Facelifts

What is facelift surgery?

A facelift (or rhytidectomy), is a surgical procedure to improve visible signs of aging on the face and neck, such as:

  • Sagging or depression of the cheeks
  • Deep creases or folds between the cheek and mouth (nasolabial folds)
  • Sagging of skin and fat in the lower face and jawline creating jowls
  • Fatty deposits under the chin and jaw making even a person of normal weight appear to have a double chin
  • Skin folds on the neck

Types of facelift:

Facelifts can be described by their incision, or their dissection layer. I have experience with both classic, and short-scar (mini) facelifts. I use both depending on what needs to be done. Sometimes the incision is hidden behind the tragus of the ear, or in the fold in front depending if you are male or female, or if it is your first facelift or second. The incision is usually immediately below the side burn and at the border of the temporal hair line and skin; therefore minimizing displacement of the hair and an operated look. The level of dissection can be beneath the skin (subcutaneous), beneath the muscle and fat (SMAS) of the face (sub-SMAS), or a combination of both.

I have experience with all these procedures and now usually employ a skin and SMAS dissection in a single layer which lifts these tissues together. This thick flap thicker has more circulation making it safer for smokers. It allows the deeper fat and muscle (SMAS) to be lifted and sutured permanently for effective correction that avoids a pulled look to the skin and a “wind-swept” appearance of the face. The key is to lift the deeper tissues to avoid an operated look, and provide a youthful rejuvenation that people will not suspect is a facelift. This procedure is safe for the facial nerve branches as they are seen directly and can be protected. The pocket has less bleeding than other procedures and patients can safely go home even the same day. I commonly use drains that are easily removed the next morning by the patient, and the follow-up is at at 1 week.

Full Face is when a brow lift is performed with a facelift. This can also include eyelid surgery or dermabrasion to treat sun damage or deep lip and cheek lines. A full face takes 6-7 hours and is done under a single general anesthesia. You will stay overnight in our fully accredited surgical clinic with 2 nurses. This is the only facility of its kind in Ottawa. Only 7-10 days is needed off work and you have a single recovery (the 7-10 day recovery is the same whether the face, brow or eyelids are done together, or separately).

Procedures that complement a facelift include:

  • Eyelid surgery (blepharoplasty) to rejuvenate aging eyes and deep tear trough grooves
  • Brow lift to elevate the eye brows, correct forehead lines and shorten a high forehead
  • Skin resurfacing of cheek or lip lines (dermabrasion)
  • Volumizing the cheek and face with permanent fat or absorbable fillers (Juvederm, Radiesse or Perlane)

Steps (consult, pre-op. surgery, recovery, follow-up):

First, a consult is necessary to come up with a surgical plan that meets your goals and is safe and gives a predictable result. This will detail whether your facelift will also include a brow lift (becoming a full face procedure) or eyelids, while still allowing for a single recovery.

At the pre-op pictures are taken, post-op instruction sheets and prescription are given and any other questions answered. The surgery is then performed under general anesthesia and you may or may not need to stay the night. Someone will need to drive you home. Recovery will take 7-10 days depending on how you usually bruise and swell. All measures including homeopathic arnica montana are employed to speed your recovery. You will be able to go out and about in just 2-3 days with sunglasses and a high collar or scarf. Stitches come out at  your 1 week follow-up. Prescribed pain killers are only necessary for the first few days as this is not a painful procedure. Mild asymmetry that only you or Dr Lacey can notice is possible, and often present before surgery too. Most people can apply some cover-up if necessary, and return to regular work at 10 days.

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