With aging the skin becomes lax and the tissue sag giving the problem of brow droop, cheek sagging, prominent nasolabial folds, jowls and wrinkles and loose skin in the neck. Although various less invasive treatments using laser, Botox and IPL can help the rejuvenate the face in milder cases, when the problem becomes more severe, generally surgical facelifts will be required. The ageing face has loose excess skin resulting instatic wrinkles and sagging of the soft tissue resulting in cheek droop, jowls or neck bands.The facelift aims to remove excess skin and reposition the sagging facial tissue. The facelift may be divided into 3 main areas.
Upper and Midface Lift – Temple and Cheek lift
Early signs of ageing usually appears around the eyes and cheek. The lateral brow starts to droop and the cheek complex starts to sag. There is associated anterior cheek flattening and appearance of the nasojugal groove. A cheek and temple lift is suitable to reposition the sagging cheek and periorbital tissue. A short scar method is used. The incision is made in the temple scalp extending down to the lobule. The skin flap is raised to expose the internal periorbital tissue and cheek tissue which are then suspended with internal sutures. The skin flap is lifted, tightened and excess skin removed before closure.
Lower and Midface Lift – Cheek and Jowls
With further ageing there is more severe sagging of the cheek and facial tissue leading to the appearance of jowls and accentuation of the naso-labial groove. A similar pre-auricular incision extending from the temple scalp down to below and around the lobule is made. The cheek and lower face tissue, particularly the SMAS, is exposed by lifting the skin flap. The sagging cheek and jowls are lifted by tightening the SMAS with plication and partial resection and transposition. The skin is lifted and tightened by removing excess skin.
Early signs of ageing in the neck is the appearance of wrinkles and excess skin. Further ageing leads to the appearance of platysmal bands. The neck can be rejuvenated by removing excess skin and tightening the platysmal bands. An extended incision from the lobule to the back of the back ear is made to expose and mobilize the skin and muscle bands. An additional transverse incision in front of the neck may be necessary in more advanced cases to achieve a better outcome.
All the above surgical procedures may be done under local anaesthesia and sedation or with general anaesthesia as an option. The duration of surgery ranges from 4-6 hours depending on the extent of surgery required in one sitting. Head or neck bandage will be applied post-operatively and they can be removed after review the next day. The recovery period is about 1-2 weeks.