Facelift

Facelift surgery, also known as a rhytidectomy is a cosmetic surgery procedure designed to address significant signs of ageing changes seen in both the face and neck region. To gain a better understanding of what facelift surgery can achieve, it is important to gain an appreciation of what is involved in the ageing process of the face and neck. With the ageing process, the skin will tend to lose between 20-80% of hydration and volume as time progresses. This loss of volume is primarily related to a reduced synthesis of the structural components of skin which include both collagen and elastin but also glycosaminogycans (GAGs) which are found in the dermal layer of the skin. This loss of structural support leads to the commonly seen end result of skin laxity. Skin laxity is also accompanied by loss of adhesion with the deeper lying muscles and soft tissues. This leads to loss of tissue tightness, the skin therefore sags and this results in jowl formation and loss of a well defined jaw line. The extra skin and underlying soft tissue sags downwards and this leads to loss of the sharply defined cervicomental angle between the neck and chin. Ageing changes in the midface region lead to volume loss in the cheeks and also bone loss from the facial skeleton. The resulting hollowed out appearance becomes more evident with age. The younger face possesses features consistent with a youthful inverted triangle. With age, this triangle flips over as the face gains more volume in its lower part as a result of sagging of the soft tissues under the influence of gravity and the loss of volume from the midface.

Facelifts in London with Centre for Surgery at our Marylebone clinic. A facelift (also known as a cervicofacial rhytidectomy or rhytidoplasty) is a broad category which refers to a number of procedures including a mini facelift that will change the look of the upper and lower face, including cheeks, jowls, and neck. The facelift surgery entails incisions placed in front of and behind the ear. The approach to facial rejuvenation has evolved significantly over the last few decades. Surgery, however, has remained the gold standard of care for long lasting treatment of the aging face in both women and men. Despite the rise of less invasive methods, a facelift or rhytidectomy has maintained its pre-eminent position in facial rejuvenation as the number of facelifts performed each year continues to increase. In fact, facelift or rhytidectomy currently ranks as the fifth or sixth most popular cosmetic surgery procedure in the UK.

At Centre for Surgery, patients have access to the full range of options for treatment of the ageing face. These options include laser treatments, injections and traditional surgery. Facelift surgery, traditionally called rhytidectomy, is an extremely popular procedure in London and the UK more broadly. Facelifts are most popular for being able to stop the ageing process, at least when it comes to the aesthetic aspect. A facelift is a surgical procedure that involves facial skin tightening to remove those wrinkles, and gives the face a younger look. The goal of modern facelift surgery is to create a natural, refreshed and rejuvenated appearance to patients so that they look like a younger version of themselves. The procedure typically involves repositioning of deep fat and muscle tissue and may involve volume replacement. Patients who are not ready for a facelift or perhaps do not want a facelift have several other options, including minimally invasive procedures like laser or injectables. Even though no one is able to reverse time, signs of ageing can be prevented by removing any trace of excess fat and skin and straighten the facial muscles. This intervention can be performed as an individual operation or in combination with other similar procedures, such as eyelid surgery.

All our London facelift surgeons are on the GMC specialist register.

Our London clinic at 106 Crawford Street was recently inspected and rated as good across all 5 domains.

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Facelift Expected Results

• Elevate redundant loose skin in the lower third of the face that is commonly responsible for jowl formation
• Address loose and sagging neck skin commonly known as a turkey neck.
• Lifting and tightening of the deep muscle layer and overlying soft tissue to restore fullness to the lower face and neck area
• Reduce the appearance of deep lines and wrinkles

What is included in my facelift treatment package?

• As many preoperative consultations with your surgeon as you like to make sure the procedure is right for you
• Treatment at a specialist day surgery facility recently rated ‘Good’ by the CQC
• Enhanced same day discharge with the added benefits of recovering in your own home
• 24/7 clinical support from your surgeon for first 48 hours and our expert postoperative support team
• Your very own dedicated patient coordinator
• In-depth preoperative medical assessment to make sure you are fully fit for the rhinoplasty procedure
• Exceptionally high standards of postoperative care described as ‘outstanding’ by the CQC with regular telephone and face to face checks by our expert postoperative support team

RealSelf Top Doctors

RealSelf top doctor status is awarded to less than 10% of the RealSelf doctor community.  This status is earned by achieving consistently high patient satisfaction (from RealSelf reviews), getting excellent feedback on expert answers to patient questions, and after investing significant time in Q&A and other doctor activity. RealSelf top doctors are rated among the very best surgeons in the United Kingdom and USA.

1. Over 15 years experience with all types of facelift surgery – short scar mini facelift, full scar facelift, necklift and combined procedures (facelift with eyelid surgery or facial fat grafting)
2. We regularly receive patients from overseas at our London facial plastic surgery specialist centre
3. Our surgeons are UK trained NHS consultant plastic surgeons who live and work in London. We don’t work with ‘fly-in, fly-out’ surgeons from Italy. This is very important because whilst your surgeon takes all precautions to minimise facelift complications, complications can and do occur and our surgeons are readily available to manage any issues if and when they arise. An example would be a haematoma (collection of blood contained under the skin) developing after a facelift which is a recognised risk of a facelift procedure. In many cases this needs addressing as soon as possible and we have the full infrastructure in place to manage this.
4. We own and manage our own surgical facilities. Properly performed facelift surgery takes time (often 5-6 hours for a comprehensive facelift) and should not be rushed. Our surgeons perform a maximum of one facelift procedure in a day. We do not cram 3-4 facelift procedures into one day like other providers. You want your surgeon to be well-rested and mentally and physically sharp to perform facelift surgery which is a very complex procedure to get the very best results.

Trust a facial plastic surgeon

A facial plastic surgeon is trained to undertake aesthetic surgical procedures in the facial region. They are dedicated sub-specialists. Compared with general plastic surgeons, facial plastic surgeons are inherently better trained to perform delicate facial procedures such as a full facelift and neck lift. The extra years of surgical training by facial specialists focused on the facial region results in an exceptionally high degree of skill.

• Alok Misra
• Ertan Erel

Our surgeons are full members of:

Based on 127 reviews.

Nadia Alam

01/10/2021

Verified

Highly recommend. I got a breast reduction performed and the results are amazing. From the moment I stepped in there for my consultation to my last post op check up, they havent been anything but lovely, nice and very accommodating. Ive got so much of my confidence back and they keep the journey completely hassle free. Thank you! 💛

Sepideh Khademi

30/09/2021

Verified

Best decision I made, I felt really like I was listened to and my surgeon was honest and professional with me. I am so happy with all the staff at the clinic. They were really friendly and made me feel super comfortable while I was there. 100% recommend anyone to use this clinic for breast augmentation 😊 thank you everyone at Centre for Surgery.

Chloe Green

29/09/2021

Verified

Had my breast argumentation here 3 months ago at Centre for Surgery. I wanted to wait till I was past my post op to write my review so I could make sure everything had gone well. Dr Ertan Erel is a fantastic surgeon and my results have been exactly what I was expecting healing great and looking how I wanted them to. So if your looking for breast augmentation I would definitely recommend this clinic.

Shaz Chaudhary

29/09/2021

Verified

I could not recommend this place enough for surgery. Greeted by the most kindest staff and nurses, from booking the surgery to the after wound care with Sophie everything was so easy and everyone was so helpful. Everyone reassured me and cared for me every step of the way. Dr Giuseppe was my surgeon for breast augmentation I am so so happy with the results! He really has done the best job. He made me feel comfortable throughout, very funny and lovely person. Can’t thank him or CFS enough for what they’ve done for me 🙂

Asha Rai

28/09/2021

Verified

It has been about 2 and half months since I had breast augmentation and couldn’t be happier with the results! Dr Erel completely put me at ease from the first consultation and has been extremely professional throughout. He was more than happy to answer all of my questions and helped me pick the right size to achieve a natural result. He knew exactly what I wanted and I’m so grateful for the natural looking results. The care I have received pre and post op at Centre for Surgery has been brilliant. I couldn’t recommend CFS enough to anyone considering this procedure.

Kirstie Ann

27/09/2021

Verified

Everyone from start to finish were professional and friendly. I felt reassured at every step of the way and confident I was getting the very best care. This is the second time I've been to Centre for Surgery and I will definitely be choosing them again in the future. From the ease of getting an appointment, to the quality of the service and facilities, and excellent medical care, I couldn't be happier and will be recommending Centre for Surgery to everyone.

Jane L

26/09/2021

Verified

Amazing experience from start to finish as all the staff were lovely and made me feel at ease during my experience.

Gary M

25/09/2021

Verified

Excellent service, highly recommend.

Kelly Reed

25/09/2021

Verified

I was very nervous coming to the clinic for labiaplasty but Dr Dimitriadi put me at ease straight away with her lovely manner and warmth. She gave me a thorough understanding of the surgical approach, the surgery itself and healing time and I felt very confident of her abilities as my surgeon. I felt a little anxious during the operation prep but Dr Dimitriadi and the lovely nurse helped keep me calm and relaxed throughout. I felt I was in very good hands. I healed really well and quickly and did not have much pain at all (in fact I completely forgot about taking pain medication after the operation). It was one of the best things I have done for myself and I am so glad that I had the courage to do this and that Dr Dimitriadi was my surgeon. I would 100% recommend her and Centre for Surgery (all the staff were so lovely, caring and warm). I now feel so much more confident in my body and I am very happy with the results.

Leanne Cooper

24/09/2021

Verified

I had a fantastic experience with Dr Giuseppe. I’m very happy with the results from my breast enlargement surgery (415cc under the muscle). Centre for Surgery have been absolutely fab from start to finish.

Facial ageing has traditionally been thought to be due to excess skin sagging on the face. For many years, the main method for reversing these aging changes has been to tighten the skin by performing skin-only facelifts. The older facelift techniques focused on repositioning skin only, without addressing the underlying tissue layers. Patients who underwent these older (often on multiple occasions) lifts obtained an unnatural, stretched appearance – the ‘wind-tunnel effect’. In some cases, the eyebrows and forehead were also pulled upward, giving a startled and highly unnatural appearance.

One important aspect of facial ageing that is missed with the older skin-only methods is that two aging other processes are occurring that skin-only facelifts do not adequately address:

1. The deeper tissues of the face (fat and muscle) gradually detach from their facial attachments and begin to descend under the influence of gravity, and
2. The soft tissue volume of the face decreases. Both bony and fatty changes occur with age. Thus, treatments to correct the ageing face should involve repositioning of these deeper structures (facelift), and restoring volume (fat grafting), as required.

Surgeons at Centre for Surgery focus on both lifting the soft tissue and muscle and restoring volume – the ‘lift and fill’ facelift. It is often not enough just to reposition the tissues with a facelift technique. Facial fat grafting to restore volume is also required.

There are many benefits to undertaking a facelift, including:

Skin tightening: Loose facial skin can make a person appear a lot older than they actually are, while taut facial skin is a sign of youthful vitality. The latest facelift techniques can completely remove loose skin from the lower face and neck creating a more revitalised appearance

Wrinkle reduction: The appearance of wrinkles can be reduced when the skin is tightened during the facelift process.

Repositioning of facial fat: At times a facial contour that is undesirable is a result of fat deposits in the face. Our surgical technique includes repositioning of fat deposits to achieve a more aesthetically pleasing facial contour. Facial fat grafting can also be performed to create extra volume. Fat transfer is an advanced method for restoring volume to the facial fat compartments. Using this alone or in combination with a facelift can provide optimal results to patients.

Procedures commonly combined with facelift

Eyelid surgery or blepharoplasty is the most common surgical procedure for facial rejuvenation. It can also be combined with a facelift. Facelifts are performed with blepharoplasty in about 70% of all cases. While a facelift focuses on the cheeks, jowls and neck area, eyelid surgery addresses other issues that may affect your appearance.

Reasons for having eyelid surgery in conjunction with a facelift include:

• Puffiness around the eyes that make you look older than you actually are
• Hooded eyelids that make you look fatigued, even if you are full of energy
• Hooded eyelids that are affecting your eyesight and your ability to see
• Sagging skin and wrinkles under the eyes

There are two types of blepharoplasty surgeries. Depending on your needs and goals, you may need one or both performed:

Upper Blepharoplasty: Surgery on the upper eyelid involves the removal of excessively stretched skin that can cause multiple wrinkles or hooding on the eyelash line. If there is an underlying droopiness of the lid, a muscle repair can be performed through the incision at the same time.

Lower Blepharoplasty: During surgery on the lower eyelid, the surgeon will redistribute the fat within the lower eyelid, which removes the appearance of bags and under-eye puffiness. By addressing these problems at the same time as a facelift, a greater portion of the face can be rejuvenated, providing a more enhanced appearance. Another procedure that can be employed is a brow lift, in order to minimise wrinkles on the forehead. The best way to determine if this procedure is appropriate in conjunction with a facelift is to discuss it with our surgeons during your consultation.

A well performed facelift does not leave visible scars

All facelift procedures involve making skin incisions and as with any surgery, there will always be a residual scar. Facelift incisions are typically hidden in natural skin creases in front of and behind and in the hair (easier in women). When performed by an experienced and meticulous plastic surgeon at Centre for Surgery in London, facelift incisions usually remarkably well and are barely visible though of course everyone will scar differently. In the majority of cases, patients and their loved ones find it very challenging to find the incisions months after the procedure.

Scars continue to naturally soften and improve and mature over the course of 12 months, but no scar every disappears completely. Fortunately surgeons at Centre for Surgery have access to the most advanced lasers to reduce redness or flatten scars after the facelift procedure.

Facelift before and after:

Although neurotoxins and dermal fillers have revolutionised the way we treat the ageing face with non-invasive techniques, these do not replace surgical procedures. Rather they complement as opposed to replace.

Key point: Big degrees of facial aging require correspondingly big procedures for a proper correction.

Facial wrinkles and volume loss are poorly treated with a facelift. This is where the injectables are most useful. Whether it is to soften lines or add subtle volume to targeted areas – this is where facial injectables work really well. Problems occur when too much is attempted with injectables alone – often leading to over volumisation – the so-called ‘pillow-face’.

Lets go through a little on how neurotoxins and dermal filller actually work:

Neurotoxins work by blocking the neuromuscular junction. This reduces or even eliminates the electrical signals from the brain to the facial muscle, thus inhibiting movement of the muscle. The result is a reduced severity of the associated wrinkles. However, Neurotoxins do nto address volume loss which is a prime component of facial ageing, nor do they treat loose skin, descended muscle or fat atrophy.

There is a increasing trend towards dermal filler treatments as an alternative to facelift surgery. Facial fillers are made up of various substances. The most commonly used substance in most modern HA fillers is hyaluronic acid. There are other less commonly used substances such as poly-l-lactic acid or calcium hydroxyapatite which work for longer but are not reversible unlike HA fillers.  HA fillers act to restore the lost volume due to atrophy of soft tissue and fat volume that occurs with the ageing process.

Facial injectables can reduce the appearance of fine lines, deeper folds, and with the more viscous HA fillers even add volume to certain areas including the temples, cheeks, chin and lips. However, these results are temporary and for many patients do not provide enough correction of the jawline, jowls, cheek bones and loose and crepey neck skin. Fillers still have an important role – they are treatment options for patients who may not be ready for facelift surgery or perhaps have had facelift surgery already and desire a ‘tweakment’ to refine or fine-tune the results from surgery.

Facelifts are not just for women

Men and women both experience the effects of the facial ageing process and both can benefit from facelift surgery. Demand for facelift surgery in men in the UK has increased over 25% over the last twenty years, while demand for female procedures has remained relatively static. About 10% of all facelift procedures are performed in men and this is a growing percentage year on year.

The ideal candidates for a facelift procedure are men and women with a face and neck that are starting to look older, but with an elastic skin and a very well defined bone structure. Even though most facelift patients are around 40 to 60, facelift can be successfully performed in patients between 70 and 80 subject to satisfactory medical clearance for the surgical procerdure.

Best age for facelift surgery

There is no ideal age for a facelift. Different people age at different rates and to different degrees. Although the normal facial ageing process causes facial skin and underlying muscle to loosen or sag over time, the effects of ageing can occur at any time although significant sun exposure will accelerate the process. In the UK, the majority of surgical facelift procedures are performed on women and men between the ages of 40 to 56.

Over the last 10 years , there has been an explosion in the number of techniques to address facial aging in younger patients as younger people are increasingly presenting to discuss options to maintain their youthful appearance. Leading facelift surgeons in London agree that, patients between the ages of 30 and 39 are particularly interested in brow lifts (forehead lift) and blepharoplasty surgery (eyelid surgery to remove excess pockets of skin and fat around the upper and lower eyelids. While blepharoplasty and browlifts are full facelifts, they are still designed to address facial rejuvenation. Centre for Surgery offer leading treatments to cater for younger patients needs.

If you are not keen on the idea of having scars from facelift surgery, Centre for Surgery also offer a ‘scarless face lift‘ utilising the innovative FaceTite platform. A FaceTite procedure utilises minimally invasive bipolar radiofrequency to tighten the skin of the neck and jowls combined with Morpheus8 RF microneedling. By using both FaceTite and Morpheus8, your surgeon is able to address mild to moderate skin laxity in a minimally invasive manner and without the downtime of a traditional face lift. A FaceTite procedure can be performed under local anaesthetic (with or without oral sedation) in properly selected candidates. Microlipo may also be performed on the lower face and neck to define the jawline. The FaceTite / Morpheus8 procedure is also known as EmbraceRF.

Your facelift surgeon may also wish to combine the FaceTite/Morpheus8 combination with a mini facelift to extend the benefits of a partial skin excision. In this case the procedure would be performed with TIVA general anaesthesia.

Causes of facial aging

Premature or early onset ageing can be caused for a number of reasons:

• excessive UV sun exposure
• smoking tobacco
• poor lifestyle habits (late nights, heavy drinking)
• genetics

Everybody’s skin is different and this has a corresponding impact on the degree of facial aging and at what rate.

We tell all our patients that there a number of key criteria for being ‘ready’ for a facelift:

1) Structural evidence of facial ageing that is amenable to reversal with a facelift. This includes areas such as the jowls, neck skin laxity, or neck bands,

2) A realistic expectation of what can be achieved

3) Good overall medical health and and a good system of social support available after the procedure. A patient who is 44 may satisfy all three of these criteria, and a patient who is 58 may not – treatment is always individualised to the needs of every patient.

A facelift with our surgeons will restore a more youthful appearance, helping to correct many of the visible signs of ageing in the face and neck area. Reasons for having a facelift include:

1. Sagging in the mid-face area
2. Deep creases below the lower eyelids
3. Deep creases along the nose extending down to the corner of the mouth
4. Loose skin and excess fatty deposits under the chin area, resulting in a “double chin” or “turkey neck”
5. Facial fat that is displaced or drooping, creating exaggerated jowls

There are other factors that help determine if you are a good candidate for facelift surgery, including:

Good health: You should be in good health and be free of any major medical conditions prior to your surgery. This is key for proper healing and recovery after your procedure.

Most importantly, you should have realistic expectations about your goals for surgery. Ideally, you want to look like a revitalised, refreshed version of yourself. The best way to determine if you’re a candidate for a facelift is to schedule a consultation with one of our specialist facial surgeons.

If you are a good candidate, you may wish to explore what finance options we have available.

Some questions to ask at your facelift consultation

• Am I an ideal candidate for facelift surgery?
• Is it possible to attain the results in line with my expectations?
• What can I do to achieve ideal results following the facelift procedure?
• Do you have before and after photos of patients who undergone similar facelift procedures?
• What can I expect in the recovery period after a facelift?
• What scars are created from facelift surgery and where will they be located?
• Will I experience pain after facelift surgery?
• How soon can I return to work after a facelift?

Things to consider before having facelift surgery

Facelift surgical techniques have evolved beyond the concept of just lifting tissue and now include incorporating superficial and deep filling of facial fat compartments to address volume deflation.

Complementary techniques to a facelift:

• Facial fat grafting – ‘lift and fill facelift’
• Chin augmentation (with chin implant or fat transfer)
• Laser resurfacing
• Chemical peels

A typical facelift at Centre for Surgery is often combination of a SMAS facelift with facial fat grafting and fully ablative Er:YAG laser resurfacing.

In one procedure, the surgeon is able to:

1. Remove excess skin and tighten tissue (facelift)
2. Revolumise the face (facial fat grafting)
3. Improve the skin quality and remove perioral and periorbital wrinkles with Er:YAG laser (laser resurfacing)

Most hospitals in the UK lack the high powered lasers for the crucial final third stage which is akin to the polish phase of a car wash (after shampoo and wax) so you would be getting only a partial procedure elsewhere.

It is crucial to be aware of differences between the genders when it comes to facelift surgery. Males have different aging characteristics compared to women. Women are often more keen on correcting wrinkles, lines and folds compared with men who are often more interested in restoring their jawline definition. Also with men, improvement tends to sought more for the lower face compared with women who often liek to have the whole addressed. A very important consideration relates to the placement of incisions and the hiding of them. Clearly for women, this is a lot more straightforward with their longer hairstyles. With men, the surgeon will take modify the facelift technique with increased emphasis on preservation on the male hairline as this is something which is prone to change with time in certain men.

Men also complain more often about neck changes with increased neck skin looseness and accumulation of excess fat under the chin. In those men with a more recessed jaw and chin, they will be more predisposed to develop fat under the chin at a much earlier age. Centre for Surgery also perform submental liposuction and chin implant surgery to correct both issues along with the facelift surgery in a single procedure.

Every patient is different with completely different facial anatomy and characteristics, facial ageing patterns and objectives for surgery.

The traditional facelift generally consists of incisions made both in front of and behind the ears. The incision behind the ears extends to the hairline. The surgeon would place the incisions in strategic locations to look as inconspicuous as possible to blend in with the natural skin folds and contours. After skin incision, the skin is gently lifted or undermined to separate the skin from the underlying soft tissue and muscle layer in the previously marked areas by the surgeon. After the soft tissue undermining component, the facelift surgeon then surgical tightens the area in its new lifted position with sutures and finally trims any excess redundant tissue.

There are many facelift techniques, but the best methods involve repositioning the SMAS, such as the SMAS plication or SMASectomy. The SMAS or ‘superficial musculoaponeurotic system’ is a distinct facial layer beneath the skin which needs to be addressed separately to the skin to ensure robust long lasting results. Which technique is used will depend on the structure of your face. In addition, as mentioned above, volume restoration in the form of fat injections of the face must be considered for each patient. Many patients also benefit from browlift or eyelid surgery (known as blepharoplasty) in addition to a facelift.

Types of facelift

Cutaneous facelift

The cutaneous lift is also known as a skin-only facelift. The cutaneous lift does not address the underlying muscle or SMAS layer. Like with all facelifts, the skin is gently separated and secured in a new lifted position before trimming any excess skin off. Cutaneous facelifts are generally considered to have a lower risk of complications and are often performed under a local anaesthetic. Many surgeons may recommend this option for older patients who may suffer from a range of medical co-morbidities that may place them at high risk of complications during general anaesthesia. There are are number of significant shortcomings associated with cutaneous lifts – only skin laxity can be corrected and the results are not particularly long-lasting and scars are more obvious with more risk of skin rippling from superficial suture placement. The scarring is more evident in skin only facelifts as the tension is being held entirely on the skin layer. With continued aging, the skin layer which is being placed under considerable stretch may actually lose more collagen and elastin compared with other methods of facelift surgery.

There are many types of cutaneous facelifts – PDO thread lifts, silhouette soft lifts, MACS lift – the cutaneous lift is not generally recommended at Centre for Surgery as there are much better options available.

SMAS Plication facelift

Plication is a term which means a state of being folded or to form folds in something. Unlike a cutaneous lift, the SMAS facelift involves tightening both the skin and underlying deeper tissues including the SMAS layer. In conjunction with the SMAS, the platysma layer in the neck is also tightened to restore youthful and contours in the lower face and neck. After reconstructing the deeper tissues using precise suture placement, the skin layer is lifted, tightened and excess skin removed. In SMAS facelifts, the incision does not have as much tension placed upon it compared with a cutaneous lift. The resulting scars have optimal scar aesthetics as a result. SMAS facelifts have more robust results and last much longer compared with skin-only facelifts. SMAS facelifts when performed by an expert facelift surgeon at Centre for Surgery can last for 10 years or more.

Composite facelift

The composite facelift builds upon the SMAS plication facelift  in a number of key ways. It is regarding as a composite technique as it brings together 2 key aspects of addressing gravitational changes to restore youthfulness to the face. A composite facelift is still a 2 layered technique like a SMAS lift but the key difference lies in the additional vertical upward vector which a composite facelift is able to achieve. A composite facelift addresses all the traditional areas of a SMAS facelift such as the jowl area, cheeks and neck but also includes rejuvenation of the peri-ocular region.

The composite facelift has both horizontal and vertical components. The downtime after a composite facelift is slightly longer compared with a SMAS facelift with a longer duration of postoperative swelling. There is also a slight increase in the risk of postoperative complications.

Deep Plane Facelift

A deep plane facelift is the most invasive and major type of facelift surgery. It is a more advanced version of the tradition facelift. Deep plane facelifts have more powerful rejuvenative effects – they are able to correct deeper naso-labial folds as the plane of dissection is actually beneath the SMAS layer on top of the facial muscles. The deep plane of dissection results in even less tension on the skin compared with a SMAS facelift. Deep plane facelifts are often ideal for those with thicker skin and heavy faces. Male facelifts are often deep plane facelifts.

A deep plane facelift requires a surgeon very experienced in facial plastic surgery and who regularly performs facelifts of this type. The deep plane facelift takes considerably longer to perform as the dissection is extremely precise and meticulous.There is a higher risk of complications including nerve injury which can be permanent in nature. Many facial plastic surgeons and well-informed patients will more commonly opt for a less invasive facelift option to minimise the risk of complications as much as possible.

Mid Facelift

The midface is the term used to describe the area of the face which comprises the nose, eyes and the corners of the mouth. With ageing and loss of skin laxity, these areas undergo sagging and downward descent under the influence of gravity. In some cases, patients may develop localised skin laxity of the eyes, cheeks and mouth without other significant ageing of other parts of the face such as the neck or jawline. In these cases, a mid facelift could address these ageing changes effectively without the invasiveness and risks of a full facelift. Compared with a full facelift, the results of a mid facelift are commonly seen as subtle in nature without the longevity of a full facelift. It is rare for our surgeons to perform a mid facelift on its own. A mid facelift is commonly combined with other complementary procedures including eyelid surgery (both upper and lower blepharoplasty), brow lift and fat grafting to the face.

Mini Facelift

A mini facelift is a less invasive form of a traditional facelift. Mini facelifts are often very suitable for patients with mild degrees of aging and facial descent in the lower third of the face. The most common age range for a mini facelift are patients in their 30s to early 50s who may not need a more extensive full facelift but may still benefit from improvement of the facial contours in particular the jowls and more defined jawline. Mini facelifts have experienced a surge in popularity recently and may go by a number of catchy names and are often promoted as being able to performed under a local anaesthetic with minimal downtime. Unlike a traditional facelift which involves incisions being made both in front of and behind the ears, a mini facelift or short-scar facelift often has incisions primarily in front of the ears without the extension into the posterior hairline. A mini facelift may not be as effective for aging changes affecting the neck in addition to the lower face. It is important to understand what the mini facelift will address for your face. Your surgeon will be able to advise you what the mini facelift can address at your consultation.

Incisions for facelift surgery

In facelift surgery, the positioning of the skin incisions is vital for avoiding the impression that you have just had surgery. The vast majority of patients prefer a natural and rejuvenated look without features of visible incisions or scars. The expert facelift surgeon takes great care to place incisions in areas that are as well concealed as possible. The skin incisions are best placed in the natural folds both in front of and behind the ear with the incision extending to the hairline where a neck lift is required. The position of the ear and hairline should preserved and remain in the same position after surgery. The gold standard method for facelift is to gently lift the deeper tissues to reduce tension on the skin layer which reduces the risk of skin stretching. This means a more cosmetically acceptable is scar is possible. Patients are often concerned about the risk of possible hair loss from the incision. To reduce this risk, the surgeon will perform a bevelled incision technique to facilitate proper hair growth. This is very important as it means patients are not restricted to wearing their in certain hairstyles to hide the incisions due to their visibility. Not all surgeons take this level of care and attention in scar cosmesis. All our surgeons are skilled in placing their incisions along the borders of the ear and behind the tragus of the ear. The incisions are much better concealed as opposed to placing incisions in front of the ear which looks more visible. The incision behind the tragus is closed in such a way as to minimise distortion of this structure. It is important to have a truly artistic eye when it comes to facelift surgery. Patient satisfaction is much higher when the results are natural with restoration of youthful vitality without the telltale signs of having had a surgical procedure.

Non-invasive facial rejuvenation:

Fotona 4D and SmoothEye are non-invasive treatments delivered using our state of the art Fotona SP Dynamis dual wavelength laser to improve the appearance of wrinkles, fine lines, texture and loss of volume – all without injectables or more invasive surgery. For those who are not yet ready for a facelift or indeed have had a facelift and would like to maintain their results can now have non-invasive laser rejuvenation at Centre for Surgery.

The gold standard for treatment of the lower face and jowls, neck skin laxity and neck banding remains the 2 layer SMAS facelift.

Centre for Surgery have pioneered the day-case full facelift – you will be able to return home the same day as your facelift procedure is performed.

You may also be suitable for a necklift. A neck lift is a surgical procedure commonly used to tighten and smooth out neck skin which makes you look more youthful, radiant and relaxed. Sometimes submental liposuction is performed at the same time to enhance the results further.

Loose or crepey neck skin can also be addressed with non-ablative Er:YAG laser over the course of 3-4 sessions.

Non-surgical facelift is an excellent procedure for the restoration of a natural and younger facial appearance with the use of anti wrinkle injections and dermal fillers. Facial injectable treatments are commonly used for replacement of loss of facial volume and filling in of lines, wrinkles and deeper skin folds. A non-surgical facelift is a powerful technique which is completely non-surgical with little to no downtime and minimal risk. Non-surgical facelift is performed in the clinic using specialised combinations of wrinkle relaxing injections and dermal fillers to stop the facial ageing process. Your surgeon will firstly apply a topical anaesthetic cream for 30-45 mins to optimise patient comfort during the injection part of the procedure. Patient downtime is minimal and is characterised by minor swelling and bruising which settles quickly. Patients can apply make-up after treatment to allow full resumption of their activities of daily living.

Although a non-surgical facelift has many benefits including its safety and effectiveness, there are disadvantages to be aware of. The main drawback is that the results are not permanent in nature. Dermal fillers last for up to 12-15 months depending on the type of filler used and location of its placement. The ideal strategy to maintain results is to have maintenance top-up treatments every 6-9 months. Anti-wrinkle injections need more frequent top-ups and this is often around every 3-4 months. Before committing to having a non-surgical facelift, it is important for patients to understand the need for regular maintenance treatments to maintain results. Non-surgical facelifts have surged in popularity in recent years however if a patient has moderate to severe skin laxity, the use of anti wrinkle injections and dermal fillers may not be enough to achieve the desired appearance. By having access to the full range of treatment options, both surgical and non-surgical, our surgeons will be able to advise you on the best treatment for you.

Traditionally, the recovery after facelift surgery was relatively painful and recovery was a long process often over 2-3 weeks. Modern methods used by surgeons at Centre for Surgery have made facelift surgery a procedure with a much more pleasant recovery thanks to more modern anaesthesia techniques, use of local anaesthetic and more delicate surgical techniques. The recovery is now much shorter and as with all procedures, a better recovery is facilitated when the patient fully complies with the postoperative instructions given by their surgeon. Patients also are shown how to look after the skin better and this complements the natural healing ability of the individual patient. At Centre for Surgery, the vast majority of patients report feeling amazing after a facelift. When patients see themselves in the mirror a week later, their satisfaction soon makes any discomfort seem very much worth it.

With any procedure, there is a usual expected period for normal recovery. The length of recovery depends on the extent of the facelift procedure and if the patient suffers from any preexisting medical problems such as diabetes or high blood pressure. Patients often return to normal activities within 10-14 days. Significant pain is not commonly reported after facelift surgery although your surgeon will prescribe a course of painkiller medication to smooth your recovery.

A large, soft dressing will be taped in place on the face. These first dressings are extremely important and should be left in place for the exact duration recommended by the surgeon, usually a day or two. It can then be removed and replaced by an elastic covering that will help to contain and reduce swelling. Sleeping with the head of the bed elevated will also aid in pain relief and also in accelerating the resolution of bruising and swelling.

You will experience some swelling and bruising for 24 to 48 hours following the surgery but it is part of the healing process and it should lessen within two weeks. We recommend our patients to try cold compression on the face to aid with the swelling and bruising.

How to speed up recovery after cosmetic surgery

With any cosmetic surgery procedure, there is always the potential for complications whether minor or major in nature. At Centre for Surgery, our facelift surgeons take extra precautions to keep the risk of complications at as low a level as possible. Despite this, it is still very important to be aware of the range of complications that could occur with facelift surgery.

Potential risks of facelift surgery

• Anaesthetic risks
• Postoperative haematoma – a haematoma is a collection of organised blood clot beneath the skin. A haematoma after facelift surgery is one of the most common complications after facelift surgery and usually arises early often within 24 hours after surgery. If a haematoma is suspected, your surgeon will assess you urgently to decide the best course of action. Most haematomas can be removed with a simple needle and syringe in the clinic. Some haematomas will require surgical removal under local anaesthetic.
• Surgical site infection (SSI) – SSI’s are always a potential risk after any surgical procedure. Bacteria can enter wounds through small entry points leading to localised infection. Clinical features of infection include redness, swelling, heat and pain in the affected area. SSI’s need treatment with a course of antibiotics.
• Nerve injury – during undermining of the skin flap, the nerves of the face could be injured leading to numbness, tingling or weakness of the affected facial muscles. Most nerve injuries are temporary in nature and often settle after a few months. A minority of nerve injuries are permanent in nature.
• Scarring and hair loss – Scars from facelift surgery are hidden in the natural hairline and natural skin folds. In some people, hypertrophic scarring can develop. Thickened scars can lead to either temporary or permanent hair loss in the region of the incision lines. Injection of steroids and or hair transplantation can address this issue effectively.
• Skin necrosis – skin necrosis refers to death of the skin flap due to an insufficient blood supply to the area. Skin necrosis is a rare complication of facelift surgery but the risk is increased in patients who smoke.

Many potential complications of facelift surgery can be effectively managed with meticulous postoperative care. Our postoperative support programme was described as outstanding by the CQC. At your consultation, it is important to understand all the potential risks and complications of facelift surgery. Please take care to follow all of the surgeons pre- and postoperative instructions to maximise the chances of successful healing.

Pixie Ear Deformity

The importance of making precise incisions for facelift surgery cannot be emphasised enough when it comes to preventing an unnatural look the the earlobe, also known as a pixie ear deformity. The pixie ear deformity develops as a result of inaccurate correction of the earlobe after the re-draping of the facial skin. Often earlobe distortion develops of excessive traction being placed on the earlobe. The stretched earlobe extends downwards and is a tell-tale sign of recent facelift surgery. It is commonly associated with older methods of performing facelift surgery with much of the tension being placed on the skin rather than the deeper soft tissue layers. Our skilled plastic surgeons avoid this unnatural appearance with modern techniques of performing facelift surgery.

Revision Facelift

Revision facelift surgery is a facelift procedure performed for patients who have previously had a facelift procedure. There are a number of reasons why patients may choose to have a revision facelift. In all cases, patients must weight up the pros and cons of revision facelift surgery before proceeding with another procedure. In many cases, patients were happy with the results of the first facelift but due to ongoing ageing, the results have diminished with time. Facelifts cannot stop the ageing process however successful the first procedure was. A well performed facelift procedure lasts up to 10-15 years. Patients who have had less invasive facelift procedures may notice their results to last about 5 years. Ageing of the face is a normal and natural process and different people age at different rates depending on both intrinsic and extrinsic factors. Revision facelift is commonly performed for patients who have experienced the natural ageing process. The timing of surgery depends on a number of factors. Your surgeon will be able to advise you of the most appropriate options.

Reasons to undergo revision facelift

• Visible and unsightly scarring
• Facial asymmetry
• Use of older methods of facelift surgery (skin-only technique)
• Major weight loss after facelift surgery
• The wind tunnel look
• Uneven results with ridges or dimpling
• Use of PDO threads
• Inadequate degree of tightening with first procedure

Revision facelift surgery is a more complex procedure compared with a primary facelift. The underlying soft tissues have been distorted by the previous scar tissue with formation of dense scar tissue. A revision facelift carries more risks compared with primary facelift surgery. At Centre for Surgery, our facial plastic surgeons are masters in facial anatomy and have specialist expertise in performing advanced facelift surgery. It is important to choose a surgeon who has sub-specialisation in facelift surgery to create results that are natural, symmetrical and youthful.

There are a number of factors which will determine the overall cost of the facelift procedure and the final quotation will be given after your face to face consultation with your specialist plastic surgeon.

Procedures to have with a facelift

Can I have a mini facelift?

What is a mini facelift?

What is a facelift and should I have one?

Different types of Facelifts

What is pixie ear correction?

What is facial fat grafting?

Our aftercare programme was recently described as ‘outstanding’ by our regulator, the Care Quality Commission. 

Our postoperative support team call all our patients the day after their procedure and then every other day thereafter for the first two weeks. The proactive nature of our postoperative support gives every patient the best opportunity for a smooth postoperative recovery free of complications. In many cases if complications were to occur, their impact is markedly lessened by early detection, prompt clinical assessment and correct treatment. Where a patient expresses concern to our team over the phone, then we often call patients in the same day for assessment with one of our expert nursing team. Even if there is no significant issue, the careful explanation and calm reassurance provided by our team can help to alleviate any worries you may have experienced.