Meloplasty (Facelift and Necklift)
As we grow older there are many changes that occur in the face and neck to mark the passing of years. These changes occur at all levels including the bone, muscle, fat and most obviously the skin.
The 3 main ways that we age
Firstly, the skin simply gets old, and the texture and colour change to produce crepe-like skin with blotchy red and brown pigmentation. These changes can only be addressed by some type of resurfacing.
The second form of ageing is due to dynamic (motion) lines produced by the contraction of underlying muscles. Examples of this are the lines at the outside of the eyes (crow’s feet), the frown lines of the forehead and the vertical lines that form on the upper lip and surrounds of the mouth. Dynamic lines are addressed by stopping the muscle from contracting, usually with injections.
The third way that we age is due to the effect of gravity on the soft tissues, especially the skin as it loses its tone from the loss of elastin and collagen. Fat also descends. This results in the classic jowls, deep nasolabial folds and loose skin in the neck that are the hallmark of the ageing face. A facelift is designed to address these gravitational effects of ageing.
How facelift surgery works
Facelift surgery at our practice in Sydney, New South Wales helps to re-suspend fat in its correct anatomical position and remove excess skin. Muscle bands in the neck can also be addressed. Dr. Darrell Perkins is skilled in a variety of facelift techniques, including full facelift and short-scar facelift, as well as liposuction to the neck.
More information
About facelifts
The term facelift covers a variety of procedures. Any facelift procedure can be tailored to address specific issues with the face or neck. Every patient is different in their goals, and intrinsically different in their anatomy - we’re all individuals. Thus, each patient needs to be assessed very accurately and expertly as to what type of facelift procedure and variations would specifically best suit them.
Some patients may be more appropriate for a short scar facelift procedure, but with others this would probably be a significant compromise providing an inadequate result. It is essential that each patient be individually assessed and that the procedure that is carried out must be tailored to the specific requirements of that patient.
There are no age limits for considering facelift surgery. The factors to consider are the health of the patient, appropriate motivation, realistic expectations and common sense.
Facelift procedures are suitable for both males and females alike. In the male patient there are special issues to consider, such as lack of hair to hide scar lines, for which specific adaption of techniques is used. More senior male patients with marked neck skin folds may also wish to consider direct excision of the neck skin, which is a lesser procedure.
In the correct patient, carefully selected (fatty neck but relatively good skin), liposuction to the neck may produce the desired result while minimising downtime with no visible scars.
As always, the experience of a surgeon over many years allows assessment and design of an operation appropriate to the patient and specific to their needs.
For more information regarding facelift surgery, please contact the practice or make an appointment for a consultation at our rooms in Kogarah or Miranda in Sydney, to discuss your specific desires and circumstances.
During the initial consultation Dr Perkins will discuss which technique is most appropriate, together with realistic outcomes and expectations.
Youthful, not tight
An important concept in facelift surgery – and a common misconception – is that tight is youthful. On the contrary, children do not have tight skin, they just do not have any excess skin. Another common facelift surgery misconception is that removing fat will make the face appear more youthful.
Some faces are intrinsically fatty, and the contour can be markedly improved by removing some of that fat, e.g. with liposuction to the neck.
Other faces, however, would benefit by having some of the fat replaced into the face to reproduce the vibrant and plump appearance of youth and childhood. Young healthy people have plump vibrant skin, with no excess. This is the goal of facelift surgery, and in doing so to produce natural looking results.
Facelift surgery
Most modern facelift procedures have two components. One of the components is removing excess skin. The other component involves re-suspending the skin and fat by carrying the tension of the facelift on the underlying fibromuscular layer called the SMAS. This can provide a very natural appearance to the face without leaving the stigma of tight, overcorrected or over-operated and repeated facelifts.
The aim of facelift surgery at our New South Wales practice in Sydney is to reduce the signs and changes of ageing without any stigma of surgery, leaving the patient to look like themselves (not someone else).
Facelift surgery is usually performed under general anaesthetic. More limited facelift procedures can be performed under local anaesthetic. Nearly all facelift operations are suitable as day-only procedures.
Types of facelift surgery
- Short scar facelift surgery, which is offered at our Sydney, New South Wales practice, is an excellent choice for younger patients to address mostly the jowl and upper neck region.
- Patients who require more extensive facial and neck surgery may be more appropriate for a standard full facelift, with or without an incision made under the chin to address the neck and muscle bands in that area.
The decision as to how long the facelift scar should be is quite simple. It should be no longer and no shorter than is required for the correct operation for that patient.
Dr Darrell Perkins has over 25 years of experience in facial surgery. At a consultation at his Kogarah or Miranda rooms he will be able to help you determine what procedure best fits the specific issues that concern you, and marry your goals with the right procedure.
Recovery
- Upon completion of the surgery a firm bandage is wrapped around the patient’s face (this is usually removed 1 – 2 days after the surgery by Dr Perkins in his rooms.)
- On discharge, post-operative instructions covering wound care, medications and booked follow up appointments will be given.
- It is essential that a responsible adult collect the patient and stay with them for the first 24 hours following the surgery.
- In the first few days following surgery patients may experience some mild discomfort. Swelling is normal following the surgery and will subside over the first few days to weeks. Sleeping with the head elevated helps to reduce the swelling. During this period there will also be some bruising, and makeup can be applied after one week or so to help disguise this.
- Numbness and a feeling of tightness may last for several weeks after the surgery.
- Strenuous activity should be avoided during the healing period.
- It is imperative that patients do not smoke after the surgery as it affects the healing process.
- Most patients would take 2 – 3 weeks off work, at which time routine activities can generally be resumed.
Attendance at your follow up appointments is essential to allow Dr Perkins to guide you through your recovery process.
Costs
Facelift surgery is classified as cosmetic and therefore no Medicare or private health fund rebates apply for the medical or day surgery fees.
An estimate of costs will be provided following the consultation with Dr Perkins.
Risks
Even with the highest standards of practice, all surgical procedures carry a level of risk and the potential for complications. In addition, every individual will have a different risk profile depending on their general health, age and the complexity of the procedure.
During the consultation Dr Perkins will explain the possible complications and risks of the specific procedure to provide the necessary information to enable you to weigh up the benefits, risks and limitations of the surgery. The following are some of the risks associated with this procedure.
- Specific risks of facelift surgery include hair loss around the scars (which is usually temporary but may become permanent), nerve injury, numbness, scarring, asymmetry, deformity of ear lobe, loss of skin due to impaired blood supply (in particular, patients must not smoke for some weeks either before or after the surgery as it impairs the blood supply).
- General risks involved in any surgery include post-operative infection, excessive bleeding, pain/discomfort and an adverse reaction to anaesthetic, unsatisfactory scarring. Read more about general risks and complications of surgery.
