or drink alcohol What happens next… Although AFT is a lifestyle procedure it is still a surgical procedure so along with rest and rehydration its imperative that you allow your body to heal in its own time You will see results straight away but swelling will set in soon. In lieu of the fat removed fluid fills in its space to heal so you need to wear your pressure garment to move the fluid out and pass it in your urine. Full results are seen after 8-12 weeks but the surgery is only the beginning you need to look after it just like anything else. Follow all after care procedures, you will be taught massages and how to wear your ‘faja’/ Pressure garment After your complete healing period. We look forward to seeing you at your last check up, More body confident and happy!