Dr Lisa Friederich              1300 375 472

Facelift

A Facelift is a surgical procedure to restore and rejuvenate ageing changes in the face and neck. 

As we approach our 40’s and 50’s ageing changes greet us in the mirror every day. For some of us this is at odds with how we feel inside. Non-surgical treatments can address early signs of ageing and with skillful and restrained use, freshen and reverse volume loss and wrinkle formation.

However, there comes a time when these aren’t enough and using more product can lead to an overdone and obviously treated face.  

Facelift surgery re-suspends and tightens laxity in the tissues of the face and neck.  This is done through elevation, plication or excision of the firm connective tissue layer called the / (Superficial Musculo-Aponeurotic System) which lies beneath the skin and subcutaneous tissues.  Re-suspension and tightening of the SMAS will also lift the skin and subcutaneous tissues. Once the SMAS is fixed in place, the skin is re-draped, trimmed and inset.  

The neck is always addressed in facelift surgery, whether it be by liposuction or skin elevation and neck muscle plication.

There are different facelift techniques and each surgeon usually develops a preference for a particular method. 

Skin only – this is rarely performed as the results do not last. The skin bears all the tension of the lift which leads not only to an early recurrence, but poor scars and a pulled or windswept facial appearance.

SMAS Excision or Plication – the skin is raised as a thin flap from the deeper SMAS layer. A long ellipse marked in a line from the outer edge of the eye to the angle of the jaw. The SMAS is either excised along these marks, or the edges are sutured (plicated) together. As the upper SMAS component is relatively fixed, the lower flap is lifted as the edges are sutured together. Most of the tension of the lift is borne by this fixation. The skin is gently re-draped, trimmed and inset. No tension or stretch is placed on the is placed on the skin during inset.

SMAS Flap –  This is similar to the plication and excision techniques in that the skin is raised as a flap from the underlying SMAS, but the SMAS is then raised as a separate flap. The underlying retaining ligaments are released which significantly increases the mobility of the SMAS layer. A high SMAS flap will provide significantly grater lift to the cheeks and midface than either a plication or excision. The skin is inset as above. 

Deep Plane – the skin is elevated separately from the deep tissues for only a short distance, before the dissection is taken deeper beneath the SMAS layer. The skin, subcutaneous tissues and the SMAS are maintained as a composite flap. The retaining ligaments are released in a similar manner to the SMAS slap technique. The flap is then elevated and inset.  As with he SMAS flap, this will provide a greater lift to the cheeks and midface than either a plication or excision. The skin is inset as above.

Ancillary Procedures  

Facelift surgery will treat the neck, jowls and cheeks. Sagging in the upper facial third will require other procedures such as Brow lift and/or Blepharoplasty

Skin wrinkles and volume distribution will be improved with facelifting, but it will not restore collagen, elasticity or lost volume.

Fat grafting can be performed at the same time as facelift surgery. Fat is harvested from your tummy, flanks or thighs, processed and then injected in facial areas that have lost volume. 

Laser resurfacing with fractional Co2 laser can be performed in the central facial and neck area directly after facelift surgery. This will stimulate a collagen formation and improve skin quality.

Microneedling with SkinPen is similar to laser resurfacing, but has a significantly faster recovery time. Microinjury to the dermis induces new collagen formation. 

PRP (Platelet Rich Plasma) is extracted from your own blood and injected into the skin in the dermis or subdermal space. The growth factors contained within the platelets accelerate healing and stimulate collagen and endogenous hyaluronic acid formation. 

The surgery is performed under general anaesthesia in an accredited hospital.   The operation will take several hours and requires an overnight hospital stay. As it is a cosmetic procedure, Medicare and Private Health insurance will not cover any of your costs.

Facelift surgery is a significant and invasive operation that is not suitable for everyone.  A thorough discussion with your surgeon is imperative to determine if you are a good candidate and if your expectations can be met. 

 

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