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Facelift

Facelift

A facelift can ensure that the skin of your face becomes tight again. You will look better, younger and less tired. The changes in your face will not be noticed by most people. The wrinkles in your face caused by laughter and talking remain visible. These wrinkles are part of your facial expression. With other treatments it is possible to reduce these wrinkles or make them disappear. A facelift is an extensive operation that takes about four hours. The treatment takes place under light anesthesia combined with local anesthesia. You stay overnight and the next day you can go home under supervision. With a smaller procedure you can go home the same day.

In the first consultation with the plastic surgeon we discuss your wishes and health. Together with the surgeon you will look at the different options based on your facial anatomy. The surgeon will also inform you about the risks of the operation and give you a realistic picture of the final result.

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During a facelift the soft tissues in the lower one third of the face and the neck are lifted towards their original position. This will specifically result in an improvement of the contours of the jawline and neck. Furthermore, there will be a reduction of folds and creases in the cheek areas and neck region. Wrinkles of the skin will decrease, but not necessarily disappear completely. Wrinkles around the eyes and lips will remain unchanged and other procedures can improve these areas such as an eyelid correction, laser treatment, dermabrasion or chemical peels. Decreasing the forehead lines, the frown area and raising the eyebrows can be achieved with a forehead lift.

During your first consultation, your specific concerns regarding your face and the relevant anatomy, including your health will be discussed. Of importance is to determine if your requests are feasible. A facelift is a long procedure and your general health should be acceptable. Any blood thinning medication should be discontinued prior to surgery and smoking must be stopped at least four weeks before and after the procedure; Not one cigarette! You will be informed on all aspects: before, during and after the procedure.

A facelift is a long procedure which can last four hours and is performed under a light general anesthetic in combination with local anesthetic. An incision will be made in the skin from the hair bearing skin in the temple, in front of the ear, around the earlobe following the ear and into the hairline behind the ear. The skin will then be mobilized over the cheeks, jaw and neck. In modern facelifts, the underlying soft tissue layer (the SMAS layer) is also mobilized and tightened. All the subcutaneous layers are therefore repositioned and the jawline corrected. Through an incision fat will be removed in the neck and slack muscles with be tightened in the midline of the neck. This will recreate the angle of the mandible and the neck.  Drains will be placed under the skin and will be connected to suction bottles. This is to remove any blood and fluid from the wound after the procedure. A bandage will be placed around the head and neck and you will stay overnight. The next day, the bandage and the drains are removed and you can go home with guidance.

Your face and neck can be swollen and bruised. The majority will settle down in two weeks and in general you will experience little pain. You will need to take it easy the first two weeks, maintain your head high with an extra pillow and prevent bending over. An antibiotic cream can be applied to all the wounds to keep all possible blood clots and scabs soft so they can easily be removed. You can shower and carefully wash your hair. After about one week all sutures will be removed in the consulting rooms. You will experience little pain but will feel some tightness in the neck which will settle in the weeks thereafter.

Aften it is assumed that after a facelift you will have a tight mask face. Also, it is expected that your face changes to the extent that you don’t look like you anymore. This is not the case. The wrinkles that appear in your face as a result of the way you smile or talk will not disappear after a facelift. These wrinkles are part of your facial expression and will always be present. You will look better, younger and more rested and specific changes in the face will not be noted by many people. The scars will always be visible only on close inspection, but in general are hardly noticeable. They run from in front of the ear, around the earlobe into the groove behind the ear and then into the hairline.  The scar under the chin will also be hardly noticeable. All scars will improve in the first year after the procedure. The result of a facelift starts to become apparent after a few weeks. The aging process and the descent of the soft tissues of the face continues with time. After a facelift, just like before, the elasticity of the skin will continue to decrease. The effects of a facelift are often five to ten years, thereafter, it would be possible to have another facelift.

A facelift has many of the same risks and complications as any other operation. There is always a chance of bleeding or an infection can develop, but, fortunately these are rare. Sometimes the circulation of the skin is compromised to the extent that the skin around the wound edges dies. This complication mainly occurs in smokers and it is therefore absolutely mandatory that smoking is completely stopped four weeks prior to and after surgery. Very occasionally a small branch of the facial nerve is damaged resulting in a partial weakness of the muscles of the mouth, lips or forehead. Normally this recovers completely after a few weeks or months. Because the skin is elevated from the underlying tissues the sensation will decrease for some time and will feel numb. This too will be temporary, although recovery may take months to a year. Sometimes scar formation may be excessive and treatment with steroid injections may be necessary. In people with darker skin tone, the scars can sometimes be more visible due to color changes and make-up may be useful.

Before and after (Dr. Karel Taams)
Before and after (Dr. Karel Taams)