Face Lift Surgery
A facelift (or face lift) is an operation designed to rejuvenate the ageing face. It may be combined with other facial cosmetic operations like eyelid surgery and liposuction of the neck, as well as with non surgical procedures like neurotoxins (derived from botulinum toxin), and gel injections. Whereas previously the emphasis of the surgery was placed on skin tightening (which gave an operated, rather than a more youthful appearance), a better understanding of the effects of facial ageing coupled with a more detailed knowledge of the facial anatomy, and how this changes with ageing, has led to the development of modern facelifts designed to re-elevate and reposition the deeper tissues to a more youthful position, without the marked skin tightening stigmata seen in the past.
EFFECTS OF AGING
- General “wear and tear” coupled with sun damage leads to changes in the skin quality (wrinkles, lines, pigmentary changes)
- Loss of facial volume, which effects both the soft tissue padding (fat) and the bone
- Descent (ptosis) of the remaining facial fat – droopiness leading to heavy naso-labial lines, flattened cheek prominences, jowls, and sagging neck skin
- Weakened support structures leading to prominent bulges in the eyelids
IDEAL CANDIDATES
A good candidate for the surgery is a patient in her late 40’s or 50’s who wishes to look somewhat younger (Patients often tell me that they feel much younger than they appear, and want to look as good as they feel!) You need to be in good general health, and a non smoker to qualify for this surgery.
how to prepare for facelift surgery
Embarking on your Face Lift Surgery (Rhytidectomy) journey is an exciting step towards a refreshed and more youthful appearance. At our practice in Cape Town, we ensure you are fully prepared, confident, and comfortable for your procedure.
Here’s what you need to know and do before your surgery:
- Comprehensive Medical Assessment:
We will conduct a thorough review of your medical history, including any current health conditions and medications. You may require specific pre-operative tests or medical clearances from your doctor to ensure you are in optimal health for surgery. - Medication & Supplement Guidelines:
You will receive explicit instructions regarding which medications (especially blood thinners like aspirin, ibuprofen, and certain herbal supplements) to discontinue in the weeks leading up to your surgery. This is vital to minimize bruising and ensure a safe procedure. - Strict Smoking Cessation:
If you smoke, it is absolutely essential to stop several weeks before your surgery. Smoking severely impairs circulation and healing, significantly increasing the risk of complications and impacting your results. - Arrange Post-Operative Support:
Plan for a trusted family member or friend to drive you home after your surgery and to assist you with daily activities during the initial recovery period (at least the first 24-48 hours). - Prepare Your Home Environment:
Set up a comfortable, clean, and quiet recovery space at home. Ensure you have pillows to keep your head elevated, a good supply of soft, easy-to-prepare foods, and anything else you might need within easy reach to avoid straining. - Fasting Instructions:
You will receive precise instructions regarding when to stop eating and drinking before your surgery. Adhering to these guidelines is critical for your safety during anaesthesia. - Final Pre-Op Consultation:
A few days before your surgery, we will have a final meeting to answer any last-minute questions, review your surgical plan, and ensure you feel completely at ease.
By diligently following these pre-operative guidelines, you will contribute significantly to a safe procedure and a smooth recovery, setting the stage for your beautiful, natural-looking results.
What to expect during your facelift surgery
The surgery is performed under IV sedation or a light general anaesthetic, most often as a day case – only occasionally is an overnight stay needed. The duration may be 3 – 4 hours, or longer, particularly if combined with other surgeries, like eyes. The usual incision commences in the sideburn area, and then (in a well camouflaged pattern) in front of the ear, and often behind the ear in the groove. The scars are usually well hidden, and generally fade significantly over time.
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Through this incision, the skin of the cheek is elevated to expose the deeper (sagging) tissues (often referred to as the SMAS), which are re-elevated to a more youthful position. In addition, liposuction of the neck serves to remove excess fat from under the chin area, and helps to tighten the sagging neck skin.
Once the SMAS has been re-elevated, some (usually minor) skin excess is evident, and this is trimmed and inset to the original incision. Fat may be injected into certain areas of the face (cheeks, naso-labial lines, and lips) to plump these out, or gels may used. Finally a bulky, supportive dressing and face-band are applied to support the re-elevated facial tissues, and drains to remove excess fluid may also be placed.
Complications can occur with any surgery, and facelift is no exception. Although uncommon, bleeding, infection, poor scarring and nerve injury are some of the potential complications of this surgery. Please read my advice to see what medication should be avoided in the weeks prior to the surgery to minimise your risk of complications (this will include herbal and homeopathic medicines and vitamins, which often promote bleeding at the time of surgery). Smoking is a major cause of complications, and I do not offer this surgery to active smokers.
POST-OP AND RECOVERY
Recovery is generally fairly rapid, and the dressings are “debulked” 1 day after the surgery. Drains, if placed, are also removed. An elastic “face band” is then worn for about a week or 2 post op, to help stabilize the neck contour, and to minimise swelling. Skin stitches are usually removed between 5 days and 1 week post op, and by 2 weeks post op, the swelling should have subsided considerably, although it will be several months before the final result can be appreciated. The objective of the surgery is to give one a more youthful, rested appearance without the tell tale signs of surgery.
Here’s a general overview of what to expect during your recovery:
- Immediate Post-Surgery:
You will wake up with bandages around your face and possibly small drains to collect any excess fluid. Swelling, bruising, and some discomfort are normal and will be managed with prescribed pain medication. Keeping your head elevated is essential. - First Week:
The majority of swelling and bruising will be most apparent during this period. We will provide detailed instructions for incision care and when drains or sutures will be removed. Rest is paramount; avoid any strenuous activity or excessive head movements. - Managing Discomfort:
Any discomfort is typically manageable with oral pain relievers. We will advise you on how to best control pain and swelling using medication and cold compresses. - Activity Restrictions:
You must avoid strenuous exercise, heavy lifting, bending over, or any activities that significantly increase your blood pressure for at least 4-6 weeks. Light walking is generally encouraged to promote circulation. - Visibility of Swelling/Bruising:
While significant bruising typically fades within 2-3 weeks, subtle swelling can persist for several weeks to a few months. Most patients feel comfortable returning to light social activities once the worst of the bruising has subsided. - Incision Care:
You will receive clear instructions on how to care for your incisions to promote optimal healing and minimize scarring. Regular follow-up appointments will monitor your progress. - Emotional Well-being:
It’s normal to experience a range of emotions during recovery. Be patient with yourself and your body. The final results will gradually emerge as swelling fully resolves. - Long-Term Care:
We will provide guidance on long-term skincare and lifestyle choices to help maintain your beautiful, refreshed results for years to come.
Embrace a Refreshed You With Face Lift Surgery
Imagine a smoother, more defined jawline and a naturally refreshed appearance that reflects your inner vibrancy. Dr. Paul Skoll offers artistic facelift techniques, expertly addressing sagging skin, jowls, and deep facial folds to restore a harmonious, youthful contour. Schedule your confidential consultation to explore your transformative possibilities.
A few commonly asked questions
What is a facelift (rhytidectomy), and how can it rejuvenate my appearance?
A facelift, or rhytidectomy, is a surgical procedure designed to address visible signs of aging in the face and neck. It involves tightening underlying muscles, redistributing fat, and removing excess skin to smooth deep wrinkles, eliminate jowls, and restore a firmer, more youthful contour to the jawline and neck. The goal is to provide a natural-looking rejuvenation that refreshes your appearance and better reflects how you feel inside.
Am I a suitable candidate for facelift surgery?
You might be a suitable candidate for facelift surgery if you experience moderate to significant sagging of facial skin, prominent jowls, deep folds from your nose to the corners of your mouth (nasolabial folds), or loose skin and banding in the neck area. Ideal candidates are generally in good overall health, non-smokers, and have realistic expectations about the outcome. During your confidential consultation, we will thoroughly assess your skin elasticity, facial structure, and discuss your aesthetic goals to determine if a facelift is the right option for you.
What specific signs of aging can a facelift address?
A facelift effectively addresses several common signs of aging. These include sagging in the mid-face, deep creases below the lower eyelids, deep lines extending from the nose to the corner of the mouth (nasolabial folds), loss of jawline definition due to sagging skin and fat (jowls), and loose skin, fatty deposits, and vertical banding around the neck.
What is the difference between a full facelift, mini-facelift, and neck lift?
A full facelift typically addresses the mid-face, jawline, and neck, providing the most comprehensive rejuvenation. A mini-facelift is a less extensive procedure focusing primarily on the jowls and jawline, with shorter incisions and recovery, suitable for those with less advanced signs of aging. A neck lift specifically targets sagging skin, fat, and muscle bands in the neck area, often performed in conjunction with a facelift or as a standalone procedure for isolated neck concerns. The best approach will be determined based on your specific needs during your consultation.
Will a facelift make me look unnatural, "pulled," or like a different person?
A common concern is looking artificial or “pulled.” Our approach emphasizes achieving natural-looking results. By focusing on repositioning underlying tissues (like the SMAS layer) rather than simply tightening the skin, we can restore youthful contours without creating an overly stretched or unnatural appearance. Our goal is for you to look like a refreshed, younger version of yourself, not a different person.
How long do facelift results last?
While a facelift cannot stop the aging process, it effectively “resets the clock,” providing a significant and long-lasting improvement. The results typically last 10-15 years, with many patients enjoying their refreshed appearance for even longer. Factors like genetics, lifestyle, and skincare routine can influence the longevity of your results. Future maintenance procedures are always an option.
What can I expect during the confidential consultation process for a facelift?
Your initial consultation is a thorough and discreet discussion. We will attentively listen to your concerns and aesthetic goals, review your complete medical history, and perform a detailed examination of your facial and neck anatomy. We will then explain the various facelift techniques, discuss the expected outcomes, potential risks, and answer all your questions, ensuring you feel completely informed and comfortable with your surgical plan.
What kind of anaesthesia is used for facelift surgery?
Facelift surgery is typically performed under general anaesthesia, meaning you will be completely asleep and comfortable throughout the entire procedure. A highly qualified anaesthesiologist will administer and continuously monitor your anaesthesia, ensuring your safety and comfort from start to finish.
Will there be visible scarring after facelift surgery?
Incisions for a facelift are meticulously planned and strategically placed to be as inconspicuous as possible. They are typically hidden within the hairline, around the ears, and sometimes under the chin. While scars are permanent, they usually fade significantly over time, becoming very well-camouflaged within natural contours and hair. Our goal is to achieve minimal and discreet scarring.
How much does facelift surgery cost in Cape Town?
The cost of facelift surgery in Cape Town varies significantly depending on the extent of the procedure (full, mini, or with neck lift), anaesthesia fees, and facility charges. Following your detailed consultation and assessment of your unique needs, we will provide you with a comprehensive, transparent quote that outlines all associated costs, allowing you to make an informed decision about this transformative investment.
What is a "SMAS" facelift, and why is it important?
The “SMAS” (Superficial Musculoaponeurotic System) facelift is an advanced surgical technique that goes beyond simply tightening the skin. It involves lifting and repositioning the underlying muscle and tissue layers (the SMAS layer) of the face and neck. This is crucial because it addresses the true cause of sagging, resulting in a more natural, longer-lasting, and youthful facial contour without a “pulled” look, as the tension is placed on deeper structures rather than the skin.
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