What does a facelift consist of, doctor?
It’s the surgical operation we use to reduce creases and wrinkles in the face to rejuvenate the patient’s appearance. The result is achieved by tensing the muscles of the face, eliminating excess fat and redistributing the skin of the face and neck. We said earlier that as we age the effects of gravity, exposure to sunlight and the stress of everyday life manifest themselves in our faces. Deep creases form between the nose and the mouth, the cheeks fall, and fat and wrinkles appear around the neck. With a facelift we can improve the most visible signs of this ageing.
Are there different types of facelifts?
Yes. We can talk about frontotemporal lifting (of the upper one-third), to correct fallen eyebrows and wrinkles in the forehead and between the eyebrows. Lifting the middle one-third rectifies the flaccidity of the cheeks, reduces the nasogenian folds and reverses the descent of fat from the cheekbone. And lifting the lower one-third reaffirms the mandibular oval and the neck. Finally, cervicofacial or total lifting includes all of these, and therefore is the most complete.
Is lifting effective for small wrinkles?
No, to treat small wrinkles there are other methods. Lifting is very effective for large folds and creases, but for small wrinkles it produces very little improvement.
Is hospitalisation necessary?
It depends on the zones to be treated. If it’s only a question of partial lifting, it’s done with local anaesthesia and sedation. In the case of cervicofacial lifting, general anaesthesia is advised, and therefore admission into the clinic.
What about the dreaded scars?
Most of the scars remain hidden in the scalp above the temples, towards the nape of the neck and behind the ears.How long do the bruises last?They tend to disappear after seven to ten days, and all of the sutures are also removed in the same period.
When can the total results of this operation be seen?
Total lifting requires rather more time. After two weeks the swelling has not yet gone down and the face is still rather numb. The real result of the operation can be seen in one or two months, or at the most three months, when the inflammation has gone down completely. That’s when the face will be totally settled, fully in its place.
When can the patient go back to normal life?
Most patients who undergo a facelift feel all right after two days, but their sick leave can last until the stitches are removed. This operation tends to cause little discomfort: some sensation of stretching of the skin or a certain insensitivity in some areas (this will disappear in a few weeks). As medical recommendations, we advise avoiding steam baths or saunas for several weeks and limiting exposure to sunlight for a few months, or using very high sunscreen protection.
What are the possible complications?
On rare occasions hypertrophic scars remain, but they can be solved with treatment, and there may also be transitory effects on the facial nerve, but these disappear after a few weeks.
Is it true that the patients who ask for facelifts are getting younger and younger?
Yes, it’s true. Ten years ago, the average age was sixty years and up. Now many women are coming in for facelifts between the ages of forty-five and fifty; and this means that the results are better, because the skin is smoother and more elastic.
Has plastic surgery been able to overcome the after-effects of facelifts that were known in this country as ‘motorcyclist’s face’?
That expression was used years ago, when we didn’t have such advanced facelift techniques as we do now, to refer to the effects of excessive stretching of the face tissue. Now, with the advances we’ve made in cosmetic surgery techniques, this effect is no longer produced: on the contrary, the results are very favourable now.
How long does a facelift tend to last?
A normal facelift tends to last from ten to fifteen years, if there’s no specific pathological problem. For instance, there are people who, because of a strange disease, a pathology called cutis laxa (which consists in extreme flaccidity of the skin due to a lack of elastic fibres), have to subject themselves to an annual facelift every year. I remember a case that’s documented in the medical literature of a girl who suffers from this disease: since the age of twelve she’s been undergoing a facelift every year, and even so, now that she’s just twenty, she appears to be forty-five or fifty. Apart from cases like this, how long a facelift will last depends on the elasticity of the patient’s skin.
What is endoscopic lifting?
It consists in lifting the upper third (forehead and eyebrows) by means of small incisions in the scalp; in one of the incisions we insert an endoscope that has a camera connected to a television monitor. In this way the surgeon can see on the monitor everything there is underneath the skin, and can perform the operation without needing the incision to be as large as in a classic facelift. This technique is very effective, especially in men, as it barely leaves any scars (since in men it’s more difficult to conceal the incisions in the scalp). This type of procedure, like all endoscopic surgery, is minimally invasive: the thing is, it’s still at an early stage and its effects are not very long-lasting. But before long endoscopic lifting will replace classic coronal lifting.
Is there any auxiliary treatment that is performed simultaneously with lifting?
There are patients who have accumulations of fat in certain zones of the face (such as the chin and cheeks): in these cases we do liposuction on those areas in addition to the facelift.