After major weight loss, much attention is often directed to changes in the body, but facial appearance can also be affected. When facial fat reduces, the skin may loosen more quickly, leading to accelerated signs of ageing such as sagging, wrinkles, and hollowing.
A facelift is a term often used to describe a combination of procedures that can address these concerns. These may include facelift, brow lift, eyelid surgery, and neck lift. They may be performed individually or in combination, depending on the changes to be addressed and the patient’s goals.
People who seek facial rejuvenation are often concerned about sagging skin, tired or aged appearance, deep wrinkles, jowls, or excess skin and fat under the chin and neck.
The Procedure
Facelift surgery is performed under general anaesthetic in an accredited hospital, usually with an overnight stay.
- Incisions: A facelift typically involves an incision that starts in front of the ear, curves around the earlobe, and continues into the hairline. This placement allows scars to be partly hidden within natural creases and hair.
- If the neck requires tightening, an additional incision under the chin may be used.
- To address wrinkles near the eyes, the incision can extend into the temple hairline.
- Technique: Both the skin and the underlying supporting tissue layer (SMAS) are lifted and tightened. This repositions fat and soft tissue that contribute to jowls and deep folds (nasolabial creases). Tightening the platysma muscle can refine the angle between the chin and neck.
- Fat grafting: In some patients, fat can be taken from another part of the body, purified, and injected into hollow areas of the face. This can help restore volume lost with weight reduction and ageing.
- Thread lifts: Thread lifting techniques are available, but these typically provide shorter-term results compared with formal facelift surgery.
At the end of the procedure, fine sutures are used to close incisions. A padded dressing may be applied to reduce swelling and support the repositioned tissues.
Recovery
- Most patients stay in hospital overnight and go home the following day.
- Bruising and swelling are expected and improve over 2–3 weeks. Makeup may help cover bruising after several days.
- Temporary tightness, numbness, or mild facial weakness can occur and usually improve over time.
- Stitches are generally removed after one week.
- Scars are permanent but usually fade with time.
- Many patients return to office-based work after about 1–2 weeks, depending on recovery.
Risks and Considerations
As with any major surgery, facelift surgery carries risks. These include:
- bleeding or haematoma
- infection or delayed wound healing
- thickened or widened scars
- temporary or permanent numbness in the face
- temporary or, rarely, permanent weakness due to nerve injury
- asymmetry or irregularities in contour
- recurrence of laxity over time due to aging.
Results vary between individuals and, while facelift surgery can provide long-lasting changes, it does not stop the natural ageing process.
Important Information:
Facial rejuvenation procedures are significant operations. Careful consideration, discussion of risks, and realistic expectations are important when planning surgery.