Making an informed decision about your face lift surgery.
Although the rate of complications from facelifts is low and decreasing with advancements in medical science, there are still important considerations when preparing for this type of surgery.
Although the anaesthesia has reached extremely high levels of safety even compared to things we do on a daily basis, the risks are not zero. It is estimated that for a healthy adult, the risks related to an anaesthetic are somewhere in the area of 1:100000.
It is interesting to note that the risks are related to local anaesthetic with sedation are actually higher than the ones from a general anaesthetic. For the purpose of comparison, the risks of driving on a motor way are about 4 times higher than having a general anaesthetic.
During the face lift surgery, a small amount of bleeding is normal. After the surgery is finished, two drains placed under the skin of the neck remove the excess oozing. The drains are typically removed between three and four days after your operation.
More significant bleeding, in the form of a haematoma, is much less frequent, and the rate is at approximately 2-3:100. If this was to occur, it would be necessary to have a short return to the operating theatre in order to wash out the blood clots under the skin.
It is possible, although extremely rare, that bleeding can occur even a few days later after your operation, and in a situation like this there is swelling increasing relatively quickly under the operational area. In a situation like this, you should contact us straight away for guidance, or attend the casualty department at the local hospital straightaway.
Infection is rare following face lift surgery, but can occur despite the antibiotic treatment prescribed.
Most of the time, if it happens, it takes the form of some redness around the scars around the ears, the which tends to settle either with topical antibiotics or Savlon cream.
However, if you noticed the redness and swelling occurring around the neck or the cheeks, temperature, increasing pain, shivering, it is important to either contact us straight away, or discuss it with your GP or your local casualty department, for assessment and antibiotic treatment.
Prompt treatment for any infection insures that the end result of the surgery is not affected.
In addition, in terms of preventive efforts, it is beneficial to use an antiseptic wash, Hibiscrub, as a shampoo and facial wash for 2 to 3 days before the operation and on a daily basis for another 2 to 3 weeks after the surgery.
Get in touch. Talk to our helpful team or book a consultation with Mr Lucian Ion. Call 0207 486 7757
Ask the surgeon. Have your question answered directly by Lucian Ion, FRCS(Plast) or call 0207 486 7757
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Any surgery that takes longer than an hour increases the risk of clots in the leg veins or deep vein thrombosis, similar to what can happen when you fly on a long journey. In some instances, these clots can travel to the lungs and become life threatening .
Typically, medication that thins the blood, increases significantly the risk of bleeding, and is usually avoided during face lift or neck lift surgery.
Alternative measures to reduce the risk of deep vein thrombosis around the time of surgery include compression stockings, inflatable calf or boots systems that are applied during and after the face lift surgery, early mobilisation within hours of surgery, and maintaining a good fluid intake in the days following your operation.
Please note that contraceptive medication and to a lesser extent hormone replacement therapy increase somewhat the risk of deep vein thrombosis.
It is estimated that it takes 3 months off the medication to bring the risk levels down to baseline, and because of the risk of unwanted pregnancies, most of the time the surgery is carried out without stopping contraception.
Also, long journeys following the surgery are to be avoided for the first month, as immobility increases the risk of deep vein thrombosis.
In special instances, where blood thinning medication is very important for patient safety, it would need to be discussed in advance of the surgery, if it may require either a smaller operation, or closer monitoring for the increased risk of bleeding.
Pain and discomfort I usually minimal with face lift surgery, but the feeling of tightness around the jawline or under the chin are more common in particular when the neck contouring takes place at the same time.
This is typically controlled very well with common painkillers, which would be prescribed for you to have for the discharge. It is very important to avoid taking aspirin-based painkillers, as they increase significantly the risk of bleeding, and there are strong equivalents to choose from.
Non-steroidal anti-inflammatory medications ibuprofen, diclofenac, can be of use, but should be discussed prior to administration, as they also produce a slight degree of blood thinning and may increase the chance of a bleed. They need to be taken with food every time, to minimise the risk of irritation of the stomach.
Delayed healing or unsightly scars are very uncommon with current facelift techniques which rely on tightening of the deeper layers rather than applying significant tension on the skin.
A small wound dehiscence in the scars around the ears will typically heal by itself relatively fast, leaving a good-quality result.
Thick or lumpy scars are usually a reflection of the body's own healing mechanisms, but can be influenced with some treatments. Should this problem start to occur, and typically that would be on the scars behind the ears, it is important to inform us so that treatment can be instituted promptly.
The risk of injury to the facial nerve branches which move the facial muscles, which is approximately 1%. In most of these patients, a full recovery still follows but may take several weeks or sometimes a couple of months to occur.
In the rare occasions when spontaneous recovery does not occur, botulinum toxin treatments to the stronger side may become necessary for the facial symmetry to improve.
Facelift and neck contouring surgery involves a degree of lifting of the skin from its deeper attachments in order to redrape it.
This leads to reduced feeling in that skin, which will take several months to return to normal, or close to normal. Reduced sensation does not mean reduced movement to those areas, but rather the numbness that is similar to having had a local anaesthetic injection.
The area under the chin tends to take longest to settle down, whereas over the cheeks it tends to be a shorter process.
Questions? Just ask. Talk to our helpful team or book a
consultation with Mr Lucian Ion. Call 0207 486 7757
Swelling is inevitable after any type of surgery, but may take different length of time to settle depending on the area is operated upon.
In the facelift procedures, swelling is mainly located along the jawline and under the chin, and will take several months to settle adequately.
Nonetheless, the main part of the swelling does settle within approximately a fortnight after surgery, making the shape of the face relatively normal, even if it does not represent the end result.
Gentle pressure, manual lymphatic drainage, cold flannel applications, sleeping with the head elevated on two or three pillows, are all able to contribute towards minimising the swelling and an accelerated disappearance of it.
Contouring of the neck leads to some tightness and stiffness under the chin, which takes sometimes several months to feel truly comfortable.
It is very tempting to minimise make movements on the assumption that trying to move too much with the damage the work done.
However, the opposite is true, and normal movements of the head are preferable in the post-operative period, and will lead to a faster return to normality.
A degree of asymmetry is inevitable since our face and body in general is not the same shape on the right and the left sides. However this asymmetry tends to be very discreet and would usually be picked up only on close inspection.
Most commonly, a degree of asymmetry is noticed in the jawline contour, since the direction of the two sides of the lower jaw bone is different.
The asymmetry of the cheekbones can sometimes be masked to a significant extent using fat transfer at the time of the surgery
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