Everything you need to know about Face and Neck lifts

A Facelift is a surgical procedure typically performed under sedation (in which you are awake but relaxed) or general anaesthesia (where you are put to sleep) which rejuvenates the face and neck to produce a more youthful appearance. Whilst it involves removal of excess skin, the main lifting and rejuvenating techniques are the result of increasing support to the deeper layers of the face, providing a long lasting improvement in facial proportion, jawline definition and neck contour.

What results can you expect?

A good Facelift should produce an enhanced jawline, a more youthful neck contour, better cheek fullness and improved skin smoothness with less wrinkling and banding in the neck. These results should appear natural and not “windswept". Results that can be delivered by Facelift surgery are typically not deliverable by injectables and nonsurgical solutions, all of which may be a compromise compared to Facelift surgery.

How to prepare for a Facelift

It is usually enough that you are generally healthy, without having to make other special preparations. It is important to avoiding smoking or vaping (directly or passively) to maximise the chances of good wound healing and forming neat scars. A comprehensive skincare regime will also help the quality of your skin prior to undergoing surgery. Coming to an operation adequately rested, well hydrated and relaxed puts you in the best position to have a good outcome from a Facelift.

What age is appropriate for a Facelift?

Whilst Facelift surgery is most common between the ages of 45 and 70, it is sometimes indicated for patients younger or older than this range. Facelift-Necklift surgery alters the effects of ageing but some techniques also help anatomical variants that people are born with. For example, the "obtuse heavy neck” (one with a less defined, fuller appearance) is an example where such surgery may be indicated for patients in their 30s or even younger who wish to to improve their neck contour and jawline definition. Older patients may also be suitable for facelifting and the techniques used may differ according to the structures of the face that have suffered from ageing. In the older age groups, simpler solutions with faster recovery times that focus more on correcting skin looseness may be appropriate.

Photography: Richard Washbrooke @rwashbrooke

Who is a good candidate for a Facelift?

Any patient who wishes to improve upon their lower facial ageing and who is fit for surgery is suitable for a Facelift. Patient selection is important to ensure that patients have an adequate understanding of the potential outcomes of surgery and the limitations of surgery. Comprehensive discussion prior to considering surgery is important to establish a surgeon-patient understanding. The best patients for this surgery are those who have a physical situation that can be significantly improved upon by surgery and in whom it is likely that this improvement will match the expectations of the patient.

Types of Facelift

Different types of Facelift-Necklift surgery vary in complexity and time. Skin-only Mini-Facelifts may take as little as two hours and can even be performed under local anaesthetic, whilst Full Facelift surgery with comprehensive neck rejuvenation may take over four hours. Adding in additional procedures such as fat grafting (for volume enhancement), eyelid surgery, browlift surgery, lip lifts or skin surface treatments all add to the time of surgery. Combination procedures need to be selected carefully to maximise patient benefit and minimise potential risk.

Duration of Facelift

Many different types of Facelift and Necklift procedures have been described over the years. It is easiest to classify these according to the structures that are operated on. Whilst the skin of the face is undermined, redraped and tightened in the setting of any Facelift, it is the surgical approaches on the deeper layers of the face that create such variability in practice. All of these approaches to the deeper layers (known as the SMAS layer in the face and the platysma layer in the neck) have different effects and different degrees of longevity. Each of these approaches should be discussed with you to give a bespoke plan for your surgery. One size does not fit all and the ability to offer a range of techniques is something you should look for in your surgeon.

The two main groups of operations relate to whether surgery is carried out purely from a lateral approach (from an incision discreetly placed around the ear) or whether additional central access is employed (typically via a short straight incision under the chin). In general terms, if the neck contour (shape) can be adequately corrected by pulling skin under your jaw towards your ear then a lateral approach correction may be appropriate. If, however this does not produce an acceptable tightening in the central neck structures or shape change in the central neck, or does not correct vertical muscle banding, then central neck access is likely to be necessary. Adding central neck access does make the procedure longer to perform but undoubtedly gives a more powerful rejuvenative effect in the neck.

What is the recovery like after a Facelift procedure?

The recovery from a Facelift procedure usually involves a short period of bruising and swelling whilst the tissues settle and heal. There may be temporary skin numbness but this typically recovers in the long term. Visible sutures are usually removed within 10 days of surgery. Minimal dressings are required soon after the procedure. Patients can shower and have their hair washed from the day after surgery. There is usually little pain and only minimal analgesia is usually required. Sometimes the face feels a little tight for a short while after surgery whilst the swelling is settling. Patients are normally very socially presentable from two weeks after their operation. Exercise can be gradually resumed from a few weeks after surgery.

How long will the results from the Facelift last?

The longevity of a Facelift correlates with the techniques used. Skin-only superficial techniques will not last because the structures beneath the skin will cause it to stretch again. More comprehensive techniques that lift, reposition and reshape the deeper structures of the face and neck have more longevity, and some Facelift manoeuvres can be considered permanent. Skin laxity and ageing will always continue because the processes of ageing cannot be reversed or halted, but typically patients who undergo proper Facelift-Necklift surgery will always be better off than they would otherwise have been. Some patients come forward for revision surgery a decade or more after an initial operation - this should be thought of as a maintenance approach to facial ageing and is not a failure of the initial procedure.

Do you have any top tips to reduce the appearance of ageing?

Undoubtedly a comprehensive approach to skin care and maintaining good general health is an important part of reducing facial ageing, and the Facelift procedure is not where the story ends. You would not buy a Rolls Royce and then run it to the ground without ever servicing it. To optimise results it is very important to avoid smoking. Early adoption of a judicious neuromodulator programme (such as botulinum toxin) may prolong your results by reducing the development of static wrinkles in the longer term. On top of this, there are individual differences in genetics that make some patients more likely to benefit from facial rejuvenation surgery than others, and this cannot be altered. The steps above, however, will have an effect to improve your overall rate of appearance changes related to ageing.

Learn more about having a Facelift procedure here at Berkshire Grove Hospital. 

The Following Surgeons Perform Face & Neck Lifts at Berkshire Grove Hospital

Mr Sinclair Gore

Mr Chris Wallace

Mr Kuen Yeow Chin