WHAT IS A FACE LIFTING?
A facelift, also known as a rhytidectomy, is a surgical procedure that removes excess skin from the face, neck, or both. It also repairs the structures below the skin to improve the appearance and contour of the face. Thus, the facelift removes excess skin from the face and neck, improves the appearance of some wrinkles, and provides a more defined facial contour.
FOR WHOM IS A
FACE LIFT INDICATED?
Good candidates for a face or neck lift, usually have some of the following characteristics:
- Excess skin and sagging on the face and / or neck;
- Excess skin and deep wrinkles both below and above the eyes;
- Loss of volume in areas such as cheekbones;
- Very pronounced nasolabial folds;
- Good overall health condition;
- Mentally stable patients with realistic expectations about the results of the surgery.
BEFORE AND AFTER CASES OF Face Lift And Neck Lift / Rhytidectomy
TYPES OF LIFTING
Cervicofacial Rhydectomy (Face and Neck)
The cervicofacial rhydecomy aims to improve the appearance of both face and neck. It treats the following signs of aging: excess skin on the face and neck, pronounced nasolabial folds, loss of volume and contour in the malar region and in the jaw, localized fat and folds in the neck area.
Cervical Lift (Neck)
The cervical lift or neck lift aims to treat the flaccid and aged appearance of the neck (“turkey neck”, or “jowls”). It can be performed alone or combined with a facelift. Neck lift involves eliminating excess skin and fat and repairing the platysma muscle in the neck.
Forehead and Brow Lift
This lift aims to improve the appearance of the wrinkles located in the forehead and raises the drooping eyebrows. It is often combined with blepharoplasty to achieve a more rejuvenated and open look.
FACE AND NECK LIFT
YOUR FACELIFT MEDICAL APPOINTMENT
The first step of your facelift medical appointment is to share with the plastic surgeon what bothers you, the expectations you have for the surgery and the degree of rejuvenation you want to achieve;
2. Treatment plan
Depending on the initial state of the face and desired result, a treatment plan will be outlined for a rejuvenated and natural appearance;
3. Detailed explanation
During the medical appointment, all the risks of the facelift, as well as pre and post-operative care, will be explained;
Following the medical diagnosis, you will be presented with an exact price for the procedure, according to the surgical plan that was drawn up. You can then schedule your surgery date. The price of the facelift will depend on the initial condition of the face, the complexity of the intervention and the combination of procedures.
WHAT RESULTS CAN I EXPECT
AFTER UNDEGOING A FACE OR NECK LIFT?
A face and / or neck lift will give you a more rejuvenated and rested appearance without compromising your natural look. The facelift is long-lasting, but it is important to understand that no surgery stops the natural aging process. As we keep getting older, the skin keeps loosing firmness and the structures continue to relax. Obviously, you will start from a better standpoint and will look better than if you had not undergone the surgery. Most patients who undergo a face or neck lift are satisfied with the results for at least 10 to 15 years.
FACE AND NECK LIFT
Advanced plastic surgery techniques allow scars to be well hidden (in natural creases and other hidden spots whenever possible). Regarding facelift scars, these will always depend on the type of facelift performed and the technique used. Usually the scars are located in one of the following points:
- Directly in front of the ear
- Behind the ear
- Top hairline
- Hairline behind the ear
- Under the chin – in case of a neck lift.
TYPE OF ANESTHESIA
Generally, the face lift is performed with sedation and local anesthesia. Sedation is administered intravenously and, when the patient is asleep, local anesthetics are administered so that the patient does not feel pain during the entire surgical procedure.
STEP-BY-STEP FACE LIFT
MARKING THE PATIENT WHILE STANDING:
Before administering anesthesia, markings are made (face and neck);
Sedation is administered intravenously by the Anesthesiologist who will be present throughout the whole surgery. Local anesthetics are then injected into the area to be treated so that the patient does not feel any pain during the entire surgical procedure;
DISINFECTION AND DELIMITATION OF OPERATING FIELDS:
The entire face and neck area is cleansed and disinfected to reduce the risk of infection. Operative fields are placed to isolate the area to be treated from the external environment;
Incisions are made in accordance with the type of facelift, at strategic points on the face and neck;
The deep tissues of face and neck are repositioned. The excess skin is removed and the remaining skin is attached to the newly rejuvenated tissues producing a more youthful appearance and a more defined contour;
The incisions are usually closed with sutures that are removed 7 to 10 days after the surgery;
Finishing the surgery, a facial band is placed;
The patient is awakened by the anesthesiologist and is then transported to the recovery room where she/he remains under observation before discharged after a few hours or the following day.
- Perform all prescribed medical examinations and send the results at least one month in advance;
- Do not take aspirin, anti-inflammatories, or anticoagulant medication in the two weeks prior to the facelift. You must inform the medical team of any medication you are on and any medical condition you suffer from;
- Do not take any weight loss medication in the month prior to the surgery;
- Do not smoke the month before surgery and during the healing process. Tobacco compromises tissue oxygenation, negatively affecting healing;
- If you get a cold or feel ill in any way in the days prior to the facelift, the medical team should immediately be informed.
- Carefully read all the documentation provided to you, as doubts may arise before surgery day;
- Organize your routines in advance so you can recover peacefully;
- If you still have doubts regarding the facelift, do not wait surgery day to clarify them, and ask all your questions beforehand.
- On the day before surgery, you should have light meals only, in order to avoid indigestion. You must be fasting for 8 hours before the surgery - do not eat or drink any liquids including water.
- Shower with the prescribed antiseptic shower gel the day before and the day of surgery.
- Do not wear jewelry or a watch, do not wear makeup or nail varnish.
- Do not wear contact lenses;
- Bring comfortable clothes to wear when you are discharged - preferably with buttons or a zip;
- After discharge, you can neither drive nor go home unaccompanied. If you have no one to take you home, you must inform us in advance. You must be accompanied for at least 48 hours;
- Bring sunglasses to wear when you are discharged and during the recovery period;
Recovery and postoperative care:
- You may experience discomfort and moderate pain for 2 or 3 days. Resting and taking the prescribed medication will help relieve these symptoms;
- Rest and avoid any type of physical effort in the first 8 days;
- Do not drive for 8 days;
- Do not smoke;
- Do not get direct sun exposure and wear sunglasses to protect your eyes;
- At home, do not lie down all the time. You should get up and take some steps, every two hours;
- Sleep with a high pillow under your head;
- Recurrently apply ice to your cheekbones during the first 24 hours to avoid excessive edema;
- Attend all follow-up medical appointments;
- Drink plenty of water and follow a balanced diet;
- You can return to work 2 to 3 weeks after the procedure.
Repositioning facial muscles
The underlying structures of the face, also known as the superficial muscular aponeurotic system (SMAS), tend to weaken over the years. Before eliminating excess skin, a repositioning of the facial structures will be done, so that the skin experiences less tension, and the result of the facelift is more natural and long-lasting.
Eliminating excess skin
The excessive and flabby skin is carefully eliminated, the remaining being placed on the new facial structure. The skin is not stretched, but instead it is adapted in a natural way to the contours of the face so that it does not look artificial or “pulled back”.
Improving the natural contours of the face
The facelift promotes the lifting of the face, considerably improving the creases and restoring facial contours such as the jaw line and the malar region. Often, the facelift is combined with fat grafts or other fillers to recover the lost volume in some areas of the face.
Dr. Luísa Magalhães Ramos / Plastic Surgery
PORTUGUESE MEDICAL ASSOCIATION, Nr. 42810
Graduated by the Faculty of Medicine of the University of Porto, she specialized in plastic, reconstructive and aesthetic surgery, at Hospital de São José, in Lisbon.
Throughout her training, she subspecialized in aesthetic plastic surgery, having worked in world-renowned clinics.
Currently, she is mainly dedicated to face and breast aesthetic plastic surgery and to intimate female surgery.
Dr. Alice Varanda Pereira / Plastic Surgery
Member of The Portuguese Medical Association, Nr. 47051
Graduated by the Faculty of Medicine of the University of Lisbon, she completed her master’s degree in human sexuality and is currently developing her PhD at this same institution.
She joined the University faculty academic staff in 2008 as a lecturer of the Institute of Anatomy. It is in this unit that she produces most of her research projects, mainly in the area of surgical anatomy, whilst also supervising master’s thesis for undergraduate students.
Face Lift And Neck Lift / Rhytidectomy
IS A FACELIFT A SAFE SURGERY?
Every surgical procedure has associated risks and a facelift is no exception. The face and neck lift is a surgery that requires a high degree of experience, specialization and precision. For the surgery to be performed safely, it is of the utmost importance to choose a reconstructive and aesthetic plastic surgeon enrolled in the Portuguese Medical Association, with several years of proven experience in performing facelifts and other facial surgeries.
HOW MUCH DOES A FACELIFT COST IN LISBON?
The price for a facelift depends on the initial condition of the skin, the complexity of the surgery and the combination of procedures. The facelift is often combined with other surgeries and non-invasive treatments – blepharoplasty, brow lift, fat transfer, dermal fillers, wrinkle treatment with toxin, CO2 laser and peelings. The exact price for the facelift will be shared with you during your medical appointment, after diagnosis.
WHAT TYPE OF ANESTHESIA IS USED?
The anesthesia will depend on the type of facelift and the combination of procedures. Generally, the facelift is performed with sedation and local anesthetics.
WHAT IS THE IDEAL AGE TO PERFORM A FACELIFT?
The aging process is different for every person and it is influenced by both intrinsic and extrinsic factors that affect the appearance of the face. There is no specific age to perform a facelift, but surgery is indicated when there are visible and bothering changes to the face, but before aging is too sharp (usually around 50/55 years). The sooner you perform the surgery, the less invasive it will be and the more natural the result will be.
ARE THERE NON-SURGICAL ALTERNATIVES TO FACELIFT?
Fat transfers or other anti-aging substances can restore lost volume – dark circles, cheekbones, nasolabial folds, perioral area, etc. However, these treatments do not provide as notorious and long-lasting results. They restore some of the lost volume and improve facial contour, but do not eliminate excess skin nor reposition facial muscles and structures.
DOES A FACELIFT TREAT WRINKLES?
The facelift eliminates excess skin and repositions the facial structures, but it is not a wrinkle treatment. It can improve the appearance of nasolabial folds, but it does not treat wrinkles caused by muscle contraction such as “crow’s feet”, frown lines or lip lines. To improve the appearance of the deeper and more pronounced wrinkles, the facelift can be combined with other treatments such as wrinkle treatment with toxin, dermal fillers, peelings and CO2 laser.
IS THE FACELIFT RESULT ARTIFICIAL?
The purpose of a facelift is to achieve a rejuvenated appearance without changing one’s natural characteristics. A natural result is achieved by repositioning the deep structures of the face (fat and muscle tissue) and eliminating excess skin. This approach allows the face to regain some of its lost contour and harmony, without looking “stretched “.
HOW MUCH YOUNGER CAN I LOOK WITH A FACIALLIFT?
Many patients look 10 years younger after undergoing a facelift, but the appearance of the face after surgery will essentially depend on each person’s genetic characteristics and personal care.
HOW LONG DOES RECOVERY TAKE AND WHEN CAN I RETURN TO WORK?
Usually, recovery takes 2 to 3 weeks, but it depends on the combination of procedures. After the second week, make-up can disguise the remaining bruises.
HOW PAINFUL IS THE POST-OPERATIVE?
In the postoperative period, there may be some discomfort due to edema, but pain is not to be expected. Swelling, bruising, and a tension and numbness feeling may occur, but these are transient symptoms that usually disappear after 3 weeks.
CAN I UNDERGO A FACELIFT IN THE SUMMER?
The facelift can be performed at any time of the year. What matters the most is to schedule it for when you can recover peacefully. However, you must understand that you cannot get direct sun exposure for at least one month after the procedure. So, if you are thinking about taking beach holidays, you should have the surgery in the fall or winter months.
DO SCARS DISAPPEAR?
Depending on the type of lift performed, the scars can be placed close to the ear, the hairline or both. Being located in transition zones, the scars are easily disguised. Over time, they become thinner and lighter, thus harder to identify. During the first three months, the tendency is for them to become redder and more sensitive. It is important to follow all medical recommendations to accelerate the healing process and achieve a discreet scarring. By the end of the first three months the scars will improve in appearance and the end result is expected 12 to 18 months after the surgery.
IS THE RESULT OF A LIFT DEFINITIVE?
We can say that the results of a facelift are definitive, as in not implying periodic maintenance as do dermal fillers for example, whose effects last 9 to 12 months and then need to be applied again to maintain the results. However, it is important to understand that no surgery guarantees lifelong results or stops the natural aging process. After performing a facelift, your skin will naturally continue to age and, after a few years, you may notice some flaccidity again. However, had you not performed the facelift, this flaccidity would have be more accentuated. On average, a patient who performs a facelift is satisfied with the result for at least 10 to 15 years.
WHAT ARE THE RISKS OF SURGERY AND ANESTHESIA?
All surgical and anesthetic procedures are associated with a certain degree of risk. Although most patients do not experience complications, you should talk to your plastic surgeon to make sure you understand all the risks and potential complications of a facelift. Some of these risks are: Bad reaction to anesthesia, infection, hematoma or seroma, hemorrhage, changes in skin sensitivity, unsightly or prolonged scarring, asymmetry, numbness and allergic reactions.