Face Lifting

    Facelifting

    Surgical procedures are recommended if it is desired to tauten certain areas of facial skin, or indeed the face as a whole, with the aim of achieving a “rejuvenated” appearance. With facelifts, it is possible to correct even extreme skin folds, flabby cheeks, sagging eyelids and wrinkled necks. Not all patients are equally susceptible to this kind of treatment. In the case of skin that has sustained severe light-ageing, peeling treatment may be necessary in addition to surgical procedures. In the case of heavy smokers, the healing process may also be disturbed, with undesirable scar formation.

    Most women decide on a facelift at the age of between 40 and 60. The best results can be obtained with people in their early 40s, as at this age the skin is still relatively elastic and the results last longest. At this kind of age, only minor facelifts are also usually necessary, with corrections to the mouth and eyes. From about 60, “major facelifts” are mostly necessary. In the case of these bigger operations, the muscles that provide facial expression are usually tautened and excessive fatty tissue removed. It should be noted, however, that the vertical folds around the mouth cannot be corrected by surgical methods. To achieve this, peeling, laser or injection methods have to be used.

    General remarks on surgery

    Nearly all facial operations can be performed under local anaesthetic. In most cases, however, a light general anaesthetic, so-called semi-narcosis, combined with local anaesthetics is recommended. This method allows the patient to undergo the procedure in a more relaxed manner. The patient only registers what is going on to a limited extent, but is able to respond to questions.

    Complications in the various surgical procedures are rare. The most common occurrence are haematomas (i.e. bruising) in about 2 to 3 % of patients. These usually occur in the first 2 hours after the operation. Depending on the extent of the surgery, a disturbed sense of feeling of the facial skin must be reckoned with. Injuries to the major facial nerves, on the other hand, are rare. In the case of nerve injuries, these effects disappear in about 80 % of cases within one year from the operation.

    Disturbances to the healing process, especially in the case of smokers with impaired blood circulation to the fine blood vessels, can result in extensive, visible scarring. This can usually be corrected in a second minor operation a few months later. As in the case of all surgery, complications can occur in the form of infections, thrombosis and embolism.

    A fresh, rejuvenated, and above all natural appearance is achieved by facelifts that achieve a clear correction, but without completely eliminating the skin folds that allow natural facial expression. “Over-tightening” of the facial skin usually corrects itself within about a year, but until that occurs, it tends to cause irritation to other people by the initial lack of facial expression and the “set” look of the facial features.

    Eyelid corrections (blepharoplasty)

    Excessive folds of skin in the area of the upper and lower eyelids, in some cases with sagging at the outer corners of the eyes, are among the most common symptoms of ageing skin.

    Moisturising face creams are able to smooth the finest wrinkles, but the excessive folds of skin remain. Peeling is risky in the area of the eyes and tends to bring only minor, short-lived improvement.

    In the area of the upper eyelids, it is relatively easy to remove the excess skin. Swollen looking eyelids are easy to correct by removing not only the excess skin, but also the excess fatty tissue underneath. In the case of the lower eyelids, as well as the excess skin it is often also necessary to remove or shorten part of the muscle (musculus orbicularis) that is located there.

    Excess tissue around the eyelids should be removed with caution so as not to produce an over-correction, giving the eyes a “sunken” appearance. Eye make-up can be applied from about the 10th day after the operation. Contact lenses can be worn again after a period of about 2 weeks.

    Forehead lift

    Sagging eyebrows and deep vertical and horizontal lines above the bridge of the nose and on the forehead can be corrected by removing excess skin and tightening the upper areas of the forehead. Smaller corrections can be performed by endoscope, through 3 button-hole sized incisions in the skin of the forehead above the hair line. The skin is thereby released using a fine endoscope, moulded into the desired shape and pulled upwards. A longer lasting result can be achieved by making a cut right across the head from ear to ear, above the hairline. In this case, the forehead muscle is shortened and excess skin removed, with the result that the forehead acquires a tauter appearance.

    Mini-lift

    In the case of minilifts, the skin of the cheeks, neck and skin is tautened. After removal of the excess skin, the skin is altogether pulled tighter and then stitched. The result lasts for about 4 years.

    Major facelift

    In this procedure, the facial skin is tautened by the removal of strips of skin around the margins of the face, i.e. at the hair line, in front of and behind the ears, and under the chin. Facial muscles are also shortened, if necessary. In the case of older people, a tautening of the facial muscles is always recommended. The excess skin (in many cases 2 to 3 cm) over the shortened muscles can then be removed. The sutures or seams are usually positioned “invisibly” under the hair at the temples, behind the ear and at the sides of the neck. The seams which are not covered by hair are placed in front of the ears, under the chin and on the lower side of the jaw.