When is it a good time to have a facelift?

There are so many considerations involved in having a facelift, and one of those is: “when exactly is it the right time to have one?”.  Here to answer this question, and other important factors regarding the procedure, is leading maxillofacial surgeon in London, Professor Kavin Andi.

What are the typical signs that someone might benefit from a facelift?

Typical signs that someone might benefit from a facelift include noticeable sagging and loss of elasticity in the skin of the face and neck, which can result in jowls, deep creases around the nose and mouth (nasolabial folds), and loose skin or excess fat around the jawline and neck. Additionally, individuals might observe a general tired or aged appearance due to the loss of facial volume and the development of fine lines and wrinkles. The overall facial contour may appear less defined, and there might be a noticeable downturn of the corners of the mouth. These changes are often exacerbated by factors such as aging, genetics, sun exposure, and lifestyle choices.

A facelift can address these concerns by tightening the underlying muscles, removing excess skin, and repositioning the remaining skin to create a more youthful and refreshed appearance. Ideal candidates for a facelift are typically those in good overall health, with realistic expectations, and non-smokers, as smoking can impair the healing process.

How does ageing affect the appearance of the face, and how does a facelift address these changes?

Ageing affects the appearance of the face in several ways, primarily through the gradual loss of skin elasticity, collagen, and fat, which leads to sagging skin, the formation of wrinkles, and a general loss of facial volume. Over time, the skin becomes thinner and less resilient, resulting in fine lines, deep creases around the mouth and nose (nasolabial folds), and drooping eyelids or brows. The jawline and neck may develop loose, hanging skin, commonly known as jowls and turkey neck. The cheeks can appear hollow as the underlying fat and muscle diminish, contributing to an aged and tired look.

A facelift, or rhytidectomy, addresses these age-related changes by tightening the underlying facial muscles, removing excess skin, and redistributing or adding fat to restore a youthful contour. The procedure smooths out deep creases, lifts sagging skin, and redefines the jawline and neck, resulting in a more refreshed and youthful appearance. By repositioning the skin and soft tissues, a facelift can effectively reverse the visible signs of aging, providing long-lasting results and enhancing overall facial harmony. This surgical intervention is often complemented by other treatments, such as eyelid surgery or dermal fillers, for a more comprehensive rejuvenation.

Are there alternative treatments or procedures that can achieve similar results to a facelift?

Yes, there are several alternative treatments and procedures that can achieve similar results to a facelift, offering options for those who may not want or require surgery. Non-surgical treatments include dermal fillers and Botox, which can smooth out wrinkles, restore lost volume, and lift sagging skin, providing a more youthful appearance with minimal downtime. Laser resurfacing and radiofrequency treatments, such as Fraxel or Thermage, stimulate collagen production and tighten the skin, improving texture and reducing the appearance of fine lines and wrinkles.

Ultrasound-based treatments like Ultherapy can also lift and tighten the skin by targeting deeper layers to stimulate collagen growth. For those seeking more dramatic results without surgery, thread lifts involve the insertion of temporary sutures to lift and support the skin, creating a subtle but visible lift. Chemical peels and microdermabrasion can rejuvenate the skin’s surface, reducing signs of aging and improving overall skin tone. While these alternatives may not provide the same long-lasting results as a traditional facelift, they offer effective solutions for those looking to enhance their appearance with less invasive methods and shorter recovery times.

What are the different types of facelift procedures available, and how do they differ?

There are several types of facelift procedures available, each tailored to address different aspects of facial aging and varying in their complexity and recovery times. The most common types include:

Traditional facelift: Also known as a full facelift, this comprehensive procedure targets the mid to lower face and neck. It involves making incisions around the hairline, ears, and sometimes under the chin, allowing the surgeon to lift and reposition the underlying muscles, remove excess skin, and redistribute fat for a rejuvenated appearance.

Mini facelift: Sometimes called a “weekend facelift” due to its shorter recovery time, this procedure focuses on the lower face and jawline. It uses smaller incisions around the ears to tighten and lift sagging skin, making it ideal for younger patients or those with early signs of ageing.

Mid-facelift: This procedure specifically targets the middle part of the face, including the cheeks and under-eye area. By repositioning the fat pads and lifting the tissues, a mid-facelift restores youthful contours and addresses sagging cheeks and deep nasolabial folds.

Thread lift: A minimally invasive option, the thread lift involves inserting temporary sutures under the skin to lift and support sagging facial tissues. This procedure provides a subtle lift with minimal downtime, although the results are less dramatic and long-lasting compared to surgical facelifts.

SMAS facelift: The Superficial Musculoaponeurotic System (SMAS) facelift focuses on the deeper layers of the face, tightening both the skin and the underlying muscles. This technique provides more natural-looking and longer-lasting results by addressing the structural components of facial aging.

Each type of facelift is designed to address specific concerns and suit different patient needs, with variations in invasiveness, recovery time, and the extent of improvement achieved.

How do I know if I'm a good candidate?

Determining if you are a good candidate for a facelift involves several key factors related to your overall health, facial aging concerns, and personal goals. Generally, good candidates are individuals experiencing moderate to severe signs of facial aging, such as sagging skin, deep wrinkles, jowls, and loss of facial volume, particularly in the mid to lower face and neck. You should be in good overall health, without any medical conditions that could impair healing or increase surgical risks. Non-smokers are preferred, as smoking can negatively affect the healing process and the longevity of the results.

Ideal candidates also have realistic expectations about the outcomes of the surgery. They should understand that while a facelift can significantly rejuvenate their appearance, it does not halt the aging process entirely and may need to be complemented by other procedures for optimal results. Good skin elasticity and bone structure also contribute to favourable results, as they allow the skin to heal and adapt better after the procedure.

What are the risks and potential complications associated with facelift surgery?

Facelift surgery, like any surgical procedure, carries certain risks and potential complications, which patients should carefully consider. Common risks include:

• Bleeding;
• Infection; and;
• Adverse reactions to anaesthesia.

Haematomas, or collections of blood under the skin, can occur and may require additional surgery to resolve. Nerve injury, which can lead to temporary or permanent facial muscle weakness or numbness, is another potential complication. Scarring is inevitable, although efforts are made to minimise and conceal scars within the hairline and natural facial contours.

There are also risks of skin necrosis, where the skin does not receive enough blood supply and dies, which is more common in smokers. Poor wound healing can result in prolonged recovery or unattractive scars. Additionally, asymmetry or dissatisfaction with the aesthetic results can occur, sometimes necessitating revision surgery. Hair loss around the incision sites and changes in skin sensation are other possible complications.

To minimise these risks, it is crucial you follow pre- and post-operative care instructions meticulously, and disclose your full medical history, including any medications or conditions, during the consultation. Understanding these risks and having realistic expectations can help you make an informed choice about undergoing facelift surgery.

How should I prepare for a facelift procedure?

Preparing for a facelift procedure involves several important steps to ensure a smooth surgery and optimal recovery. Follow any pre-operative instructions provided by Prof Andi, which may include avoiding certain medications, such as blood thinners, that can increase the risk of bleeding. If you smoke, you will need to stop at least a few weeks before and after the surgery to promote better healing.

Organise your home and schedule to accommodate your recovery period. Arrange for someone to drive you home after the procedure and to stay with you for at least the first 24 to 48 hours. Prepare a comfortable recovery area with essential items within easy reach, such as medications, gauze, ice packs, and any prescribed ointments.

Ensure that you follow a healthy diet and maintain good hydration in the weeks leading up to your surgery. Professor Andi will recommend certain nutritional supplements to support healing. On the day of the surgery, wear loose, comfortable clothing and avoid wearing makeup, lotions or jewellery.

Finally, familiarise yourself with the post-operative care instructions and recovery timeline. Knowing what to expect can help you manage your recovery more effectively and reduce anxiety about the process. By carefully preparing, you can contribute to a more successful facelift procedure and smoother recovery.

Considering a gold-standard facelift? Arrange a consultation with Professor Andi via his Top Doctors profile.