Facelift/Rhytidectomy/Meloplasty

Why consider a face lift or a neck lift and what is the best age for this procedure ?

Patients often ask when is the best age to have a facelift. The answer is simple, everyone is unique, and so the best time for you to have a facelift is whenever you are ready for one, provided that you are otherwise a suitable patient.

There are two main age groups of patients who wish to have a facelift. The first group are patients in their 30s-40s. This group of patients are generally starting to see early signs of ageing, especially in the lower face. If this is you, you may have just started to see deepening of the naslolabial folds, you may notice that the skin in your lower face may not be quite as taught as you remember it, or you may feel that your neck is starting to look less taught, and you are aware of a little extra skin in the angle between your chin and your neck. You may also be someone who has recently lost some weight. You may have finished having your children and after being pregnant and having breastfed you have lost some weight, and it is apparent in your face and neck that the skin and soft tissues do not quite look how they used to. You may feel that you have tried volumising and non-volumising wrinkle reduction treatments, or perhaps some skin tightening devices, and although they may have made a slight difference, you wish to have something more permanent to lift and tighten your face and neck area.

Perhaps you wish to slow the ageing process down, so that if you get a lift now, people will not notice a dramatic difference, but over time your ageing will not be as visible. It is perfectly fine to have a facelift at this point and Dr Wetton will discuss your options with you, in regards to a mini facelift or a face and neck lift.

The second group of patients are those who are between the ages of 50-80 years. This age group of patients are generally fit and well and are leading busy and active lives. They have begun to realise that they are starting to look a little weathered by the years, but they feel young inside and wish to project that on the outside too. Patients of this age are usually very satisfied with the result and notice that at work and socially they feel the same on the inside, as they look on the outside. They usually recover well from this procedure and go back to their usual lifestyles after a couple of weeks.

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What is a facelift or a necklift ?

There are many types or variations of facelift procedures– all with varying degrees of lift, from mild to more dramatic. Sometimes a facelift is best accompanied by other aesthetic procedures of the face, while in other instances it is best to perform it as a stand alone procedure. Your face is unique and so the operation that Dr Wetton will perform will be unique to you. Some facelift procedures require more downtime than others.

How is a Face and neck lift performed ?

Medically known as a rhytidectomy, a facelift is a surgical procedure, in which the superficial tissues are manipulated, tailored and fixed to a new, higher position with permanent sutures. The aim of this procedure, is to improve the overall look of the face, by lifting skin and subcutaneous tissues which may have become lax and sagging due to various factors such as ageing and gravity.

In a combined face and neck lift, soft tissues are lifted and repositioned, excess skin is removed and the remaining skin envelope is draped back over the newly positioned contours of the face. This procedure can positively affect the whole facial area, from the lateral corner of the eyes, down to the collarbones of the neck. At times, this procedure can be accompanied by neck and submental liposuction or by anterior neck surgery. Anterior neck surgery involves removing fat, or plicating – that is suturing together – the platysma muscles and possibly resecting and tightening the digastric muscles.

The incisions for a facelift are hidden around the temporal hairline, travel back behind the ear and into the scalp behind the ears.

The final scar and healing process will be determined by the placement of the incision and the way in which the stitches are performed, as well as by the patient’s health, age and lifestyle.

How can I prolong the effects after a facelift?

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What is the difference between a Deep-plane Facelift, a SMAS lift or a skin-only facelift and what is a a mini-facelift? How are they performed ?

Dr Wetton has studied most techniques over the years and in addition has been taught in the personal techniques developed by cosmetic and plastic surgeons such as Dr Darryl Hodgkinson, Dr Brain Mendelson and Dr Giovanni Botti to name a few.

Before considering a facelift, it is important to distinguish the difference between a deep-plane, SMAS lift, Skin-only and Mini-facelift.

In patient forums, as well as surgical circles, there is and probably always will be ongoing discussion regarding the perceived advantages and disadvantages of different facelift techniques. Debates about deep-plane facelifts, as opposed to SMAS manipulation are frequently part of the discussion as surgical styles, preferences and techniques evolve and develop.

To understand the different facelift techniques, it is import to understand facial anatomy and the layers of the face. Quite simply, the skin is the most superficial layer, then there is the SMAS (a fibrofatty layer called the Superficial Muscular Aponeurotic System), then the muscles, which lie at the level of the nerves, major blood vessels and ligaments, and finally facial bones as the last layer.

‘Deep Plane’ refers to the tissue layer or space between the SMAS and where the deeper structures like the muscles, ligaments and nerves lie. It is called ‘deep plane’, because the entry point is deep to the SMAS layer. The layer in which the surgery takes place, may be in direct contact with facial nerves, parotid ducts and important blood vessels of the face. To this end, a deep-plane facelift, is an invasive type of facelift surgery,

To some, the deep-plane technique is preferable, as it addresses muscles, ligaments and fat, however, the SMAS layer of the subcutaneous tissues is a fibrous network connected to these muscles and ligaments. This means, that when the SMAS layer is lifted, so too, are the structures that lie beneath it. We can therefore understand that in both techniques there is a substantial lift of the facial tissues.

There is no doubt that a deep-plane facelift is a procedure which has a much higher risk profile when compared to other facelift techniques. Some argue that it is longer lasting, while others say that all facelift procedures will not last your entire lifetime because you will continue to age and of course, ageing is not a static process.

The aim of a SMAS lift is to still look like yourself, but provide you with a lifted appearance without some of the typical stigmata of ageing. In a SMAS lift, the risks of surgery are much lower than a deep plane facelift, and patients are usually out and about after two to three days. After one week, you may still be swollen, although you will able to go back to work and resume your normal daily life.

A skin only facelift, is a facelift of the past. We know the ‘wind swept’ appearance of facelifts decades ago was not aesthetically pleasing. Too much tension was placed on the skin itself, and this resulted in a tight appearance and stretched unsightly scars.

A mini facelift is for patients who are on the younger side, and have localised areas of concern. The incision will be smaller and the area addressed will be limited to your particular desires and instructions.

Frequently Asked Questions

What Should I expect when I wake up from having my surgery?

When you wake up after your surgery, you will be in the recovery room of the hospital. You will feel like you have woken up from a deep sleep.When you wake up, you may be a little sore, and you may feel the firmness around your face and neck from the garment or dressings.

What will my recovery be like?

Many patients are keen to have a facelift, but the thought of a long recovery process and many weeks off work is a deterring factor. If you have a facelift with Dr Wetton, this is not usually the case. You will experience discomfort and swelling for the first 48hrs, but it is not unusual for her patients to go out to dinner on day 3 or 4 and be back to work after about 5-7 days.

When will I be able to see the results of my facelift?

Initially you may be a bit swollen, but you may notice some positive results straight away. Your results should start to become obvious after about 1 week and evolve over the next 3 months.

How long will the results of my facelift last?

The results of your facelift depend on many factors, such as what kind of procedure you had, your general health, if you smoke and your age. The results of a facelift can last 8-10 years, but it is important to understand that ageing is not a static process and you will continue to age.

Can I just keep having injectable treatments and forget about a facelift?

The reality is that injectable treatments, will only take you so far. A combination of things lead to facial ageing and so combination treatment may be the best option. When a face begins to age, there is usually a combination of volume depletion, soft tissue and skin laxity and skin deterioration.

Fat grafting and volumising treatments can help with the volume loss, but if you start trying to treat skin laxity and facial ptosis (tissues hanging down) with more volume, you will end up in a situation where your face looks puffy and unnatural. So, in short, there does come a time when a facelift may be the treatment of choice for facial ageing.

What are the risks associated with a face and neck lift ?

Any surgical procedure carries with it some potential risks. Although Dr Wetton is fastidious in her approach to facelift surgery, it is still important to be aware of the potential risks, which include:

  • Slow or poor wound healing
  • Poor scars or keloid scars
  • Asymmetrical results
  • Blood clot under the skin (haematoma) or fluid under the skin (seroma)
  • Bleeding
  • Infection
  • Facial skin compromise
  • Numbness or nerve damage
  • Damage to underlying structures
  • Persistent pain
  • Prolonged swelling
  • Deep vain thrombosis (clot in the leg veins) or pulmonary thrombosis( or in the lungs)

How much will my facelift cost?

A mini facelift will cost $6,000- $8,000, while a full face and neck lift will cost $12,000- $16,000, depending on individual factors that need to be taken into consideration. This procedure is based on your anatomy, and so the procedure will be designed specifically for you.

This fee does not include the Hospital or the Anaesthetic Fee.

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