Face Surgery

Facelift Melbourne

What is a Facelift?

Facelift surgery, also known as a rhytidectomy or meloplasty, is designed to change the appearance of the face, neck and jaw by the use of precise surgical techniques. While over-the-counter products and non-surgical options may be appropriate for some people, in other cases a facelift is the most visible means of changing your appearance.

With a better understanding of facial anatomy, facelift procedures have reached greater levels of sophistication and can be used to create results which do not hint at the surgery required to obtain them. Treatments can be customised to suit your preferences and one of our experienced specialist plastic surgeons at Niche Plastic Surgery can prove invaluable in helping you determine which techniques will produce the most enduring results. Importantly like all surgery, facial aesthetic surgery such as facelift involves risks which must be considered by patients.

Anatomy of the Face

The face is a complex structure with the facial skeleton (bones) at the base, with various layers of soft tissues overlying it in a complex but relatively consistent manner. The overlying tissues include muscles (which move structures on your face e.g. to smile), nerves (which control the muscles or allow you to feel), arteries and veins (blood vessels which carry blood into and out of the face), connective tissues and their compartments (eg. ligaments, fat and the Superficial Musculo-Aponeurotic System or SMAS which determine the shape and volume of the face) to name but a few, covered by skin. The SMAS is a layer of connective tissue, which lies deep to the skin and underlying fat, but above the muscles and nerves which control them. It is of relevance when discussing the various planes of facelift; a deep plane facelift involves surgery below the SMAS whereas more traditional techniques stay above or at this layer.

Facelift Outcomes

In general, people seeking information about this procedure tend to be middle-aged (aged 40’s and onwards), of all genders, and are seeking to address their facial laxity. Most have tried and been unsatisfied with less invasive techniques.

A facelift procedure works to lift, tighten and add volume to structures which underlie the skin thereby targeting facial lines and shape. The surgery redistributes fat and tightens ligaments of the face. A facelift also addresses other concerns such as:

  • Jowls which break up the lower jawline
  • Excess fat or skin below the chin due to submental fat underneath the jawline
  • Skin laxity throughout the mid and lower face
  • Deep fold lines that run from the nose to the mouth (nasolabial fold)
  • Deep fold lines that run from the corners of the mouth to the jawline (“marionette lines”)
  • Facial hollowing in the midface

Types of Facelifts

Since there are different types of facelift procedures, the areas you want to focus on and your overall expectations will determine which technique works best for you. For this reason, the initial consultation is a big part of the process involved in getting a facelift. During the initial meeting, your surgeon will ask you which areas you want to focus on and discuss the various options available and the benefits and risks of each procedure.

Overall there are three types of facelifts:

  • Traditional full facelift
  • Mid facelift
  • Lower facelift

Traditional Full Facelift

A full or traditional facelift addresses both the mid and lower facial regions. As a result, the incision needed is generally more extensive, and the surgery takes longer as does the recovery time. The incision created for a full facelift will likely run from the temples and around the ears. Our surgeons carefully place incisions within the hairline and in the natural folds of the skin to minimise visible scarring after surgery. Areas addressed by a traditional full facelift include:

  • Loose skin around the cheeks
  • Facial hollowing and loss of definition in the cheekbones
  • Deep creases beneath the eyes
  • Lines around the mouth and nose
  • Skin laxity in the lower area of the face

Our surgeons will determine whether a full facelift is the right choice for you based on the number of areas you want to be addressed during your surgery.

Mid-Facelift

A mid-facelift, concentrates on the areas underneath the eyes and around the cheeks. Facial implants or fat grafting may be used to add definition to the cheekbones and create a more contoured profile. To add implants to the procedure the surgeon lifts the underlying muscles and places the implant or graft within a pocket created for this purpose. The technique requires a deeper incision than that used for a facelift alone. If the facelift is the only procedure performed, incisions are placed in the temples and around the ear like a full facelift, but they are generally smaller. Alternately sometimes midface lifts can be performed in combination with a lower eyelid procedure (lower blepharoplasty) through an incision in the eyelid. A mid-facelift aims to:

  • Add definition to sunken cheekbones
  • Reduce hollowing in the midface
  • Lift and firm the skin from the jawline to the cheekbone
  • Reduce wrinkles and deep creases around the eyes, nose and mouth

The mid-facelift is less powerful than a full facelift but can be used to target specific regions in the mid-face area based on your specific concerns.

Lower Facelift

A lower facelift targets the lower third of the face, which includes the mouth and jaw. This procedure can eliminate jowls that tend to form along the jawline and the excess fat and skin under the chin that is caused by the formation of submental fat in this area. It can also be used to get rid of deep nasolabial folds which are the creases that you will see develop from the nose to the corners of the mouth, and the lines from the corner of the mouth to the jawline.

During a lower facelift, the surgeon redistributes or removes fat and excess skin by making incisions along the ears and hairline. In many cases, this procedure is combined with a neck lift.

The Facelift Procedure at Niche Plastic Surgery

A facelift procedure must be approached with a clear plan to address the changes you wish to achieve. With international Craniofacial Fellowships, all the doctors at Niche Plastic Surgery have sub-specialised training in facial plastic surgery as well as over a decade of experience in performing these procedures. While the steps involved will vary depending on the type of facelift procedure here is a general overview of the process:

Step 1:

Anaesthesia will be administered before your surgery so you are comfortable throughout the operation. Generally, patients are given general anaesthesia or occasionally local anaesthesia with intravenous sedation, depending on the extent of your surgery and the preferences of you and your surgeon.

Step 2:

The incisions are created using care to minimise visible scarring after surgery. This means keeping incisions within the hairline and natural creases of the skin whenever possible.

Step 3:

Your surgeon will redistribute or remove excess fat and skin while repositioning underlying muscle and other tissue to create a change in your appearance. If facial implants are added, they will also be placed at this time.

Step 4:

Your surgeon will meticulously close your incision, which may involve using dissolvable sutures, skin glues or sutures that require removal. Occasionally drain tubes are placed under the skin to help remove any fluids that can accumulate after surgery like this.

What’s the Recovery Process Like?

Facelift surgery, like any operation, will require recovery time afterwards to allow you to heal completely from the procedure. A general recovery timeline for a facelift procedure will entail:

  • As the effects of the anaesthesia wear off, you may feel some discomfort and nausea. You will be given prescribed painkillers and anti-nausea medications and will go home with these. Some procedures such as a full facelift require overnight admission to the hospital to ensure you are comfortable after surgery. Usually, drain tubes are removed before going home.
  • Localised swelling and some bruising are to be expected though this can vary in severity. We encourage patients to have a soft diet and drink plenty of fluids.
  • During the first week of recovery light activities like short walks, are encouraged to stimulate blood circulation but strenuous activities should be avoided during this time.
  • You will be reviewed within a week of surgery to ensure your recovery is progressing as anticipated.
  • Mild swelling and bruising may persist for the following few weeks and sometimes require make-up to disguise.
  • You should be able to return to your daily schedule at this point but continue to avoid vigorous activities. Periodic check-ins with the doctor will also be required.

What are the Risks of a Facelift Procedure?

Like all invasive surgery, having facelift surgery has risks associated with it. There are general risks common to any lengthy operation including but not limited to:

Adverse reaction to the anaesthetic.

  • Clots in your legs (or elsewhere) which can enter the circulation (deep venous thrombosis, pulmonary embolism). This is mitigated by the use of compression stockings and pumps, and the use of blood thinners in the immediate post-operative period.
  • Lung collapse/Chest infection.
  • Wound healing problems, adverse or visible scarring.
  • Bleeding/Bruising.

Specific to facelifts there are risks which include but are not limited to:

  • Visible deformity (shape, position, asymmetry) can affect the quality of the desired cosmetic result.
  • Nerve injury
  • Sensory – these nerves help you feel. As the skin is lifted from the underlying structures, there will be numbness resulting in parts of the face, which will gradually partially recover.
  • Motor – these nerves move your facial muscles. Injury to this results in weakness which is often temporary and usually recovers over weeks to months. Occasionally, permanent weakness occurs necessitating further treatment.
  • Need for revision or re-operation.

Who’s a Good Candidate for a Facelift?

Good candidates for a facelift procedure share certain traits.

  • A clear idea of the changes they wish from the procedure and a firm understanding of the risks of the procedure
  • Realistic expectations of what a facelift can and cannot do
  • Strong or well-defined bone structure that can support the changes to the muscle and skin
  • Good skin elasticity that’s retained some of its suppleness
  • Good health and a healthy lifestyle to support the healing and recovery process

Call us to Discuss Your Face Lift Options

Scheduling a one-on-one consultation with a specialist plastic surgeon is the best way to find out if facelift surgery is right for you. If you need more information or wish to schedule a consultation with one of our FRACS qualified surgeons, call Niche Plastic Surgery on 9853 9705.