Facial rejuvenation

It can often seem that the goal of plastic surgery after massive weight loss is to achieve a trim and tight body. Many people become overwhelmed by the melted appearance of their body to such an extent that they fail to see what the rest of the world can see- their face.
Facial ageing accelerates greatly after massive weight loss as your skin loosens significantly once your facial fat deflates. Some of these changes can be reversed with a facelift. Facelift is the term often used to describe a combination of procedures including cheek, eyelid surgery, brow and neck lift. They can be performed separately or together.

Every face ages with time. Some seem to do so too quickly, and this can seem out of proportion with the person’s character and vitality. People seeking a facelift are often concerned by sagging skin, looking sick or tired, deep wrinkles, sunken cheeks and excess skin and fat at the neck.

The Procedure

Facelift surgery is performed under a general anaesthetic and requires admission to hospital.

There are different types of facelift. All involve tightening the facial and neck muscles as well as tightening your skin. This gives the most natural and harmonious appearance to the face, rather than a tight, windswept appearance.

There is currently a vogue to offer simple thread inlay lifts. These can be useful, but the results tend to be very short lived. Unfortunately a long lasting result requires significant surgery. Not much is achieved with “lunchtime” procedures.

There are three different parts of the face that can be addressed, and different camouflaged incisions are used for each:

  1. A facelift improves the contour of your face and the wrinkles around the jawline and cheeks. It involves an incision that starts in front of the ear, curving around the earlobe and into the hair behind your ear. This allows the scars to be concealed by natural crease lines and your hair.
  2. For patients requiring significant contouring of their neck (neck lift), the same incision is employed in addition to an incision just under the chin. This allows the neck muscle (platysma) to be tightened to restore a sharper contour between your chin and neck.
  3. In patients requiring the wrinkles of the eye to be addressed, the facelift incision is carried up into the hair next to your temples.

Dr Sanki is experienced in all three variations of the facelift operation and will recommend which procedure you would benefit from the most.

The skin and the underlying tissues (SMAS) are elevated separately. When the SMAS is tightened, it recontours and elevates the underlying fat of the face. This sunken fat is what causes jowls and the deepening of the crease extending from the nose to around your mouth (nasolabial fold). The muscle at the neck (platysma) is tightened to help lift fallen neck fat and tighten the angle between the chin and neck. All of the incisions are repaired with fine, precise suturing.

Fat grafting is the process of harvesting fat from another part of your body, purifying it and then precisely injecting small amounts back into your face. This significantly helps to replace the hollows of your face caused by weight loss and ageing.

At the completion of surgery, a padded dressing is applied to your face and neck. This helps control bruising and pain and allows the recontoured tissues to adhere to their new position.

The recovery

Staying in hospital for one night can make you more comfortable. Most patients are able to leave hospital within one day of surgery. Following surgery your skin will be bruised and swollen. This improves over two weeks, and can be camouflaged with makeup a few days after surgery. Your skin can feel tight, with patches of numbness and even slight facial weakness. These will improve with time. It is recommended that you rest at home for at least one week after the surgery to prevent bleeding and bruising caused by movement, and to allow your wounds to settle. Patients in office occupations can return to work after this.

The fine stitches will be removed one week after surgery, leaving thin, pink scars. With time, these scars become paler, but the result of your facial rejuvenation will be lifelong.