A modern facelift remains the gold standard procedure for facial rejuvenation and is a particular interest of Marc Pacifico’s. It restores a more youthful appearance to the lower face and neck by removing major wrinkles and sagging skin. It will also improve a tired facial appearance by smoothing the skin and re-establishing defined contours along the neck and jawline. A good facelift should give someone the appearance of being refreshed, alert and confident, as people do when they have just returned from a holiday. A good facelift could be described as returning the look of freshness and vitality that person had when younger.
A natural appearing facelift is obtained by restoring the youthful shape of the face. It is only the latest facelift techniques that are capable repositioning the underlying soft tissue facial framework that result in the youthful shape of the face being restored.
This soft tissue facial framework is known as the SMAS. Knowledge and understanding of the role of the SMAS has revolutionised our approach to facelifts. In order to rejuvenate the face, the position of the SMAS must be addressed. Modern facelift techniques all work by altering the SMAS to effect a change in the outward appearance of the face. This provides a longer lasting result but the procedures require a high degree of specialised surgical skill and can be time-demanding. If the SMAS is not addressed, there is a risk of a “wind tunnel” appearance after a facelift (watch Mr Pacifico discussing this in the videos below)
“I find it incredibly rewarding to perform a wide range of facelift techniques – each bespoke for the right person. Whether it is a local anaesthetic facelift (or wide awake facelift) performed at Purity Bridge, or a more intensive lower face and neck lift, combined with an eyelid lift and brow lift, the key is to obtain a result that looks fresh, bright and, most importantly, natural. My facelift patients come from far and wide – from London and surrounding areas, the SouthEast of England, other parts of the UK and even from abroad.”
“I only use surgical drains for the most comprehensive neck lifts, but otherwise my facelift patients are drain-free, have no bandages and are usually able to go home the following day. The exact plan for each of my patients is modified according to their individual needs, as everyone’s face, skin and soft tissue is different, so needs to be treated as such”
What can I expect to look like?
If you stand in front of a mirror and lightly pull the skin up and back in the temples and in front of the ears, you will get an indication of what a facelift will achieve.
The aim is a harmonious well-rested, fresh look from forehead to neck, whilst maintaining normal facial expression. A facelift and ancillary procedures will achieve this, but NOT all wrinkles, furrows and folds will disappear – especially if they have been longstanding and permanent skin damage has occurred over the years.
Patient of Mr Pacifico who has undergone a full lower face/neck lift – notice the significant improvement to the neck and jowl areas
When should I have one and how long will it last?
There is no specific age that is best for a facelift – we all age differently according to our individual genetic make-up and our environmental experiences. Facelifts can be performed from your early 30’s to your 70’s. Usually a more youthful look is maintained for longer when a facelift is performed on a younger person whereas, in an older person a more dramatic change may be noticed. For other recommendations on how a facelift result is best maintained, please watch here ›
The pictures above show a series of a patient who underwent a full face/neck lift, including an open neck lift – they are taken at 6-weeks following surgery. Notice how natural the result is, especially when the patient smiles. Also note the incredible improvement in neck and jawline, particularly clear when the patient looks down to try and make a double chin
Is it painful and how will I feel?
Facial cosmetic surgery, like any operation, will produce some pain, but it is usually only mild to moderate and should be easily relieved by mild painkillers. Stronger pain relief is available if required. One of the temporary side-effects of facelift operations is the numbness felt in the cheeks and upper neck following surgery. This returns to normal over the next 6-8 weeks. The benefit of this side-effect is that the numbness reduces the amount of pain felt! See here › to watch Mr Pacifico commenting on pain after facelift surgery.
What are the dangers?
Before you make a decision to undergo cosmetic surgery, it is important that you be informed of the potential risks, complications and side-effects. Complications may occur even with the best surgical care. For this reason, it is crucial that you carefully read and understand the risks.
The following is a list of commonly-occurring side-effects of facelifts:
- Swelling- this is normal following a facelift and reaches a maximum about 3-days following surgery. It may last up to 3-weeks and very occasionally up to 6 or 8-weeks in some patients.
- Pigmentation(discolouration and bruising) – bruising usually comes to the surface within a few days and then gradually resolves over 2-3 weeks. Occasionally extensive bruising can require many weeks or months to totally resolve.
- Loss of or increased sensation, feeling of tightness, headaches- it is usual to have a reduction in skin sensation after a facelift. This can include the skin around the cheeks, chin and neck and it is also possible to have numbness of the lower portion of the ear and the hairline, both above and below the ears. Feeling will usually return over a period of 8-12 weeks but in some patients this does take a little longer. When the superficial muscle layer of the neck is tightened, occasionally a feeling of tightness or even choking can be experienced. This is not a permanent problem as the muscle layer and stitches on the inside tend to relax slightly and the feeling of tightness around the neck reduces.
- Alteration of the hairline- this may occur, especially in the side burn areas.
- Hair loss- this can occur around the temple or behind the ear. This is usually temporary with normal regrowth within several months.
- Scarring- scarring will occur whenever the skin is cut and of course, every effort is made to place scar lines where they will not be detected by the unknowing observer. Although scarring on average is minimal, scar maturation varies from person to person and occurs over 6-12 months, with scars passing through a red, itchy and lumpy phase, prior to settling down to thinner, softer less distinct lines.
What are the possible complications?
- Infection- this is rare, despite the proximity of hair around the wound, as the face has an excellent blood supply. Antibiotics are administered to further minimise this possibility.
- Blood clots or haematoma- although care is taken to minimise bleeding, occasionally a blood vessel will start to bleed after the operation producing a swelling or mass of blood (usually clotted). This clot (known as a haematoma) is usually noted within the first 24-48 hours after surgery and requires further surgical exploration to drain the collection of blood and stop the bleeding.
- Skin death- skin death or necrosis is fortunately a very rare complication of facelift surgery. However, even with the best operating skill, it can occur. The area most frequently affected is the non hair-bearing skin behind the ear. If necrosis occurs, it is usually allowed to heal on its own, or occasionally small skin grafts are used to speed up the healing process.This complication is around 12 times more common in smokers.
- Nerve damage – Damage to the nerves which supply the facial muscles can occur infrequently (about 0.7% of facelifts). This may cause facial distortion – weakness of the eyebrows or around the mouth. This is usually transient and returns to normal over 6-weeks to 6-months. Occasionally it can persist as a permanent complication.