Face Lift Surgery
Facial facial ageing is a gradual process; the skin becomes thinner and less elastic and the structures supporting it to the facial skeleton become weaker and less able to resist the pull of gravity. The cheeks descend, the nasolabial and marionette lines become heavier, jowls start to obscure the definition of the jaw line and the neck becomes loose. A full lower face and neck lift addresses these signs of facial ageing, helping to restore a more youthful appearance.
Although commonly termed "a face lift", there are many different surgical methods used to perform face lifts. Almost all of these procedures can be broken into two components. Firstly, the manoeuvres performed on the deeper structures to create the 'lift', changing the underlying structures of the face. Secondly, the management of the overlying skin.
Before and after photographs
The New Zealand Medical Council has banned New Zealand doctors from using "Before and After" photographs in any form of public communication, including websites. The only permissible use of such photographs under the New Zealand Medical Council rules is during a medical consultation.
Dr Masters will show you examples of previous patient's "Before and After" photographs during your consultation.
The Procedure
The ideal patient for a face lift procedure has moderate to advanced signs of facial ageing including cheek decent, deepening of the nasolabial and marionette lines, jowl formation obscuring the jaw line and loose neck skin.
Relevant Anatomy
The head and neck region can be thought of as being composed of multiple layers of tissue of varying strengths. Beneath the skin and its attached thin layer of fat is a layer called the SMAS which is strong and resistant to stretching. It is this layer which is manipulated during a face lifting procedure to create the actual lift. This allows the outer layer, the skin, to be manipulated without the need to apply tell tale signs of excessive skin tension associated with older styles of face lifting procedures. The nerves of the muscles of facial expression are located deep to the SMAS layer.
Pre Operative Preparation
Mr Masters will provide you with precise instructions well in advance of your surgery to allow you a smooth and stress-free preparation for the procedure. Take the time to read your consent form thoroughly, along with any other written information Mr Masters has provided for you with regard to your surgery. This will allow you to have all of your questions answered prior to having the procedure, and ensure there are no unexpected surprises during the post-operative period.
If you are the main domestic executive in your home, or you live alone, you should plan ahead with regard to housework and meal preparation. Do your grocery shopping, cleaning, etc the day before your surgery and plan to have meals that require minimal preparation and/or cooking time.
If you are a smoker, stop smoking at least one month pre-operatively (see the "Policies" page). Do not take any aspirin or aspirin-containing products for at least one week prior to the surgery. If you are on any other medications, ensure that Mr Masters is aware of the medications (including homoeopathic remedies) so that any that require cessation during the pre-operative period can be discontinued.
Anaesthesia
Face and neck lifts are performed under a general anaesthetic administered by a fully qualified Specialist Anaesthetist, in a purpose built full operative facility. Usually the patient will remain at the surgical facility for the first postoperative night.
The Surgery
Although each patients operation is individually tailored, the standard incisions run from the temporal hairline in front of and around the ear into the hairline behind the ear. The deeper SMAS layer is re-positioned and firmly sutured in place thereby completing the lifting component of the procedure. The skin is then re-draped over the face and any excess removed. Because the "lifting" has been done at a deeper layer there is no need for tension to be placed on the skin, resulting in a natural appearance.
Any other procedures are then completed (e.g. liposuction to the lower face or neck, eye lid surgery, etc).
Post Operative Period and Recovery
Patients spend the first night at the surgical facility. Any postoperative discomfort is usually mild to moderate and easily controlled with the use of simple pain relievers. If Mr Masters has placed a surgical drain during the operation this will be removed the morning after the procedure prior to your going home.
Initially your face will feel tight and the skin may have altered sensation. Usually this sensation returns to normal over a period of weeks to months. There are no specific postoperative exercises or manoeuvres to be performed. You will however be advised to wear a postoperative compression garment to hold the tissues in place and put mild pressure on them whilst they are re-establishing themselves in their new position.
Your facial sutures will be removed at five days and the sutures within the hairline at 10 days. Most people are able to resume work and social activities at two weeks. Strenuous activities should be avoided until four weeks postoperatively.
Complications (general)
Before deciding to proceed with surgery, every patient needs to thoroughly consider the risks, as well as the benefits, of the proposed procedure. During your pre-operative consultation(s), Mr Masters will openly discuss the risks with you so that you can consider them. A full listing of all the potential complications and risks of this procedure is beyond the scope of this website.
There are two broad groupings of surgical risks: those that pertain to surgery in general; and those specific to the procedure being performed.
Generalised surgical risks include:
- Bleeding - usually occurs within the first 24-48 hours of the procedure and may require a return to the operating room. A quiet, restful post-operative period will help to avoid this problem.
- Bruising - whenever possible, Mr Masters uses medications and techniques that help to avoid post-operative bruising. The appropriate use of Arnica may help to speed the resolution of bruising.
- Infection - surgical incisions, even though created in ideal circumstances, can become infected. When appropriate, antibiotics will be prescribed to lower this risk.
- Unfavourable scarring - every surgical incision results in a scar. It is Mr Masters' role to maximise the quality of your scars and, whenever possible, to hide them in natural skin creases.
Risks and Complications Specific to Face Lifting Procedures
In people with poor blood supply to the skin (particularly smokers) there is a risk of poor wound healing with face lifting. In extreme cases there may be some skin loss due to poor blood supply.
The SMAS layer sits directly upon the facial nerve branches. There is a small risk associated with SMAS face lifting of damage to these nerves that can leave movement asymmetries in the face.
Mr Masters will fully discuss the risks and complications of the procedure during your preoperative consultations, if you have any concerns or questions these should be openly discussed with him.
Approximate Costs
Including the operating theatre charges, consumable items used, overnight stay, post operative garment, anaesthetist and surgeons fee the approximate starting cost for a face and neck lift is $25,000. Many patients choose to have additional procedures performed at the same time (e.g. chin implants, brow lift, eye lid surgery, nasal reshaping, etc). The combination of procedures reduces the overall cost compared to having the procedures done at different times. An exact quote will be provided following your consultation.
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